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  • RTGS Application Form - 2022

    Uploaded by

    Arina Zulkifli
    1K views3 pages
    This document is an RTGS (real-time gross settlement) application form for Shahjalal Islami Bank Ltd. It contains fields for the sender/applicant and receiver/beneficiary information needed to process an international funds transfer, including names, account numbers, currencies, amounts, and purposes. The terms and conditions state that the bank is authorized to process the RTGS transaction based on the provided details and debit applicable charges from the sender's account.

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    This document is an RTGS (real-time gross settlement) application form for Shahjalal Islami Bank Ltd. It contains fields for the sender/applicant and receiver/beneficiary information needed to process an international funds transfer, including names, account numbers, currencies, amounts, and purposes. The terms and conditions state that the bank is authorized to process the RTGS transaction based on the provided details and debit applicable charges from the sender's account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    1K views3 pages

    RTGS Application Form - 2022

    Uploaded by

    Arina Zulkifli
    This document is an RTGS (real-time gross settlement) application form for Shahjalal Islami Bank Ltd. It contains fields for the sender/applicant and receiver/beneficiary information needed to process an international funds transfer, including names, account numbers, currencies, amounts, and purposes. The terms and conditions state that the bank is authorized to process the RTGS transaction based on the provided details and debit applicable charges from the sender's account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 3

    SHAHJALAL ISLAMI BANK LTD

    RTGS Application Form


    Originating Branch Name Date
    Sender/Applicant Information
    Account holder's Name

    Account Number

    Mode of Currency NBDT tr USD trEUR NGBP NCAD NJPY


    Amount in Figure

    Amount in Words

    Purpose of Fund Transfer

    Sender Address &


    Contact no

    Receiver/Benefi ciary Information


    Receiver Name

    Receiver A/C Number

    Receiver A/C Type I Currcnt AIC .- Savir.rgs A/C - Investment A/C a FC A/C
    Receiving Bank

    Receiving Bank's Branch

    Routing Number

    Payment Detaits
    IAVo hcreby agrce that this Translbr is madc to the conditions printed on the reverse herein. In payment, pleasc Debit my/our Account
    Nr,ulber below:
    Sendcr Accourrt Nunrber

    \
    Signature of the Applicant Signature of the Applicant ilffi;;;;;;;.,
    For Bank's Use Only
    Transt-er Ar.nount Commission Amount VAT Amount Total Amount

    ;;;;;; ;;;;,;i;. .,*,,.",,. ;;;;;; ;;;,; ;;*;;;;;.

    Customer Acknowledgement Receipt


    (Shahialal Islarni Bank Ltd)
    Originating Branch Name Date
    Mode olCulrenoy ,IBDT f USD .EUR GBP I,CAD JPY
    Receiver Name
    Receiver A"/C Number
    Receiviug Bank & Branch Name
    Atrount in Figure
    Arnount in Words
    Originator's Nanre

    Branch Offi cial's Signatr.rre Branch Official's Signature


    Terms and Conditions

    1. I/we agree that the RTGS will be generated based on my/our information provided in the form.
    2. IIW e hereby authorizecl Shahjalal Islami Bank Ltd to cany out the RTGS transactions as per the details rnentioned overleafl
    3. I/We understand RTGS request is subject to Bangladesh Bank regulations and guidelines governing the same.

    4. I/We autliorized the Bank to debit my/oul accolrnt number for the charges as applicable.
    5. I/We hereby agree that aloresaid details including the RoLrting Number and beneficiary acconnt nurnber are correct. I/We further
    acknowledge that Shahjalal lslan.ri Bank Ltd accepts no liability for any consequence arising out oferroneous details plovided by rne/us.

    Signature of the Applicant


    (Seal in case of Company or Firm)

    'I'erms and Conditions


    l. I/we agree that the RTGS will be generated based on rny/our information provided in the fbrnr.

    2.IlWe hereby authorized Shahjalal Islarni Bank Ltd to carry out the RTGS transactions as per the details rnentioned overleat-.

    3. I/We understand RTGS request is subject to Banglaclesh Bank regulations and guidelines governing the samc.
    4. I/We authorized the Bank to debit my/or.rl account number for the charges as applicable.
    5. I/We hereby agree that aforesaid details inclLrding the Routing Number and beneficiary account number are correct. I/We further
    acknowledge ttrat Shahjatal Islarri Bank Ltd accepts no liability for any consequence arising out oferroneous details provided by mc/us.
    Date:

    The Head of Branch


    Shahjalal lslami Bank Ltd
    Mohakhali Branch
    Dhaka

    Subject: Fund Transfer Amount in BDT Tk...


    {Tk. lnward r{...,.....,,.........,,..... .,.)only

    Partlculars Debit Accou nt lnformatlon Cred it Account lnformation

    Account Name:

    Account Number:

    Your cooperation would be highly appreciated.


    Thanking You,

    Account l-Ioldel Signatu re

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