Refund Request - Information Needed

To Be Completed By Student

----------------------------------------------------- For Wires Only -------------------------------------------------

**Any fees charged to American Flyers for incomplete or incorrect information provided
will be deducted from the original refund amount.**
STUDENT BANK INFORMATION
Name of Student Juan Angel Quijano Naranjo
Name of Bank BANCOLOMBIA
Country Colombia
Name of Person on Account Juan Angel Quijano Naranjo
Account number 79542955274
Swift Code COLOCOBM
ABA/Routing number (MUST BE SPECIFICALLY FOR A
WIRE) :
*If sending through Intermediary Bank:
Intermediary Bank ABA/Routing Number:
Intermediary Bank Account Number:

** Cualquier cargo cobrado a American Flyers por información incompleta o incorrecta

otorgada será deducido del monto del reembolso original. **
INFORMACION DE REEMBOLSO
Nombre del Alumno Juan Angel Quijano Naranjo
Nombre completo del Banco BANCOLOMBIA
País Colombia
Nombre del titular de la Cuenta Juan Angel Quijano Naranjo
Número de Cuenta 79542955274
Código Swift COLOCOBM
ABA/Número de Routing (El número de Routing debe
ser específico para realizar la transferencia bancaria):
*En caso de envío a través de Banco Intermediario:
Banco Intermediario ABA/Número Routing:
Número del Cuenta de Banco Intermediario:
To Be Completed by School Only

Method of sending refund: _____ Check _____ Credit Card ____ Wire

Student's Full Name:

Student's Mailing Address:

For Credit Card Transactions:

Name on Credit Card:
Last 4 digits of Credit Card:
Rev 5-2019