Beruflich Dokumente
Kultur Dokumente
Date 18-Feb-2016
Reset
Branch
Remittance Details
Remittance to be processed against
Cash
Transfer
Account Holder
Non Account Holder
Currency of Transaction
EURO
PKR
GBP
USD
Cheque No #
(Debit Authority) if transfer,Please Specify
Branch Code
AED
Debit Account:
SAR
Other
Online Transfer
(For UBL to UBL Transfer only)
Cashier's Cheque
FDD
SWIFT
Foreign Transfer
SDR
Amount in Figures
Amount in words
Beneficiary Details
Favoring/Name of the Beneficiary
Bank Account No/IBAN
Swift / FDD
Drawn On
Address of the Bank
Country
City
CNIC/SNIC
NICOP
(Overseas Pakistani)
Passport No.
Expiry date
ARC
POR
DD-MMM-YYYY
Address
Contact No. (Mobile/Landline)
N.T.N No:
Remitter's/Applicant's Details
Name
Father/Husband Name
CNIC/SNIC
NICOP
Passport No.
(Overseas Pakistani)
Expiry date
ARC
DD-MMM-YYYY
Address
Contact No. (Mobile/Landline)
Nationality
N.T.N No:
Relationship with
the Beneficiary
Source of Funds
Salary
Business
Remittance
Rental
Date of Birth
Place of Birth
Date of Registration
Registration No.
Purpose of
Remittance
DD-MMM-YYYY
DD-MMM-YYYY
Personal
Education (Admission/Term fee)
Vehicle
Business
Commercial Remittance
Medical Treatment
Property
Agent Commission
Other
Import
Other
Declaration
It is understood and agreed that this transfer is to be made entirely at my/our risk without responsibility
on the part of United Bank Limited or its correspondent(s), for any loss occasioned by errors ordelays in
transmission nor for the correspondent(s) or agencies necessarily employed by United Bank Limited in
the transfer of the money. I/We confirm that the information provided by me on
this form is true and correct. The Bank reserves the right to ask for any transaction related documents
from the applicant whenever required. I/We authorise the Bank to disclose any information
statedabove, should it be required by the Bank's Branches / correspondents for effecting Payment. I/We
have also read, understood and accept the terms and conditions printed overleaf.
Applicants Signature
Applicants Acknowledgement
(I confirm having received the instrument)
Principal Amount
PS.
Instrument No:
Fax Charges
Commission
F.E.D
Withholding Tax
Total Deduction
Cashier
Officer 1
Officer 2
POR