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Name or tittle under which the account has been opened and not the name of the authorized agent CONTACT TELEPHONE FAX E - MAIL BANK BANK NAME BRANCH ADDRESS TOWN/CITY POSTCODE COUNTRY ACCOUNT NUMBER IBAN (2) (2) If the IBAN Code (International Bank accout number) is applied in the country where your bank is situated REMARKS : BANK STAMP + SIGNATURE OF BANK REPRESENTATIVE DATE + SIGNATURE OF ACCOUNT HOLDER : (Both obligatory)(3) (Obligatory) (3) It is preferable to attach a copy of r.

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