<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Monetization Application Form</title>
<style>
:root {
--primary-color: #0e4b75; /* Corporate Deep Blue */
--text-dark: #2c3e50;
--text-light: #546e7a;
--bg-accent: #f7f9fa;
--mandatory-color: #c0392b; /* Crimson Red */
--border-color: #d1d7dc;
}
body {
font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;
line-height: 1.6;
color: var(--text-dark);
background-color: #f4f6f7;
margin: 0;
padding: 20px;
}
/* Watermark Layout Layer */
.form-container {
position: relative;
max-width: 850px;
margin: 0 auto;
background: #ffffff;
padding: 40px;
border-radius: 4px;
box-shadow: 0 4px 15px rgba(0,0,0,0.05);
overflow: hidden;
}
.form-container::before {
content: "PROPERTY OF RICHARD RANA DAS FINANCIAL COMPANY LLC";
position: absolute;
top: 50%;
left: 50%;
transform: translate(-50%, -50%) rotate(-30deg);
font-size: 2.8rem;
font-weight: bold;
color: rgba(224, 224, 224, 0.22);
width: 150%;
text-align: center;
pointer-events: none;
z-index: 1;
letter-spacing: 2px;
line-height: 5rem;
}
/* Header Styles */
.corporate-header {
display: flex;
justify-content: space-between;
align-items: flex-start;
border-bottom: 3px solid var(--primary-color);
padding-bottom: 20px;
margin-bottom: 30px;
position: relative;
z-index: 2;
}
.logo-area h1 {
color: var(--primary-color);
margin: 0;
font-size: 24px;
letter-spacing: 1px;
}
.logo-area p {
margin: 5px 0 0 0;
font-size: 14px;
font-weight: 600;
color: var(--text-light);
}
.meta-area {
text-align: right;
font-size: 12px;
font-style: italic;
color: #7f8c8d;
line-height: 1.4;
}
/* Title Area */
.form-title {
text-align: center;
color: var(--primary-color);
font-size: 18px;
font-weight: bold;
margin-bottom: 15px;
text-transform: uppercase;
position: relative;
z-index: 2;
}
.instructions {
text-align: center;
font-size: 13px;
color: var(--text-dark);
margin-bottom: 30px;
padding: 0 10px;
position: relative;
z-index: 2;
}
.star {
color: var(--mandatory-color);
font-weight: bold;
}
/* Grid / Form Design */
.form-section {
margin-bottom: 25px;
position: relative;
z-index: 2;
}
.section-title {
color: var(--primary-color);
font-size: 14px;
font-weight: bold;
text-transform: uppercase;
margin-bottom: 10px;
border-left: 4px solid var(--primary-color);
padding-left: 8px;
}
.form-grid {
border: 1px solid var(--border-color);
border-bottom: none;
}
.form-row {
display: flex;
border-bottom: 1px solid var(--border-color);
}
.form-label {
width: 30%;
background-color: var(--bg-accent);
padding: 12px;
font-size: 13px;
font-weight: bold;
display: flex;
align-items: center;
border-right: 1px solid var(--border-color);
}
.form-value {
width: 70%;
padding: 12px;
font-size: 13px;
}
/* Input Controls */
input[type="text"], textarea, select {
width: 100%;
padding: 8px;
border: 1px solid #ccc;
border-radius: 3px;
box-sizing: border-box;
font-family: inherit;
color: var(--text-dark);
}
textarea {
resize: vertical;
}
.options-group {
margin-bottom: 8px;
}
.options-group:last-child {
margin-bottom: 0;
}
.checkbox-label {
display: inline-flex;
align-items: center;
margin-right: 15px;
cursor: pointer;
font-weight: normal;
}
.checkbox-label input {
margin-right: 6px;
}
/* Section 6 List */
.attachment-list {
list-style: none;
padding: 0;
margin: 0;
border: 1px solid var(--border-color);
border-radius: 3px;
background: #fff;
}
.attachment-item {
padding: 12px 15px;
border-bottom: 1px solid var(--border-color);
display: flex;
align-items: center;
font-size: 13px;
}
.attachment-item:last-child {
border-bottom: none;
}
/* Section 7 Declaration callout box */
.declaration-box {
background-color: var(--bg-accent);
border-left: 4px solid var(--primary-color);
padding: 15px;
font-style: italic;
font-size: 13px;
margin-bottom: 25px;
line-height: 1.5;
}
/* Signature layout block */
.signature-grid {
display: grid;
grid-template-columns: 1fr 1fr;
gap: 20px;
margin-top: 20px;
}
.signature-cell {
padding: 10px 0;
}
.signature-cell label {
display: block;
font-size: 13px;
font-weight: bold;
margin-bottom: 45px; /* space to execute physical signature */
}
.signature-line {
border-top: 1px solid #bdc3c7;
width: 100%;
}
/* Branded Footer configuration */
.corporate-footer {
margin-top: 40px;
border-top: 1px solid var(--border-color);
padding-top: 15px;
display: flex;
justify-content: space-between;
font-size: 11px;
color: var(--text-light);
position: relative;
z-index: 2;
}
.corporate-footer a {
color: var(--primary-color);
text-decoration: none;
font-weight: bold;
}
/* Responsive Layout Overrides */
@media (max-width: 650px) {
.corporate-header {
