TO: FIRST INVESTMENT FINANCE LIMITED DATE: …………………………….

APPLICATION FOR:

 TELEGRAPHIC TRANSFER  BUY/SELL FOREIGN CASH

CURRENCY AMOUNT

BENEFICIARY

RESIDENTIAL ADDRESS / CONTACT DETAILS

ACCOUNT No. BSB/SWIFT/BILLER CODE

BENEFICIARY BANK AND BRANCH INTERMDIARY BANK

ADDITIONAL INFORMATION: (INVOICE NUMBER, ORDER NUMBER, STUDENT ID ETC...)

METHOD OF PAYMENT

 Cheque __________________  Cash__________________ Direct Deposit___________________

I/We hereby authorize First Investment Finance Limited to make any enquires it deems necessary
associated with this Application in relation to anti-money laundering and/or compliance.

___________________________ _____________________________
Name of Remitter Signature

DOB: __________________ Customer Code: ________________

OFFICE USE ONLY

FOREIGN AMT
Received By
RATE

NET KINA K Entered By

CHARGES K
Authorized By
TOTAL KINA K

P.O. Box 326, Port Moresby

Ela Beach Tower, Port Moresby, NCD
Papua New Guinea
Telephone: (675) 321 7900 Fax: (675) 321 7907 VAT Registration: VT 1437