Get Myrepublic Interbank Giro

INTERBANK GIRO APPLICATION FORM Please complete PART 1 of this form and return to the Billing Organisation. Part 1 For Applicant s Completion fill in the spaces indicated with a Date Name of Billing Organisation BO To Name of Bank / Finance Company MAYBANK KIM ENG SECURITIES PTE. LTD. BO Customer Name DBS BANK / POSB Branch BO Customer Reference No a I/We hereby instruct you to process the BO s instructions to debit my/our account. b You are entitled to reject the BO s debit instruction if my/our account do / does not have sufficient funds and charge me/us a fee for so doing. You may also at your discretion allow the debit even if this results in an overdraft on the account and impose charges accordingly. c This authorisation will remain in force until terminated by your written notice sent to my/our address last known to you or upon receipt of my/our written revocation through the BO. My/Our Name s My/Our Contact Tel/Fax/Mobile Tel My/Our Account No My/Our Company Stamp/Signature s /Thumbprint s As in Bank/Finance Company s records Note For thumbprints please go to branch with your identification* Part 2 For Billing Organisation s Completion Bank BO s Account No 7 1 7 1 0 7 4 0 7 4 0 0 1 2 8 3 3 Account No to be debited Part 3 For Bank / Finance Company s Completion To The Manager Maybank Kim Eng Securities Pte. Ltd. 63 Market Street 13-00 Bank of Singapore Centre Singapore 048942 Attn Client Services This application is hereby REJECTED please tick for the following reason s Signature/Thumbprint differs from Bank s/Finance Co s records Wrong account number Amendments not countersigned by customer Account operated by signature/thumbprint Others Name of Approving Officer Please delete where inapplicable Authorised Signature. BO Customer Name DBS BANK / POSB Branch BO Customer Reference No a I/We hereby instruct you to process the BO s instructions to debit my/our account. b You are entitled to reject the BO s debit instruction if my/our account do / does not have sufficient funds and charge me/us a fee for so doing. b You are entitled to reject the BO s debit instruction if my/our account do / does not have sufficient funds and charge me/us a fee for so doing. You may also at your discretion allow the debit even if this results in an overdraft on the account and impose charges accordingly. You may also at your discretion allow the debit even if this results in an overdraft on the account and impose charges accordingly. c This authorisation will remain in force until terminated by your written notice sent to my/our address last known to you or upon receipt of my/our written revocation through the BO. c This authorisation will remain in force until terminated by your written notice sent to my/our address last known to you or upon receipt of my/our written revocation through the BO. My/Our Name s My/Our Contact Tel/Fax/Mobile Tel My/Our Account No My/Our Company Stamp/Signature s /Thumbprint s As in Bank/Finance Company s records Note For thumbprints please go to branch with your identification* Part 2 For Billing Organisation s Completion Bank BO s Account No 7 1 7 1 0 7 4 0 7 4 0 0 1 2 8 3 3 Account No to be debited Part 3 For Bank / Finance Company s Completion To The Manager Maybank Kim Eng Securities Pte.