| Deutsche Bundesbank

Test procedure application form

To open a test procedure, please fill out this form. All additional necessary information about the procedures can be found in each of the specific applications to participate in the individual procedure, which have to be submitted to the relevant customer support service team.

Providing complete data – including the names and details of contact persons – greatly simplifies the procedure. It is important that you specify all persons responsible for the practical implementation of the test.

Furthermore, please note that henceforth in the course of the test procedure we will send all letters of confirmation directly to the email address specified under the contact person details.

Please return the completed application form well in advance of the start of the test.

If you have any questions, please contact us.

*mandatory field

Account holder

Date*

Account holder*

At least one of the following fields must be filled in:

Bank sort code or giro number

Production BIC (11 characters)

Test BIC (11 characters)

EBICS customer ID

Required only for test of settlement in T2-UTEST:

Account BIC of RTGS DCA in T2 (11 characters)

RTGS-Subaccount in T2

Adress (used as postal address)

Department

Employee ID number

Street or postbox*

Postcode/City*

Contact persons

First name*

Last name*

Phone

E-mail*

First name

Last name

Phone

E-Mail

We hereby ask the Deutsche Bundesbank, to arrange test-activities for the following procedures*

via the following communication channel

EBICS

SWIFT

Purpose of the test-procedure

Please submit the corresponding applications for participation in the individual Deutsche Bundesbank procedures and for submissions to and deliveries from these Bundesbank procedures to the relevant customer support service team.

Purpose of the procedure

New participant

Retest owing to/because of

Expansion of range of functions

Hardware migration

Software migration

Others

If necessary, several procedures can be selected.

Requested period for test activities

from*

till*

email_114488*

Information about the software

Software product (producer, name of software, version)

Remarks

The personal data you provide are used by the Deutsche Bundesbank (Wilhelm-Epstein-Strasse 14, 60431 Frankfurt am Main, Germany, tel: +49 (0)69 95660, e‑mail: info@bundesbank.de) for the purpose of processing your request. The Bundesbank’s Privacy Policy also apply.

Statement of Privacy*

I hereby agree that my personal data may be processed for the designated purpose. I have read the data protection provisions.

You are entitled to withdraw your declaration of consent for the processing of personal data at any time. This does not affect the legitimacy of any processing that has taken place on the basis of this declaration of consent before it was withdrawn. You may withdraw your consent by contacting the Bundesbank. No special form is required.