(INVOICE COMPANY LETTER HEAD)

Date :

SUITE 9-1 & 9-2, LEVEL 9, TOWER 9 UOA BUSINESS PARK,

NO.1 JALAN PENGATURCARA U1/51A SEKSYEN U1,

40150 SHAH ALAM,

SELANGOR DARUL EHSAN.

Dear Sirs,

AUTHORIZATION FOR REFUND OF PAYMENT TO OUR FREIGHT FORWARD/ AGENT

We, (CONSIGNEE COMPANY SDN BHD), hereby confirm that (FORWARDER COMPANY @ REFUND
RECIPIENT SDN BHD) is our freight forwarder agent. We hereby authorized you to release the refund to
our Agent / Representative :-

Beneficiary Name : REFUND RECIPIENT SDN BHD

ROC Number :

Bank Name : ABC BANK BHD

Bank Account No :

Thank you & best regards,

Yours faithfully,

_______________

Authorised signature & Company Chop

Name

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