TD F 98-22.61 OFAC License Application Cover Letter

License Application

Reference Number:

RPPR

Generated on

Application Information
Transactional
New Application
Iranian Transactions and Sanctions
Regulations
Description of Subject Matter:
Sample for RPPR
Application Type:
Application Reason:
Program(s):

Category:
Subcategory:
Previous Case ID:

Transactional
Financial Transactions

Contact Information
Applicant
Institution
Contact Category:
Sample
Organization Name:
Point of Contact Name:
Sample
Address:
Line1:
Line2:
Line3:
Sample
City:
20005
Zip:
Email Address:
Phone:
Office:
Mobile:
Fax:
Principal Place of Business:
Place where Business is Incorporated:

State:
Country:

DC
United States

Correspondent
Person
Contact Category:
First Name: Sample
Sample
Address:
Line1:
Line2:
Line3:
Sample
City:
20005
Zip:
Sample@test.com
Email Address:
(202) 000-0000
Phone:
Office:
Mobile:
Fax:
Principal Place of Business:
Place where Business is Incorporated:

Middle Name:

Last Name:

State:
Country:

Sample

DC
United States

Attachments
Name
None
Application Summary

Document Type
Supplemental Information
License Request

Certification
Signature:
Email Address:

Sample

Date:

Page

1

6/28/2021

6/28/2021