OSP TRADE REQUEST FORM Buyer/Seller InformationCompany NameCountry of IncorporationDate of IncorporationRegistration NumberCompany AddressWebsitePrimary ContactTitleTelephoneEmail Buyer StatusBuyer Status(Required) End Buyer Refinery Trading Company Government Entity State-Owned Enterprise Authorized Mandate Broker / Facilitator Importer Exporter Other Transaction TypeTransaction Type(Required) Spot Purchase Trial Lift Term Contract Annual Contract Rolling Contract Desired Contract Term(Required)PRODUCT REQUIREMENTSPRODUCT REQUIREMENTS(Required) WTI Crude Oil Brent Crude Oil BLCO EN590 Jet Fuel Gasoline Diesel Other Other Product RequirmentsVOLUME REQUIREMENTSTrial Volume (Barrels)Monthly Contract VolumeMaximum Monthly CapacityDesired First Lift Date(Required) MM slash DD slash YYYY DELIVERY REQUIREMENTSDelivery Method(Required) FOB CIF Tank-to-Tank Pipeline Tank Transfer Lease Tank Truck Rail Other Delivery Location(Required)Receiving Terminal / Port(Required)PAYMENT METHODPayment Method(Required) Wire Transfer MT103 SBLC MT760 DLC Escrow Bank Guarantee Other Has Buyer previously purchased crude oil?(Required) YES NO Does Buyer maintain storage capacity?(Required) YES NO Does Buyer maintain lifting capability?(Required) YES NO Has Buyer secured financing?(Required) YES NO Can Buyer provide Proof of Funds?(Required) YES NO Has Buyer reviewed OSP process?(Required) YES NO PRICING EXPECTATIONSPricing Structure(Required) WTI Benchmark Minus Differential Fix Price Market Indexed Formula Seller Proposal Requested Target Differential: WTI Minus $DUE DILIGENCE CAPABILITYDocuments Buyer Can Provide Certificate of Incorporation Corporate Resolution Proof of Address Bank Comfort Letter UBO Information Litigation Disclosure Certificate of Good Standing Authorized Signatory ID Proof of Funds AML Documentation PEP Declaration Banking Information SPECIAL REQUIREMENTS / COMMENTSSpecial Requirements / CommentsBUYER DECLARATIONBuyer Declaration(Required) Buyer has the legal authority and corporate capacity to purchase petroleum products and enter into the proposed transaction. Buyer possesses, or can obtain, the financial capability necessary to complete the proposed transaction. Buyer acknowledges that OneSource Petroleum LLC may rely upon the representations contained in this form during its evaluation of the proposed transaction. FORM VALIDITYThis Trade Request Form shall remain valid for thirty (30) calendar days from the date of submission unless withdrawn by the Buyer or extended in writing by OneSource Petroleum LLC.FORM SUBMISSIONCompleted Trade Request Forms are submitted electronically to OneSource Petroleum LLC. Submission notifications will be sent to Albert T. Bentley, Chief Executive Officer, at Albert.Bentley@onesourcepetroleum.com.PRIVACY NOTICEOneSource Petroleum LLC (“OSP”) collects the information submitted through this Trade Request Form for the purpose of evaluating proposed petroleum transactions, conducting commercial and compliance due diligence, verifying counterparties and authorized representatives, communicating regarding transaction opportunities, preventing fraud, satisfying legal and regulatory obligations, and maintaining appropriate business records. OSP may disclose submitted information when reasonably necessary to authorized OSP personnel, professional advisers, compliance providers, financial institutions, transaction counterparties, service providers, or governmental and regulatory authorities as required by law. By submitting this form, you acknowledge that the information provided may be collected, used, stored, and disclosed for legitimate transaction, due-diligence, compliance, legal, and business purposes.Privacy Acknowledgment(Required) I acknowledge that I have read the OneSource Petroleum LLC Privacy Policy and understand how information submitted through this form may be collected, used, stored, and disclosed for legitimate transaction, due-diligence, compliance, legal, and business purposes. Read the FULL OneSource Petroleum LLC Privacy PolicyAUTHORIZED SIGNATORY INFORMATIONCompany Name(Required)Authorized Signatory(Required)Title(Required)Date(Required) MM slash DD slash YYYY Consent(Required) Electronic Signature and CertificationI certify that I am authorized to submit this Trade Request Form and that the information provided is true, accurate, and complete. Typing my name above and checking this box constitutes my electronic signature.
