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Get Remittance Application Form

Yes No From Account Others (specify) Telephone No. ID/ Passport No. Transfer Instructions Payment Method Debit A/C No.* Currency Please enter remittance amount or equivalent amount to be converted* Currency Amount Currency Remittance of Account Amount In Words Charges Debit A/C No.* Currency Account OR 32A Value Date 56A Intermediary Bank Name Optional for routing payment to Beneficiary Bank Address 57 Beneficiary's Bank Equivalent of Code Country Name* Address*.

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