FUND TRANSFER APPLICATION (AvšÍtwnmve A_© ¯’vbvšÍi Av‡e`b/dvÛ Uªvbùvi Gwcø‡Kkb)

Date (ZvwiL):

Branch Manager (kvLv e¨ve¯’vcK) Account Number (wnmve bv¤^vi):

City Bank PLC. (wmwU e¨vsK পিএলপি)
Branch (kvLv): ____________________ Account Title (wnmve/bvg):__________________________________________

Dear Sir/Madam (wcÖq g‡nv`q),

Kindly arrange to transfer (debit)

BDT/USD/GBP/EURO _________________________________
From my/our above mentioned account number and credit to below account:
(Avgvi/Avgv‡`i Dc‡iv³ wnmve ‡_‡K †WwWU K‡i wb‡¤§ ewY©Z wnmv‡e/wnmvemg~‡n †µwWU Kivi Rb¨ webxZ Aby‡iva KiwQ|)

Account Number:

Account Title: _____________________________________________________________________ And

BDT/USD/GBP/EURO ___________________________________
From my/our above mentioned account number and credit to below account:
(Avgvi/Avgv‡`i Dc‡iv³ wnmve ‡_‡K †WwWU K‡i wb‡¤§ ewY©Z wnmv‡e/wnmvemg~‡n †µwWU Kivi Rb¨ webxZ Aby‡iva KiwQ|)

Account Number:

Account Title: _____________________________________________________________________ And

BDT/USD/GBP/EURO ___________________________________
From my/our above mentioned account number and credit to below account:
(Avgvi/Avgv‡`i Dc‡iv³ wnmve ‡_‡K †WwWU K‡i wb‡¤§ ewY©Z wnmv‡e/wnmvemg~‡n †µwWU Kivi Rb¨ webxZ Aby‡iva KiwQ|)
Account Number:

Account Title: _____________________________________________________________________

“Space for Confirmation of Customer(s) Physical

Presence with Bank official sign & seal”

______________________ Signature Signature ________________________

Signature of 1st Applicant Verified By Verified By Signature of Joint Applicant
(cª_g Av‡e`bKvixi ¯^vv¶i) (hyM¥ Av‡e`bKvixi ¯^vv¶i)

FOR BANK USE ONLY Customer ID: C B

CHECK POINTS
Transaction ID No. __________________________
We the undersigned confirm that all the related document(s) are in order as per City Bank Ops Manual/SOP/related circulars and all
necessary approval(s) are taken.

Initiated By CS Official/CFP Recommended by BOM/Designated Approved by BM/Designated

(with seal & sign) Official (with seal & sign) Official (with seal & sign)