6/18/2015

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REQUESTFORWIRETRANSFERREFUND(*=Mandatoryfields)

*Date:18Jun2015

*Currency:USD

*Amount:3,615.00

GCIAccountInformation(Detailsoftheaccountthatthefundswillbetakenfrom)
*LoginUsername:cfd81942usd
*AccountNumber:8373

OrderingCustomer(Yourdetails)
*Name:IMRANHina
*Street:AlWahdaStreet,YasmeenBuilding
*Town/City:Sharjah
*State/Country:Sharjah
*Telephone1:00923213522790
*Email:m.yaseenkhan@yahoo.com

BeneficiaryBankInformation(Yourbankdetails)
*SwiftCode:DUIBAEAD
*BankName:DubaiIslamicBank
*Street:WasetRoad,IndustrialArea6,SecondIndustrialStreet*Town/City:Sharjah*State/Region:Sharjah
*Country:UnitedArabEmirates

BeneficiaryAccountInformation(YourBankaccountdetails)
Note:Thirdpartypaymentsarenotpermitted.
*BankAccountNumber/IBAN:AE890240017580071358901
*BranchNumber:017
*BranchName:WasetBranch
*Accounttype:Savings
*BankAccountName:HinaImran
PaymentDetailsifany(ExampleInvoiceNo1234):None

IdentificationRequired
PLEASESENDTHEFOLLOWINGDOCUMENTSIFNOTSUPPLIEDALREADY:

GCIUSEONLY

ONFILE

DATERECD

1.Passportcopy(NOTIDCARD)

2.copyoffrontandbackofcard(blockingoutthefirst12digitsifyouwish)

3.copyofautilitybillorbankstatementshowingthecreditcardbillingaddress

Additional
*WillyoubeclosingyourGCIaccount?NO
*Anycommentsonourservice?Satisfactory
AuthorisedCustomerSignature:
I/WeacceptthatthisrequestisgovernedbytheAccountsGeneralTerms&ConditionsofGCIFinancialLLC.

*Place&Date:

*Signature:

AllinformationprovidedwillofcoursebekeptCONFIDENTIAL.
Pleasefaxtherequesteddocument(s)toanyofourfaxnumbers(http://www.gcitrading.com/aboutus/contact)
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