Bank Details Form sea chefs River Cruises Ltd sea chefs River Management Ltd Qi, Are you the beneficiary of the account? _ IFYES, Please proceed to Question 2 (Q.2) - — INO, Please complete all details in Part B and return signed form (Q2. Are your Bank Details the same as previous detai ITYES, Please complete bottom section of Part A only and return signed form INO, Please complete all details in Part A and return signed form PART A — Name of Vessel: Name des Schiffes ‘TRAVEL MARVEL JEWEL 2 | Sign on Date (if known) Einstiegsdatum (falls vorhanden) 3. | Name of Crewmember: Name des Besatzungsmitgliedes | MARL! WAHYUDIONO 4, | Name of Account Holder: Name des Bankkontoinhabers _| FARIDA AYU DWI HASTUTI, SE Name and Full Address of Bank: Wecin eamacan aed BANK CENTRAL ASIA KCP. SRAGEN IBAN Number (Compulsory to EU Countries) / IBAN Nummer (obligatorisch fuer EU Laender) LUTIIT1 LUI IT Notes: Germany 22 Digits / Austria 20 Digits / Romania 24 Digits / Switzerland 21 Digits / Turkey 26 Digits Hungary 28 Digits / Bulgaria 22 Digits / Greece 27 Digits / Slovakia 24 Digits / Serbia 22 Digits ‘Account Number (Non EU Countries) / Banickontonumimer (fuer nicht Europaeische Laender) ‘Bh ph | BIC / SWIFT Code (Compulsory): [ele alals [p a] al o17|710 BIC /SWIFT © ‘ll of the above blank spaces must be completed TYPED with the comect and current information required to ensure a Bank transfer. ‘Any incomplete or incorrect details may result in extra Bank charges, which the crewmember is liable for. If the Bank details should ‘change affer this form has been submitted (from below date), iis the responsibilty of the crewmember to inform, complete and submit ‘a new Bank Form to sea chefs Cruises Ltd. or to the vessel to avoid further Bank charges, Alle oban genannten Felder muessen EIN TIPPT, volistaentig und mit den Falsche oder unvolistaendige Angaben verursachen zusaetzliche Bankkoster tigen Bankd: die jedes Besatzungsmitglied selber tragen muss, Soilte sich fhre Bankverbindung nach dem Ausfuellen dieser Form aendem, sind Sie dafuer verantwortlich, sea chefs oder den Crew Purser uebor die neve Bankverbindung zu informieren | (Full Name) MARLI WAHYUDIONO. f : ‘understand and will comply with the above ‘Terms and Conditions. Ich (Vorsund Nachname). Bedingungen und werde diese erfualien, ausgefuellt werden, verstehe oben genannte Date: 20/03/2019 Signature of Crewmember: Datum Unterschrift des Besatzungsmitgliedes: ‘This Bank form is valid for one(1) year from date of issue Dieses Dokument ist fuer 1 Jahr guelti F7.5 Bank Details Form Issue: 5 / Issue dat 11-04-2018) 1/2