You are on page 1of 1

www.aftemplates.

com

Remittance Template
To Send Money
Sender: _________________________ (Name Here) Code: _____________________________________
Address: __________________________________ Date & Time: _______________________________
Telephone: ________________________________ Agent: ____________________________________

ID: _____________________________________ Amount Sent: $ ____________________________


ID Number: ______________________________ Originating Country: ________________________
Expiration Date of ID: ______________________

Receiver: ________________________________

Terms and Conditions: Write your terms and conditions regarding transfer here write your terms and conditions regarding
transfer write your terms and conditions regarding transfer write your terms and conditions regarding transfer write your terms and
conditions regarding transfer write your terms and conditions regarding transfer write your terms and conditions regarding transfer

________________________________
________________________________ Agent Signature
Customer Signature Date: _____/______/_____________

Remittance Template
To Receive Money
Receiver: ________________________ (Name Here) Code: _____________________________________
Address: __________________________________ Date & Time: _______________________________
Telephone: ________________________________ Agent: ____________________________________

ID: _____________________________________ Amount received: $ _________________________


ID Number: ______________________________ Originating Country: ________________________
Expiration Date of ID: ______________________

Sender: ________________________________

Terms and Conditions: Write your terms and conditions regarding transfer here write your terms and conditions regarding
transfer write your terms and conditions regarding transfer write your terms and conditions regarding transfer write your terms and
conditions regarding transfer write your terms and conditions regarding transfer write your terms and conditions regarding transfer

________________________________
________________________________ Agent Signature
Customer Signature Date: _____/______/_____________

You might also like