User information

Login: *

not less than 2 symbols

Password: *

not less than 6 symbols

Repeat password: *

this password again

Full name of organization: *

Converdgeon Inc.

Surname, name, patronymic of the head: *

John Daffner

Post of the head: *

Director

Surname, name, patronymic of a person in charge: *

Michael Lepsh

Country: *

Republic of Belarus residents only

Legal address: *

333 Sixth Avenue, New York, NY 1143-0081

Postal address: *

397 Sixth Avenue, New York, NY 1143-0088

Phone numbers: *

+1 218-790-3000, +1 218-790-3001

Fax:

+1 218-790-3002

E-mail address: *

asaqwer@gmail.com

Website of the organization:

www.vvquad.net

Account number of the taxpayer (ANT): *

198002300

Bank: *

Barclays Bank PLC, London

Bank code: *

153001357

Settlement account: *

3012019500043

Surname, name, patronymic: *

John Daffner

Country: *

Registration for Republic of Belarus residents only

Address: *

397 Sixth Avenue, New York, NY 1143-0088

Phone numbers: *

+1 218-790-3000, +1 218-790-3001

Fax:

+1 218-790-3003

E-mail address: *

asaqwer@gmail.com

Personal website:

www.vvquad.net

Passport series and number: *

NJ5343413

Date of issue and issuing authority: *

28 Jun 2005 Burgmeester Tilburg

Personal number: *

3090673Н034РВ1