Cheque Request form

Date:
This is acknowledged that E-valy.com Limited has received the goods from the following shop.
Shop name:

Seller SME Corporate type:

Payment Details

Bill SL Number/s (Must)

Tracker Number: 005
Beneficiary A/C Name:
Beneficiary A/C Number:
Routing Number:
Branch Name:
Bank Name:
Amount:

Best Regards

______________________
BDM: Zahidul Kyum Shawon

KAM:

Mobile:

Approved by Checked By
Head of Commercial Head of Category

E-valy.com Limited