CLIENT INFORMATION SHEET

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• SHEET UNIONPAY QR
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RIYAS KAKKATTUMMAL
UNIONPAY SENDER INFORMATION:

Name : Riyas Kakkattumal

Address : Preah Sihanouk Blvd., Phnom Penh, Cambodia
Passport Number : N9661896
Passport issue Date : 03.08.2016
Passport Expired Date : 02.08.2026
Passport issue Place : INDIA

UNIONPAY BANK INFORMATION:

BANK NAME : ADVANCED BANK OF ASIA LIMITED

BANK ADDRESS : No. 148, Preah Sihanouk Blvd., Phnom Penh, Cambodia
ACCOUNT NAME : Kakkattummal Riyas
ACCOUNT NUMBER : 003600432
CIF NUMBER : 2051559
SWIFT CODE : ABAAKHPP

Declaration:
I hereby swear under penalty of perjury, that the information provided is both true and
accurate. I am the signatory on the aforementioned bank account. All monies engaged in
this transaction are derived from non- criminal origin; and, are good, clean and cleared.
The origin of funds is in compliance with Anti-Money- Laundering Policies as set forth by the
Financial Rules by the corresponding Country.

RIYAS KAKKATTUMMAL
 UNIONPAY QR CODE:

RIYAS KAKKATTUMMAL
 UNIONPAY CARD
COPY:

RIYAS KAKKATTUMMAL
 PASSPORT COPY:

RIYAS KAKKATTUMMAL