Uy Nhiem Chi

Y NHIM CHI
Payment Order
CHI NHNH .
Mu s DP005 km theo Quyt nh 1371/Q-NHNo-TCKT ngy 16/11/2011
Lin 1: Ngn hng S:

No Original Sep No Bank
S bt ton: Loi tin:

Currency
Ngy:
Date
21/11/2013
VND
n v tr tin:
Applicant
Dnh cho ngn hng (For bank use only) in thoi:

Tel
S ti khon:
Account No
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
NHNo&PTNT Nng
Ti khon ghi c: Ngy cp:
Date of issue Credit account
n v th hng:
Beneficiary
CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
500,000,000.00
Nm trm triu ng
S tin bng ch:

Amount in words
Ni dung:
Details
n v tr tin (Applicant) K ton trng

Chief accountant
Ch ti khon
Account holder
Ngn hng A (Bank of Applicant) Ghi s ngy (Settled date) ../.. /20 Giao dch vin Kim sot
Teller Supervisor
Ngn hng B (Bank of Beneficiary) Ghi s ngy (Settled date) / /20 Giao dch vin Kim sot
Teller Supervisor
23 Phan nh Phng, Q.Hi Chu TP Nng - in thoi: 05113812155 - Fax: 05113817467 - www.agribank.com.vn
Y NHIM CHI
Payment Order CHI NHNH
Lin 2: Khch hng S:

No
Original
S bt ton:
Sep No
Ngy:
Date
21/11/2013
Loi tin:
Currency
VND
n v tr tin:
Applicant
0
in thoi:
Tel
Dnh cho ngn hng (For bank use only)
S ti khon:
Account No
0 NHNo&PTNT Nng 0
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
0 0 0 Nm trm triu ng
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
S tin bng ch:

Amount in words
Ni dung:
Details
0
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH
Lin 3: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:

Currency
Ngy:
Date
21/11/2013
VND
n v tr tin:
Applicant
0
in thoi:
Tel
S ti khon:
Account No At bank
0 NHNo&PTNT Nng =F15
Ti khon ghi n:
Debit account
Ti ngn hng:
Beneficiary
n v th hng: CMT/H chiu:

ID/Passport No
Ngy cp:
Date of issue
Ti khon ghi c:
0 0
Credit account
Ni cp:
Place of issue Account No
0 0 0 Nm trm triu ng
in thoi:
Tel
S ti khon: Ti ngn hng:

At bank
-----
S tin bng s:
Amount in figures
S tin bng ch:

Amount in words
Ni dung:
Details
0
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 1: Ngn hng S:

S bt ton: Loi tin:
Ngy:
Date
12/1/2011
VND
Currency
n v tr tin:
Applicant
Cng ty TNHH DV TM SX XD
in thoi:
Tel
S ti khon:
Account No
6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No At bank
045704070000898 NHNo&PTNT Chi Nhnh 10
-----
S tin bng s:
Amount in figures
Ti ngn hng:
123,456,789,123.00
S tin bng ch:

Amount in words
Ni dung:
Details
Mt trm hai mi ba t bn trm nm mi su triu by trm tm mi chn ngn mt trm hai mi ba ng Cty U Nhim
Ngn hng A (Bank of Applicant) Ghi s ngy (Settled date) / /20 Giao dch vin Kim sot
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
326 Nguyn Ch Thanh, P5, Q.10, TP HCM - in thoi: (+84-8)-38534339 - Fax: (+84-8)-38534340 - www.agribank10.vn
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 2: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:
Ngy:
Date
12/1/2011
VND
Currency
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
0 045704070000898 NHNo&PTNT Chi Nhnh 10
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
123,456,789,123.00
S tin bng ch:

Amount in words
Ni dung:
Details
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 3: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:

Currency
Ngy:
Date
12/1/2011
VND
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
0 045704070000898 NHNo&PTNT Chi Nhnh 10
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
123,456,789,123.00
S tin bng ch:

Amount in words
Ni dung:
Details
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 1: Ngn hng S:

S bt ton: Loi tin:

Currency
Ngy:
Date
21/11/2013
USD
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No At bank
045704070000898 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M
-----
S tin bng s:
Amount in figures
Ti ngn hng:
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 2: Khch hng S:

No
Original
S bt ton:
Sep No
Ngy:
Date
21/11/2013
Loi tin:
Currency
USD
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
0 045704070000898 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 3: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:

Currency
Ngy:
Date
21/11/2013
USD
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No At bank
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
Beneficiary
n v th hng: CMT/H chiu:

ID/Passport No
Ngy cp:
Date of issue
Ti khon ghi c:
0 0
Credit account
Ni cp:
Place of issue Account No
in thoi:
Tel
S ti khon: Ti ngn hng:

At bank
-----
S tin bng s:
Amount in figures
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 1: Ngn hng S:

S bt ton: Loi tin:
Ngy:
Date
12/1/2011
USD
Currency
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No At bank
642004570407000 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M
-----
S tin bng s:
Amount in figures
Ti ngn hng:
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
368-370 Tng Thin Vng, P13, Q8, TP HCM - in thoi: (+84-8)-39512552 - Fax: (+84-8)-39512551 - www.agribank.com.vn
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 2: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:
Ngy:
Date
12/1/2011
USD
Currency
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 3: Khch hng S:

No
Original Sep No
Bank
S bt ton: Loi tin:

Currency
Ngy:
Date
12/1/2011
USD
n v tr tin:
Applicant
in thoi:
Tel
S ti khon:
Account No
38534339
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

Date of issue
CMT/H chiu:
ID/Passport No
0 0
Credit account
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
500,000.00 USD
S tin bng ch:

Amount in words
Ni dung:
Details
Cty U Nhim
Teller Supervisor

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 1: Ngn hng S:

S bt ton: Loi tin:

Currency
Ngy:
Date
n v tr tin:
Applicant

Tel
S ti khon:
Account No
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
S tin bng ch:

Amount in words
Ni dung:
Details

Chief accountant
Ch ti khon
Account holder
Teller Supervisor
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 2: Khch hng S:

S bt ton: Loi tin:

Currency
Ngy:
Date
n v tr tin:
Applicant

Tel
S ti khon:
Account No
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
-----
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
S tin bng ch:

Amount in words
Ni dung:
Details

Chief accountant
Ch ti khon
Account holder
Ngn hng A (Bank of Applicant) Ghi s ngy (Settled date) 1/0/1900 Giao dch vin Kim sot
Teller Supervisor
Ngn hng B (Bank of Beneficiary) Ghi s ngy (Settled date) 1/0/1900 Giao dch vin Kim sot
Teller Supervisor
Y NHIM CHI
Payment Order
CHI NHNH 10
Lin 3: Khch hng S:

S bt ton: Loi tin:

Currency
Ngy:
Date
n v tr tin:
Applicant

Tel
S ti khon:
Account No
Ti khon ghi n:
Debit account
Ti ngn hng:
At bank
n v th hng:
Beneficiary

CMT/H chiu:
ID/Passport No
Ni cp:
Place of issue
in thoi:
Tel
S ti khon:
Account No
S tin bng s:
Amount in figures
Ti ngn hng:
At bank
S tin bng ch:

Amount in words
Ni dung:
Details

Chief accountant
Ch ti khon
Account holder
Ngn hng A (Bank of Applicant) Ghi s ngy (Settled date) 1/0/1900 Giao dch vin Kim sot
Teller Supervisor
Ngn hng B (Bank of Beneficiary) Ghi s ngy (Settled date) 1/0/1900 Giao dch vin Kim sot
Teller Supervisor

Uy Nhiem Chi

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Y NHIM CHI

Lin 1: Ngn hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only) in thoi:

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 2: Khch hng S:

Dnh cho ngn hng (For bank use only)

Ti khon ghi c: Ngy cp:

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 3: Khch hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

0 NHNo&PTNT Nng =F15

n v th hng: CMT/H chiu:

S ti khon: Ti ngn hng:

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 1: Ngn hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

Ti khon ghi c: Ngy cp:

045704070000898 NHNo&PTNT Chi Nhnh 10

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 2: Khch hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

Ti khon ghi c: Ngy cp:

0 045704070000898 NHNo&PTNT Chi Nhnh 10

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 3: Khch hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

Ti khon ghi c: Ngy cp:

0 045704070000898 NHNo&PTNT Chi Nhnh 10

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 1: Ngn hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

Ti khon ghi c: Ngy cp:

045704070000898 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 2: Khch hng S:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

Ti khon ghi c: Ngy cp:

0 045704070000898 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M

S tin bng ch:

n v tr tin (Applicant) K ton trng

Lin 3: Khch hng S:

S bt ton: Loi tin:

Dnh cho ngn hng (For bank use only)

6420207000549 NHNo&PTNT Chi Nhnh 10 Cng ty CP T XD BMT

n v th hng: CMT/H chiu:

0 045704070000898 NHNo&PTNT Chi Nhnh 10 Nm trm ngn la M