flex-direction: column;
gap: 10px;
}
.meta-area {
text-align: left;
}
.form-row {
flex-direction: column;
}
.form-label {
width: 100%;
border-right: none;
border-bottom: 1px solid var(--border-color);
}
.form-value {
width: 100%;
}
.signature-grid {
grid-template-columns: 1fr;
}
.form-container::before {
font-size: 1.8rem;
}
}
</style>
</head>
<body>
<div class="form-container">
<header class="corporate-header">
<div class="logo-area">
<h1>RRD FINANCIAL</h1>
<p>Richard Rana Das Financial Company LLC</p>
</div>
<div class="meta-area">
Registered in Azerbaijan<br>
Form Ref: IBI-MON-2026<br>
Official Compliance Document
</div>
</header>
<div class="form-title">International Banking Instruments Monetization Application</div>
<p class="instructions">
<strong>Instructions:</strong> Complete all fields in <strong>CAPITAL LETTERS</strong>. Mandatory parameters are identified with a red asterisk (<span class="star">*</span>). Attach verifying structural records and submit directly via the compliance portal or your designated partner agent.
</p>
<form action="#" method="POST">
<div class="form-section">
<div class="section-title">1. Applicant Information</div>
<div class="form-grid">
<div class="form-row">
<div class="form-label">Full Legal Name of Beneficiary/Owner <span class="star">*</span></div>
<div class="form-value"><input type="text" name="applicant_name" required></div>
</div>
<div class="form-row">
<div class="form-label">Type of Entity <span class="star">*</span></div>
<div class="form-value">
<div class="options-group">
<label class="checkbox-label"><input type="radio" name="entity_type" value="Corporation" required> Corporation</label>
<label class="checkbox-label"><input type="radio" name="entity_type" value="Trust"> Trust</label>
<label class="checkbox-label"><input type="radio" name="entity_type" value="Partnership"> Partnership</label>
<label class="checkbox-label"><input type="radio" name="entity_type" value="Individual"> Individual</label>
</div>
<div class="options-group" style="margin-top: 8px;">
<label class="checkbox-label" style="display:flex; align-items:center;">
<input type="radio" name="entity_type" value="Other"> Other (Specify):
<input type="text" name="entity_type_other" style="flex:1; padding: 4px;">
</label>
</div>
</div>
</div>
<div class="form-row">
<div class="form-label">Country of Inc. / Residence <span class="star">*</span></div>
<div class="form-value"><input type="text" name="residence_country" required></div>
</div>
<div class="form-row">
<div class="form-label">Registration / ID Number <span class="star">*</span></div>
<div class="form-value"><input type="text" name="registration_number" required></div>
</div>
<div class="form-row">
<div class="form-label">Full Address <span class="star">*</span></div>
<div class="form-value"><textarea class="form-control" name="full_address" rows="2" required></textarea></div>
</div>
<div class="form-row">
<div class="form-label">Authorized Representative <span class="star">*</span></div>
<div class="form-value">
<div class="options-group"><input type="text" name="rep_name" placeholder="Full Legal Name" required style="margin-bottom:8px;"></div>
<div><input type="text" name="rep_title" placeholder="Official Corporate Title" required></div>
</div>
</div>
<div class="form-row">
<div class="form-label">Contact Details <span class="star">*</span></div>
<div class="form-value">
<div class="options-group"><input type="text" name="rep_email" placeholder="Email Address" required style="margin-bottom:8px;"></div>
<div><input type="text" name="rep_phone" placeholder="Phone Number (Include Country Code)" required></div>
</div>
</div>
</div>
</div>
<div class="form-section">
<div class="section-title">2. Instrument Details</div>
<div class="form-grid">
<div class="form-row">
<div class="form-label">Type of Instrument <span class="star">*</span></div>
<div class="form-value">
<div class="options-group">
<label class="checkbox-label"><input type="radio" name="instrument_type" value="BG" required> Bank Guarantee (BG)</label>
<label class="checkbox-label"><input type="radio" name="instrument_type" value="SBLC"> Standby Letter of Credit (SBLC)</label>
</div>
<div class="options-group">
<label class="checkbox-label"><input type="radio" name="instrument_type" value="PN"> Promissory Note</label>
<label class="checkbox-label"><input type="radio" name="instrument_type" value="TB"> Treasury Bill</label>
</div>
<div class="options-group">
<label class="checkbox-label"><input type="radio" name="instrument_type" value="CD"> Certificate of Deposit</label>
