apa alas
standing Instructions
eIB a ee Co
(TB setter boon we
one sot
Standing arctiont cuentas
cstaer tne sant
erequyoun net mylou sandstone la iL ad pe
| rrequenoy of Payment: Ewrapeartny
unety Susie Monty Det wey Oar
Efecive ot: capone
cawias ae dal gaa OR Tae OTe ED a
a Je ttt at
| Amount mort ni tidaltaen |
| tamer ete | ancy |
| pecoune ome je |
7 j
| econ no (eae LI tetas |
| raatr Dota : ! danaicey |
teeter on es vera ads |
| Malue Date: Jugal Sadan |
| purpose of Fayment/Tansfer: idesalon gent |
Senay Deas sacle
| Benetisary Name eset
| penal Aco N/A paisa oy
\ rene jet Slt ptt t otetetstctd
Beni Bank Deas oe al
‘Beneicary Bank Name
eneriary Bank Ades
‘cy /eounty
‘SW code (# avalabie)
Intermediary Bonk Name (avaiable):
Charges com tanto
11 OUR: Remeter boars af banks charaes
1 ia Remar bears CB ces oly
1D BEN; Bonefitary bars banks emo
agree on deducting lcormions fees to execute these ansacbs,
armcnos cba ode al elated commons and fees rom my account
opal) hereby aceon ate
Conomer tame
costomer Signatur
For Bank Use Ooty
ome of ee:
Stat Name:
Back Ofce ead Noe
COmAN sda lRONLECANORARETD
ferme ana conation stated ove
acid gat
scnhalialie
ah iad)
(nanysmet
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5 Jans inal 864 CD
phan (aryl) Sell Aa gS Ll te ene rss
deep teat
te
Wo oeeees
eam taney
Signature
Signotre
‘wwrw.cibeg.com‘General Torme and Conditions
‘Application for Transtor of Funds:
IWthcorder expressed cance tan that ofthe county 0 which the
‘rer transted st e aldo Ue payetn the curency of he country
‘iter payments eect a the then buying ate of echange fer tan
We may us any ofce branch, comespendent. agent a ther sree
connection with thse ad we sal natbelablerany of halos def,
‘ely oF omisions. Nether we nor ay ee conespendent, agent oF other
Instrumental sll be abe for ans damage esting fom eos o days
Inthe vansmastion of delivery of messages document or structions, fale of
eter tees. resulting Wor fale locate o earning he named
payee or resting fom any other cause whationer beyond the contol of
‘urseies oF ay office, branch, conespondent oF agent the payment her in
rogue ot flected and 3 vlan requested by yoU we wl ended" fo
‘not the fe branch correspondent agent or ether instrumentally concerned
{0 cancel the transaction his oder expressed nthe crenyof the county
‘hare suedrefang wl be made such enc bu otro enya
Shale to make refund te you atthe crt mart vale the forsgn cuency,
Iniheplace where this oder ieved tthe tn uch eure a, an se
‘ofactutonimtherateof exchange rte impuemento desaction a the forign
tarrencyin question bing sumed by your provided that such ekand may ol be
equed unless and unt we are in receipt of poo satisfactory 10 us thatthe
payment requested has not been made thatthe order for sch payment i no
Tonge operate, that na chorge by wet of such err xs oF wl be made
gat the account upon which ad order eam and hat any potion a id
‘count debited or exmarhed for paymer tert 3 oot fr dspora. AR
‘expenses in conection therewith obo bom you: and provid futher at
the ime when sac efund woul beri be requ Rereunder thee 90
‘ret nthe place where thi order used for sch foreign cneny ae may De
le or in order, or obligation to make rend shal ot sen nest te
‘ntheucha mate ent
elit gona
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sont Na lA Sa adage Sap pg AED AS i
en ec ee lg el gd A gh Jon TLS
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BO. Rely gat pL! pd Mt Sy le le ei pe
AA GIN yp RyRy SU at
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SL a a Mya YIN Joa apa apne
Byki e Ly LAE A | yan pn anginal eds
Ala pp tng pl ght aks
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