2001 ISDA Credit Support Protocol Payment Form



If you are paying by:

Check, please enclose it with your Adherence Letters and send to one of two ISDA offices: either ISDA at 600 Fifth Avenue, 27th floor, New York, New York 10020-2302, USA; or ISDA at One New Change, London EC4M 9QQ England.

Wire Transfer, the transfer information is listed on the form below.

Credit Card, please fill out this form and either hit the submit button at the bottom or print it out and fax it to ISDA at 1-212-332-1212.

It would be helpful if you could indicate how you are paying by filling out this form and hitting the submit button.

Name
Job Title
Company
Number of Adhering Parties
Names of Adhering Parties
Address
City
State Postal Code
Country
Telephone
Fax
E-mail

Please indicate the ISDA office to which you are submitting your Adherence Letters and payment:

New York

London

Payments must be issued only in US funds. No cash payments will be accepted.
A check for $ ($500 X number of Adhering Parties) (Payable to ISDA) will be sent to only one of the two ISDA offices specified above.
I will wire funds to ISDA's New York account. Funds will be wired to Account #18429091, ABA #021000089, Citibank Branch 046, New York, NY 10019
Please bill to: Amex Visa MasterCard Discover Diners Club
Name of Cardholder
Account Number
Expiration Date





If you should have any questions regarding payment or require a copy of the invoice, please contact Huzefa Deesawala in New York at (1) 212-332-1200, or e-mail HDEESAWALA@ISDA.ORG.