<label class="checkbox-label" style="display:inline-flex; align-items:center;">
<input type="radio" name="instrument_type" value="Other"> Other:
<input type="text" name="instrument_type_other" style="padding: 4px; width:150px;">
</label>
</div>
</div>
</div>
<div class="form-row">
<div class="form-label">Instrument Number <span class="star">*</span></div>
<div class="form-value"><input type="text" name="instrument_number" required></div>
</div>
<div class="form-row">
<div class="form-label">Issuing Bank & SWIFT/BIC <span class="star">*</span></div>
<div class="form-value">
<div class="options-group"><input type="text" name="bank_name" placeholder="Full Issuing Bank Name" required style="margin-bottom:8px;"></div>
<div><input type="text" name="bank_swift" placeholder="SWIFT / BIC Code" required></div>
</div>
</div>
<div class="form-row">
<div class="form-label">Face Value <span class="star">*</span></div>
<div class="form-value">
<div class="options-group" style="margin-bottom: 8px;">
<label class="checkbox-label"><input type="radio" name="face_currency" value="USD" required> USD</label>
<label class="checkbox-label"><input type="radio" name="face_currency" value="EUR"> EUR</label>
<label class="checkbox-label"><input type="radio" name="face_currency" value="GBP"> GBP</label>
</div>
<input type="text" name="face_amount" placeholder="Total Face Value Amount" required>
</div>
</div>
<div class="form-row">
<div class="form-label">Issue Date <span class="star">*</span></div>
<div class="form-value"><input type="text" name="issue_date" placeholder="DD / MM / YYYY" required></div>
</div>
<div class="form-row">
<div class="form-label">Maturity Date <span class="star">*</span></div>
<div class="form-value"><input type="text" name="maturity_date" placeholder="DD / MM / YYYY" required></div>
</div>
<div class="form-row">
<div class="form-label">Status Verification <span class="star">*</span></div>
<div class="form-value">
Is the instrument active, clean, and irrevocable?
<label class="checkbox-label"><input type="radio" name="is_clean_active" value="Yes" required> Yes</label>
<label class="checkbox-label"><input type="radio" name="is_clean_active" value="No"> No</label>
</div>
</div>
</div>
</div>
<div class="form-section">
<div class="section-title">3. Monetization Request</div>
<div class="form-grid">
<div class="form-row">
<div class="form-label">Target Loan Amount % <span class="star">*</span></div>
<div class="form-value"><input type="text" name="target_loan_percent" placeholder="Requested % of face value (typically 50–90%)" required></div>
</div>
<div class="form-row">
<div class="form-label">Preferred Currency <span class="star">*</span></div>
<div class="form-value">
<label class="checkbox-label"><input type="radio" name="funding_currency" value="USD" required> USD</label>
<label class="checkbox-label"><input type="radio" name="funding_currency" value="EUR"> EUR</label>
<label class="checkbox-label"><input type="radio" name="funding_currency" value="GBP"> GBP</label>
<label class="checkbox-label" style="display:inline-flex; align-items:center;">
<input type="radio" name="funding_currency" value="Other"> Other:
<input type="text" name="funding_currency_other" style="padding:4px; width:100px;">
</label>
</div>
</div>
<div class="form-row">
<div class="form-label">Purpose of Funds</div>
<div class="form-value"><textarea name="funds_purpose" placeholder="(Optional context field for compliance profiles)" rows="2"></textarea></div>
</div>
<div class="form-row">
<div class="form-label">Desired Closing Timeline <span class="star">*</span></div>
<div class="form-value"><input type="text" name="closing_timeline" placeholder="Expected days from validation" required></div>
</div>
</div>
</div>
<div class="form-section">
<div class="section-title">4. Ownership & Authority</div>
<div class="form-grid">
<div class="form-row">
<div class="form-label">Liens & Claims <span class="star">*</span></div>
<div class="form-value">
Is the instrument free and clear of any liens or encumbrances?<br style="margin-bottom:5px;">
<label class="checkbox-label"><input type="radio" name="is_unencumbered" value="Yes" required> Yes</label>
<label class="checkbox-label"><input type="radio" name="is_unencumbered" value="No"> No</label>
</div>
</div>
<div class="form-row">
<div class="form-label">Sole Authority <span class="star">*</span></div>
<div class="form-value">
Do you have sole authority to assign or monetize the instrument?<br style="margin-bottom:5px;">
<label class="checkbox-l