takeover20122262ini European Free Trade Associationhttp://www.lei-lookup.com/#!record;lei=HB7FFAZI0OMZ8PP8OE26
Dusseldorf, DC 40215 US Telephone: (003) 02103807064 NEW GLOBAL OPEN WEB E BANKING MARKET HANDLING INTERNATIONAL GREEK CHARGES GR0112005674 Name und Anschrift des Leistenden Name/Unternehmen E.D.GOUTOS SA Postleitzahl 21300 Ort PORTOCHELI GREECE Staat Vereinigte Staaten von Amerika Steuernummer/USt-IdNr. 93172860596 Sitz des Geldinstitutes GREECE Bankleitzahl (Sortcode) 20122262 Bank Identification Code (BIC) HRB68648
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FATCA Registration Questions and Responses
1. FATCA Registration
Listed below are the questions and responses you entered in the registration:
Part 1 - My Information
1) Financial Institution Type:
Member of an Expanded Affiliated Group
2) Legal Name of the Financial Institution:
HellinikonSA IGTB Guarranteed shares USD G20/GAAP/CETA since 31 March 2011 Article 42of Law
3943/2011.EuroBond Market35 BILLION EURO11/10/11EUROPEDEBT
3A) What is the Financial Institution's country/jurisdiction of residence for tax purposes?
United States
3B) What is the Financial Institution's country/jurisdiction tax ID?
EL094504379
4) Select the Financial Institution's FATCA classification in its country/jurisdiction of tax residence:
Registered Deemed-Compliant Financial Institution (including a Reporting Financial Institution under a Model 1 IGA)
5) Mailing Address of Financial Institution:
United States
Mitropoleos 5
Athens
AE
16777
6) Indicate whether the Financial Institution has in effect a withholding agreement with the IRS to be treated
as one of the following: Qualified Intermediary (QI), Withholding Foreign Partnership (WP), Withholding
Foreign Trust (WT) or Not Applicable.
Not Applicable
7) Does the Financial Institution maintain a branch in a jurisdiction outside of its country/jurisdiction of tax
residence?
Yes
8) Is the Financial Institution a tax resident of the United States or does it maintain a branch in the United
States (other than the U.S. territories)?
No
9A) List each jurisdiction (other than the United States) in which the Financial Institution maintains a branch.
If none click "next" to go to question 10.
Select the Download Registration Tables option from your home page in order to see the information you entered in
this question.
10) Provide information about the Responsible Officer (RO) for the Financial Institution:
CHIEF OF HELLENIC COAST GUARD
STAMATIOS RAPTIS
FATCA ID: G2YPA9.00039 04/10/2017
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2. United States
ATKI VASILEIADOU
PIRAEUS
DC
18510
Phone: +0030 2104191561
contact@yna.gov.gr
11A) The Financial Institution’s RO will be a point of contact (POC) for the Financial Institution. In addition,
the RO of a Financial Institution registering as a Lead of all or part of an Expanded Affiliated Group will be a
POC for each Member of that group.
Does the RO or an Authorizing Individual wish to designate one or more additional POCs for the Financial
Institution?
Yes
11B) This question 11B must be completed by the Financial Institution’s RO or an Authorizing Individual.
Upon entering the POC information below, checking the box that follows, and submitting this registration
form, the RO or Authorizing Individual is providing the IRS with written authorization to release FATCA
information to the POC. This authorization specifically includes authorization for the POC to complete this
Form 8957: FATCA Registration, to take other FATCA-related actions, and to obtain access to the Financial
Institution’s tax information.
POC Information - 5 POC(s)
Part 2 – Expanded Affiliated Group Information
This part does not apply to your registration.
Part 3 – QIs, WPs, or WTs Renewal
This information is no longer part of FATCA Registration.
Part 4 - Submit
I, EVANGELOS GOUTOS, certify that, to the best of my knowledge, the information submitted above is accurate and
complete and I am authorized to agree that the Financial Institution (including its branches, if any) will comply with its
FATCA obligations in accordance with the terms and conditions reflected in regulations, intergovernmental
agreements, and other administrative guidance to the extent applicable to the Financial Institution based on its status
Legal Name Country/
Jurisdiction
Address Telephone Fax Email
GOTSIS,
CHARALAMPOS
United States KOLOKOTRONI 1
& STADIOU,
ATHENS, DC,
10562
0030 2103377100 e-
Protocol@cmc.go
v.gr
PROVOPOULOS,
IOANNIS
United States ELEFTHERIOU
VENIZELOU 21,
ATHENS, DC,
10250
0030 2103201111 COMPLAINTS@B
ANKOFGREECE.
GR
STOURNARAS,
IOANNIS
United States ELEFTHERIOU
VENIZELOU 21,
ATHENS, DC,
10250
0030 2103201111 COMPLAINTS@B
ANKOFGREECE.
GR
Apalagaki,
Charoula
United States 21A Amerikis Str,
ATHENS, DC,
10672
0030 2103386500 hba@hba.gr
Schaeuble,
Wolfgang
United States Wilhelmstrasse
97,
BERLIN, DC,
10117
0049 3018682 buergerreferat@b
mf.bund.de
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