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Signing confirms responsibility for appointing or revoking authorized (sub-authorized) persons and for ensuring they are informed of applicable general terms and conditions and card use 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Company code (personal code, if individual activity)  \n\n|  |  |  |\n| --- | --- | --- |\n\n\n| Registration address (street, building, apartment, city) |  |  |  |  |  |  | Postal code |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |\n| The Company provides the following list of persons who are the Company's authorized persons for communication with Circle K Lietuva, UAB regarding the execution and administration of the Agreement: |  |  |  |  |  |  |  |\n|  | Name, Surname | Mobile number |  | E-mail address |  |  |  |\n| 1 |  |  |  |  |  |  |  |\n| 2 |  |  |  |  |  |  |  |\n| 3 |  |  |  |  |  |  |  |\n| 4 |  |  |  |  |  |  |  |\n| 5 |  |  |  |  |  |  |  |\n| 6 |  |  |  |  |  |  |  |\n| 7 |  |  |  |  |  |  |  |\n\nThe following persons (listed earlier in the Business Customer Card form) in the table below lose their authority to communicate regarding execution and administration of the Agreement:  \n\n|  | Name, Surname |\n| --- | --- |\n| 1 |  |\n| 2 |  |\n| 3 |  |\n| 4 |  |\n| 5 |  |\n| 6 |  |\n| 7 |  |\n\nBy signing this form, you agree that:  \n\n| • The signee is responsible for the appointment or revocation of authorized (sub-authorized) persons for communication with Circle K Lietuva, UAB regarding the execution and administration of the Agreement. |  | \u003Cbr>General terms |\n| --- | --- | --- |\n| • The signee assumes the responsibility for acquainting the authorized (sub-authorized) persons with the General Terms and Conditions of the Circle K Lietuva, UAB Goods Sale Agreement and the terms and conditions of card use, which are published on the website at [circlek.lt/B2B](circlek.lt/B2B). |  |  |\n| The authorized (sub-authorized) persons of the Company are indicated in the Business Customer Card Form or in the appendix to the Business Customer Card Form. Circle K Lietuva, UAB does not check the authorizations of authorized (sub-authorized) persons appointed by the signee and, when servicing the Client under the Agreement, relies on the information provided by authorized (sub-authorized) persons specified by the signee. |  |  |\n| Manager or other person authorized to represent the |  |  |\n\n\n| Name, Surname |  |  |  | Date |  |\n| --- | --- | --- | --- | --- | --- |\n| Position |  |  |  | Signature |  |","cbCaisQBKKpCr8Nx","https://ap.wps.com/l/cbCaisQBKKpCr8Nx","pdf",655480,"English","# Business Customer Card Form appendix\n## Customer information\n## Authorized persons for communication\n## Revocation of communication authority\n## Signatory acknowledgements and responsibilities\n## Authorized representative signature","[{\"question\":\"What information is collected for the business customer in this form appendix?\",\"answer\":\"It records the customer number, company name, company/personal code, and the registration address with postal code.\"},{\"question\":\"How does the form define authorized persons for communication?\",\"answer\":\"The company provides a list of persons authorized to communicate with Circle K Lietuva, UAB regarding execution and administration of the agreement, including their names and contact details.\"},{\"question\":\"What happens when a person loses authorization?\",\"answer\":\"A separate table lists persons who lose their authority to communicate regarding the agreement, indicating that authorization is revoked for those individuals.\"}]","CIRCLE K LIETUVA UAB - Business Customer Card Form appendix - Authorized Persons Appendix | PDF",1789835155]