OFPER 4 – EMPLOYEE BANK FORM (Ver.

5 Jul'18)

Note: Please Complete this form in block letters

Payroll : _______________________________________ PCN No: ____________________

Name : ___________________________________________

I hereby authorise you to pay my monthly salary into the following account:

Bank Name: _______________________________________________________________

Bank Address: _______________________________________________________________

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Sorting Code: ____________________________

Name of Account Holder / Beneficiary: ___________________________

Account Number: ____________________________

Account Currency: Select Currency (Delete as applicable)

IBAN Number – required for Euro bank accounts: ______________________________________

______________________________________
Swift Code – must be completed if an IBAN is present:
16 Digit Card Number – This field is Mandatory for Russian Banks Only: _________________

Signed: Date: