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  • Remittance Application Form

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    Muhammad Raheel
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    This document is a remittance application form requesting the processing of funds transfers by debiting an account number. It provides fields for the applicant to fill in details of the beneficiary such as name, address, contact and account details. The applicant also declares that the information provided is correct and authorizes the collection of funds by an authorized person whose signature is included. The bank section notes the remittance reference number, conversion rates, account debited, applicable charges and receipt acknowledgment.

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    Remittance

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    This document is a remittance application form requesting the processing of funds transfers by debiting an account number. It provides fields for the applicant to fill in details of the beneficiary such as name, address, contact and account details. The applicant also declares that the information provided is correct and authorizes the collection of funds by an authorized person whose signature is included. The bank section notes the remittance reference number, conversion rates, account debited, applicable charges and receipt acknowledgment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    596 views1 page

    Remittance Application Form

    Uploaded by

    Muhammad Raheel
    This document is a remittance application form requesting the processing of funds transfers by debiting an account number. It provides fields for the applicant to fill in details of the beneficiary such as name, address, contact and account details. The applicant also declares that the information provided is correct and authorizes the collection of funds by an authorized person whose signature is included. The bank section notes the remittance reference number, conversion rates, account debited, applicable charges and receipt acknowledgment.

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    © All Rights Reserved
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    of 1

    _______________ Branch.

    Date:_____________________

    REMITTANCE APPLICATION FORM


    You are requested to process the following remittance(s) by debiting my / our account no.

    against

    cheque no. ___________________ dated____________ amounting _________________ favoring Meezan Bank Ltd.
    Please mark the mode of remittance.
    Payment Order

    Demand Draft

    Foreign Telegraphic Transfer

    Remittance Details (* denotes mandatory fields)


    CNIC / SNIC* or
    NTN number* (for corporate entities)

    Name of Beneficiary (in Block Letters)*

    Amount in words*:

    Currency*

    Complete address of the beneficiary:*

    Amount in figures*

    Contact No. of the beneficiary:*

    Purpose of remittance:*
    For Demand Draft, Foreign Telegraphic Transfer Use Only Please fill where applicable
    Town, City and Country where Payable:
    Name and Address of Beneficiary Bank:
    SWIFT Code:*

    Beneficiarys Account number:*

    Relationship between Originator & Remitter:*


    Message or Instructions if any (for FCY remittances only):
    Name of Applicant / Remitter (in Block Letters):*
    Conditions:
    I / we hereby declare that information presented above is correct and verifiable. I / we further hereby agree that the above payment order / draft / remittance is
    to be dispatched entirely at my / our own risk; and in case of a telegraphic transfer, you are at liberty to send the same either literally or in spirit and you shall
    have no liability whatsoever for any delay, error, omission, which may occur in the transmission of the message or from its misinterpretation when received. I /
    we further agree that the bank may share with other banks/authorities including correspondent banks, as the Bank deems fit, the information about my/our
    account provided by me/us, or that the Bank may obtain as a result of transaction(s) or other activity, for among other things, the purpose of offering products
    and services.

    I/we authorize Mr./Mrs./Ms._______________________________________

    (Customers signature & Company Stamp)

    having CNIC No. (copy enclosed)____________________ to collect the above

    S.V.

    PO/DD/FDD on my/our behalf. His / her specimen signature is as under.

    __________________
    Customers Signature

    ___________________________
    Signature of Authorized Persons

    For Bank Use Only


    PO /DD /FDD / Ref no.

    Checked by

    Authorized signature

    Remittance Amount
    Conversion Rate
    Account debited by amount

    Remittance charges
    FED
    Courier / SWIFT Charges
    TOTAL

    I hereby acknowledge the receipt of the above PO / DD / FDD.


    Receivers signature:
    Date Received:

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