9. Contact phone number of the physical person, authorizer on behalf of the Owner 8. Work e-mail of the physical person, authorizer on behalf of the Owner 7. Postal code of the management address of the Owner 6. Contact address of the Owner 5. Management address of the Owner as in the current state certificate 4. Name and date of birth of the physical person, authorizer on behalf of the Owner 3. Identification number*, BULSTAT*, VAT* ¹ 2. Company ¹ and date of registration 1. Name of organization/trader 11. Passport ¹, date of issue, validity date, issued by , person authorizer on behalf of the Owner 10. Capacity of the physical person, authorizer on behalf of the Owner /for example: Spektar AD/ /for example: 123456789 , BG123456789/ /for example: John Mishel , 12.12.1970/ /for example: Carnegie Str., 11À, entr.1,fl.3, Sofia,BG/ /for example: Carnegie Str., 11À, entr.1,fl.3, Sofia,BG/ /for example: +359123456789/ for example: manager/ OWNER’s DATA ORGANIZATION/TRADER This information is an integral part of the Certificate Services Contract Information is to be filled in and signed by the Owner or by a duly authorized person (Signatory). FORM 4.1 ® Spektar Org Revision: 1.1/01.02.2007 Form 4.1 OWNER’s data – organization/trader SIGNATURE: IN , BULSTAT Passport ¹ , issued on , Valid until , issued by CONTENT FIELD . . . . VAT