APPLICATION FOR FUNDS TRANSFERS(DOMESTIC)
日期 Date：2016-11-11
| 电汇T/T 票汇D/D 信汇M/T | 发电等级Priority： 普通Normal 加急Urgent |
| 申报号码 Report No. | |||
| 银行业务编号 Bank Transac.Ref.No 20 |
收电行/付款行 Receiver/Drawn on |
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| *汇款币种及金额 Currency & Interbank Settlement Amount 32A |
金额大写 Amount in Words |
人民币 壹佰壹拾元整 |
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| 其 中 |
现汇金额 Amount in FX | 账号 Account No./Credit Card No. | ||
| 购汇金额 Amount of Purchase | 账号 Account No./Credit Card No. | |||
| 其他金额 Amount of Others | 账号 Account No./Credit Card No. | |||
| * 汇款人名称及地址 Remitter's Name & Address 50a |
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| 对公 组织机构代码 Unit Code | 对私 | 个人身份证号码 Individual ID NO. |
| 中国居民个人 Resident Individual 中国非居民个人Non-Resident Individual | ||
54a/56a
收款银行之代理行名称及地址 Correspondent of Beneficiary’s Bank Name & Address |
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57a
* 收款人开户银行名称及地址Beneficiary's Bank Name & Address |
收款人开户银行在其代理行账号 Bene's Bank A/C No
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59a
* 收款人名称及地址Beneficiary's Name & Address |
*收款人账号 Bene's A/C No | ||
70
汇款附言Remittance Information |
只限140个字位 Not Exceeding 140 Characters |
71A
* 国内外费用承担All Bank's Charges If Any Are To Be Borne By 汇款人OUR 收款人BEN 共同SHA |
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| *收款人常驻国家（地区）名称及代码 Resident Country/Region Name & Code | |||||
| 请选择： 预付款 Advance Payment 货到付款 Payment Against Delivery 退款 Refund 其它 Others | 最迟装运日期 | ||||
| 交易编码 BOP Transac. Code | 相应币种及金额 Currency & Amount |
*交易附言 Transac.Remark |
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| 是否为进口核查项下付款 | 是 否 | 合同号 | 发票号 |
| 外汇局批件/登记表号 | 报关单经营单位代码 | ||||
| 报关单号 | 报关单币种及总金额 | 本次核注币种金额 | |||
| 报关单号 | 报关单币种及总金额 | 本次核注币种金额 | |||
| 银行专用栏 For Bank Use Only |
申请人签章 Applicant's Signature |
银行签章 Bank's Signature |
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| 购汇汇率 @ Rate |
请按照贵行背页所列条款办以上汇款并进行进口核查申报 Please Effect The Upwards Remittance , subject To The Conditions Overleaf
申请人姓名： Name of Applicant 电话 Phone No. |
核准人签字 Authorized Person 日期 date |
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| 等值人民币 RMB Equivalent |
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| 手续费 Commission |
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| 电报费 Cable Charges |
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| 合计 Total Charges |
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| 支付费用方式 In Payment of the Remittance |
现金 by Cash 支票 by Check 账户 from Account |
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| 核印 Sig. Ver. | 经办 Maker | 复核 Checker | |||