1. RETURN OF PROCESSING FEE, RIGHT OF PERMANENT RESIDENCE
FEE OR RIGHT OF LANDING FEE
ELECTRONIC FUNDS TRANSFER (EFT)
Immigration file # B 050641474
REQUESTED INFORMATION
Due to the varying banking standards between each country, CIC cannot provide a unique completion
format for fields in sections B and C below.
As a result, these sections should be completed by an official of your financial institution in order to avoid
any delays in processing your fee return.
A. PRINCIPAL APPLICANT INFORMATION (PRINT ONLY):
Family Name YAMSON
Given Name, Middle name (If applicable) ANNA LIZA, RIVERA
Date of Birth (YYYY-MM-DD) 1968-07-07
B. BANK ACCOUNT DETAILS (PRINT ONLY):
Family Name(s) of Account Holder(s) YAMSON
Given Name(s), Middle Name(s) (If
applicable) of Account Holder(s)
ANNA LIZA, RIVERA
Domestic Bank Account Number 005970159019
Bank Account Type Savings
International Bank Account Number
(IBAN No.)
0059 70159019
C. FINANCIAL INSTITUTION DETAILS (PRINT ONLY):
Bank name BANCO DE ORO UNIVERSAL BANK
PO Box or Street Address CHUA O/ CO BUILDING, ELIAS ANGELES STREET
City NAGA CITY
State or province CAMARINES SUR
Postal or ZIP code 4400
Country PHILIPPINES
Bank Branch Name NAGA ELIAS ANGELES BRANCH
Bank Number 597
Bank Identifier Code (SWIFT No.) BNORPHMM
Name of financial institution official MR. RENATO P. TAPEL
Telephone No. of financial institution +63 054 4739016
DISCLAIMER - Please note that this form includes personal information. Should you choose to return this form by e-mail, please be
advised that e-mail is not a secure channel, and therefore Citizenship and Immigration Canada cannot guarantee the secure
transmission of your personal information.