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Date:

The Manager
Korea Exchange Bank
32/F., Far East Finance Centre,
16 Harcourt Road,
Hong Kong

APPLICATION FOR BANK STATEMENT

I/We hereby request you to issue bank statement (A/C movement record) starting from
______________ to ________________ for the following account :

Account Number : ________________________________________

Account Name : ________________________________________

Please debit my/our Account Number :_______________________for this issuance fee.

Please deliver the statement as follows: (please tick √ )

( ) by fax. Fax no. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .

( ) hold for my collection.

Thank you for your kind attention and co-operation.

Yours faithfully,

_______________________________
Chop(if any) and authorized signature

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