LOCAL REMITTANCE SERVICE REQUEST

_____________
(DATE)

To: ACM INTERNATIONAL BUSINESS INTEGRATION INCORPORATED

From: (USERNAME)
RE: LOCAL REMITTANCE SERVICE
__________________________________________________________________________________
________________
I would like to express my interest to use VIP Payment Center Local Remittance Services to be
enabled in our enterprise system.

I am attaching my DTI Registration and Copy of Valid ID as part of this request for your record.

NAME: __________________________________________________________________________
COMPLETE ADDRESS: ___________________________________________________________
CONTACT NUMBER: _____________________________________________________________
SETUP TYPE: ____________________________________________________________________
EXPECTED DAILY REMITTANCE TRANSACTIONS: (GROSS AMOUNT)

I am expecting a positive reply with the approval within 2 working days upon receipt of this
document.

Sincerely yours,

_____________________________
(Signature over printed Name)