FORM-SPSA-HR-025-E

SNAMPROGETTI SAUDI ARABIA CO. LTD.

Rev. 02 Date 1/11/15

OVERSEAS BANK DETAILS Page 1 of 1

Ref. Doc. WI-SPSA-HR-014-E

This Form must be filled-up in BLOCK letters only; Cursive or handwritten form is not accepted.

BADGE NUMBER

EMPLOYEE’S NAME

ACCOUNT HOL DE R’ S NAM E

(p le a s e re fe r to c la u s e 1 )

Address :

Post Box :
ACCOUNT HOLDER’S ADDRESS
State :

Country :

BANK ACCOUNT NUMBER:

BANK IBAN NUMBER:

BANK SWIFT NUMBER:

ACCOUNT CURENCY: IFC CODE

BANK NAM E (F u ll):

(Ab b re via tion s n ot a llowe d )

Address :

Post Box :
BANK ADDRE SS:
(p le a s e re fe r to Cla u s e 2 )
State :

Country :

Term s & Conditions

1. The account holder’s nam e shall not be different from Em ployee’s nam e; however the account can
co-beneficiary.
2. The indicated bank shall not be located in any other Country different from the em ployee’s resident country.
3.   The Com pany does not accept liability due to any bank inform ation, which has been inaccurately quoted, resulting
to any loss and/or delay in rem ittance.
4.    Salary paym ent delays due to interm ediary / beneficiary / correspondent banks or any third party involved
in the bank transaction cannot be im puted to the Com pany.
5. The banking fees for the m onthly wage rem ittance shall be at com pany's charge. How ever the rem m itance fees
deducted from the rem itted am ount by any international interm ediary bank or beneficiary's bank at source
shall be at the Em ployee's charge.

The inform ation provided above is true to the best of m y knowledge and I hereby authorize the com pany to rem it m
m onthly salary, and I fully understood and acknowledge the condition stated.

Employee's Signature

Date