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Foreign Currency Telegraphic Transfer/Demand Draft

Branch

Dubai

Date

Please select

Foreign Currency Telegraphic Transfer

OR

Debit Account Number

( )

Transfer from Late Mr. Richard Burson

Debit Currency

8 0 2 1 6 4 2

( )
Transaction Amount and Currency (Select)

Debit Currency
Remittance Currency
OR

Amount in Words

1 8

Issue a Demand Draft

Ordering Customer Details (Complete in Block Letters)

Inherited
Applicants Name

1 6

Amount in Figures

Remittance Currency

3 8 2 3 1 0 0 0 . 0 0

Thirty Eight Million Two Hundred and Thirty one Thousand US Dollars Only

Contact Number
Beneficiary Details (Complete in Block Letters)

( )

Fernando Graziano Ferrari
Beneficiarys Name

Via Ganne di fuori 5, 6721
Beneficiarys Address

Ludiano Switzerland

Beneficiarys Account Number

9 1 3 5 2 8 3 6

Beneficiarys IBAN

4 7

Name and Address of Beneficiarys Bank

0 9 0 0

0 0 0 0

9 1 0 3

5 2 8 3

Swisspost PostFinance

Via Ganne di fuori 5, 6721 Ludiano - Switzerland

/
SWIFT/Routing Code of Beneficiary Bank

Swift Code:POFICHBEXXX

/
Correspondent/Intermediary Bank Details
( ) /
Correspondent Bank Routing Code/Account Number (for TT only)
( )
Details of Payment/Purpose of Remittance (Mandatory)
( )
Special Instructions (if any)

Inheritance from Late Relations Deposit with this

This payment has been cleared of all money Laundering /Terrorism Activities.

( )
Charges (Select)
( )
Beneficiary (Please charge beneficiary for your charges and correspondent banks charges from the TT amount)
( )
Ours (Please debit my account for your charges and correspondent banks charges)

( )
Shared (Please debit my account for your charges, beneficiary will bear the charges of your correspondent banks from the TT amount)

Demand Draft Bearer Delivery Instruction (Applicable for 3rd Party Delivery Only)

Please deliver the Demand Draft to the bearer, as per the signature appended

Bearers Signature

(
)

Demand Draft Received

Applicants Signature(s)

Signature Verified

Applicants Signature(s)
I/We have read, understood and accepted the Banks terms and conditions
governing this application as stated in the Business Accounts General
Terms and Conditions a copy of which I/we have received.

/ / /
. /

Select One:

IBTRY Deal Number

Client Rate*

Transaction Ref. Number*

Branch Rate

Special FX Deal
Signatures

(only in case of Special FX Deal)

Normal FX Deal
Teller:

Emirates Islamic is a registered brand name of Emirates Islamic Bank PJSC

Head Teller:

EIB U 300 02D

BOO/BOM/BSSM:

NI06FRM0049

EIBTTI0000000000000001

Bank Use Only