ONE SWIS BANK

International Banking Division

INVOICE

INV-2025-FATCA-001847

One Swis Bank

Compliance & Regulatory Department

45 Bahnhofstrasse

8001 Zürich, Switzerland

Tel: +41 44 234 5678

Email: compliance@oneswisbank.com

David Hudson

Account Number: ****6198814

Customer ID: OSB-DH-2024-001

Invoice Date: 15/10/2025

Due Date: 30/10/2025

Description	Amount
Foreign Account Tax Compliance Act (FATCA) Clearance Fee Mandatory compliance processing fee for U.S. tax reporting requirements under the Foreign Account Tax Compliance Act. This fee covers: Account verification and documentation review IRS Form W-9/W-8BEN processing FATCA status determination and reporting Compliance certification and clearance Regulatory filing with U.S. Treasury Department Reference: FATCA-2025-DH-001847 \| Processing Period: Q4 2025	$132,214.00

Description

Amount

Foreign Account Tax Compliance Act (FATCA) Clearance Fee

Mandatory compliance processing fee for U.S. tax reporting requirements under the Foreign Account Tax Compliance Act. This fee covers:

Reference: FATCA-2025-DH-001847 | Processing Period: Q4 2025

$132,214.00

Subtotal:$132,214.00

Administrative Fee:$0.00

Total Due:$132,214.00 USD

This invoice has been generated electronically and is valid without signature.

One Swis Bank | Registered in Switzerland | Company Registration No. CHE-123.456.789

VAT Registration No. CHE-123.456.789 MWST | Regulated by FINMA

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