Standard Chartered Bank
Remittance Form;C09
Date; 1/12/2016.
International Remittance Form
Notice: This form must be completed before we can commence fund transfer.You are to fill all columns and sign
the allotted spaces. This form is compulsory for international remittance and should be returned along
with your identification material
Customer’s Info;
1). Last Name: First Name:
Address:
Tel: Fax:
E-mail:
Next of Kin;
2). Name;
Address;
Tel/Fax Nos:
Account Name;
(If different from above)
Identification Material;
(Tick the box)
International Passport; National ID Card; Others; (Specify)……………………………………….
Passport/ID Card Number……………………………………………………… Sex; ………………………… Age; ……………………
Date of Issue (DD/MM/YY);………..…/………………/…………. Date of Expiry (DD/MM/YY);…………/………………/…………….…
Other information;……………..………………………………..……..………………………………………………………………………………
…………………….…………..………………….……………
Customer’s Signature & Date
FOR OFFICIAL USE ONLY
Confirmed and approved by:
Sign…………………………….…… Sign:……………..……..………………….
(payment officer) (Director Int. Remit.)
Sign:………………………………………………..
Bank Manger.
International Remittance Department

Remittance form (2)

  • 1.
    Standard Chartered Bank RemittanceForm;C09 Date; 1/12/2016. International Remittance Form Notice: This form must be completed before we can commence fund transfer.You are to fill all columns and sign the allotted spaces. This form is compulsory for international remittance and should be returned along with your identification material Customer’s Info; 1). Last Name: First Name: Address: Tel: Fax: E-mail: Next of Kin; 2). Name; Address; Tel/Fax Nos: Account Name; (If different from above) Identification Material; (Tick the box) International Passport; National ID Card; Others; (Specify)………………………………………. Passport/ID Card Number……………………………………………………… Sex; ………………………… Age; …………………… Date of Issue (DD/MM/YY);………..…/………………/…………. Date of Expiry (DD/MM/YY);…………/………………/…………….… Other information;……………..………………………………..……..……………………………………………………………………………… …………………….…………..………………….…………… Customer’s Signature & Date FOR OFFICIAL USE ONLY Confirmed and approved by: Sign…………………………….…… Sign:……………..……..…………………. (payment officer) (Director Int. Remit.) Sign:……………………………………………….. Bank Manger. International Remittance Department