1 dlioe Read, 02-01, Wades Buking, Ggapore 208734 SN SINGAPORE MARITIME OFFICERS’ UNION "Tat 60080123 Fax exo 8008 Wobnte srw Smo O80 SMOU Request to Withdraw SMOU (Officers) Seafarers’ Provident Fund |1Wa hereby apply to recotve SMOU (Oficers) Seafarers’ Provident Fund under the Scheme of Administration. mpoRtarr: Please wt Cleary and provide cored! and comeleteiformation aa Incomplete withrawal form wil delay the application process. Please enciose copies of ‘bh certiieate, new & ok passports, sefare's handbook, bank booUstatement and any other form of denicaton for verification. “See reverse for Particulars of Member GLONTI REVAZ 12.5UN. 1936 99S S Py $193 58 'A) TELEGRAPHIC TRANSFER TO OVERSEAS | BANK BRANCH / STATE BANK ACCOUNT (‘bank charges apply) tary) [BANKS SWIFT CODE (computsory field) ISWIFT: MIBGGE 22 1 B) DIRECT FUNDS TRANSFER TO LOCAL (SINGAPORE-BASED) BANK ACCOUNT ("bank charges may apply) coRRENGY TYPE | 500 Sus Clones GE FAPC 034% 0010000 9356 cick | Seecty carey "Omer REVA2 GLonTI ProCredt Bank TSC, TBilisi, Georgia a1 Al. Karbegi Ave, 0160 TBilisi, Georgia ‘This section must be completed if member would lke to transfer the fund to his nominee/beneficiary OR if application is by the [Nominoe/Beneficiary. * tease attach copie of marriage ceiicatetitcerticae of Norinee Beneficiary, whichever is sppkc {ave rad and uncerstoed e Tema and Condos of Withdrawal underthe Scheme of Aariniaton. Urey autre you to wir and vanster myour Proven Fund {oie speted bank as etaledabowe. {conse my Person Data beng clacte, used and retained by SMOUMavele Theft kr fe purposes of processing, administering and managing my SPF waherawal. | ‘consent omy Personal Data beng sone by SMOUMavelnk TB arsed Bird pares fr he purposes ef managing SPF wlbcrawal !cosert oe corkacted by ‘SktouMworciet Tira va Weshore.emat et messages, fa andr poor maters ising b SPF withenwal Forth parpases OSPF mierawal elated ses, onaeet SSMOUWavelnh Tet ctaning my Persona ata and reovart data reltng io my employment Rom my campy Leute pect meer eo rts ade romping ner irene ye UOUN rk TRL, ‘SwouMaee Tea ne sand rete te phtog apts ander Video Feeds lr nor pro purposes ft ews and pubily purposes, edge ‘snertnelcieconi toms ad a se! loons of mea etvomiedpe Ba SMOUN aver The ours gh i be andor veo recardegs.|agre ‘Rens SUOUMaven Th? Bx management. ices and employes agar al cas, demands, proceedings tabi. damages ancl cots aocaied wih Bw above, [tater detare fat he perzna ata praning omy spouse and dependa) ae tue and caret aha hese persons ae mare of and coment to SMOUWaveink Tet ‘gig ber omanan i oooares eae Upted 3t oxbeer 208