Suite 3, 35A Carrington Road, Box Hill VIC 3128
Tel: +61 3 90412580 Email: info@ageforex.com.au
Date (日期):
Payee Full Name(收款人姓名)*
Date of Birth(生日)*
Address / Post address(家庭住址 / 邮寄地址)*
Email (电子邮箱)*
Mobile(手机号)*
Home Phone(住宅电话)*
2 Identification Documents(需提供 2 个身份证件)* Passport with signature / ID Card / Driver License 护照 (需要有签字页) / 身份证 / 驾照
护照照片 *
须是清晰彩色原件电子版本。可以是扫描件或数码拍摄照片,支持Jpg、Png、Jpeg的图片格式。
请上传证件1的照片附件!
手持本人护照自拍照 *
确保护照文字清晰(应为他拍角度,请勿镜面反拍);确保脸部无遮挡,露出肩膀和手臂!
Occupation(职业 / 公司信息)*
Relationship with payer(与汇款人关系)*
Source of Fund(资金来源)*
BSB & Bank Account No (银行账户号)*
Bank name & Branch name(收款人银行全名,及分行名称)*
Swift Code(银行国际代码)*
Bank address (银行地址)*
Please understand that we are not responsible for any incorrect and uncompleted information provided, please double check and confirm your information are correct before sign this form. Please note that your signature stands for the acknowledgement and agreement to the term of this transaction.
请注意: 请您签字之前再次确认所填写信息的正确性,我们将不负责由于您所填写的个人信息或账户信息错误所造成的损失, 同时客户需要 支付因此错误造成的各种费用。 如果外币支付时产生多付或者重复付款,收款方必须退还多付的款额。
Signature 签名*