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上海商业储蓄银行国际金融业务分行 THESHANGHAICOMMERCIAL&

SAVINGSBANK,LTD.OBUBRANCH 外汇活期存款取款凭条暨汇出汇款申请书 CURRENTACCOUNTWITHDRAWSLIPANDAPPLICATIONFOROUTWARDREMITTANCE DR借2317外汇活期存款 ,,

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日期Date: , 02-28-23 ,,

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兹声明本户并非境内个人、法人或政府机关,敬请惠依下列指示汇款,并自下述帐户支取扣款金额以缴付本笔汇款及费用.1) I/WedeclarethatI/Weam/arenotalocalindividual,corporatebodyorgovernmentinstitution.Inpaymentoftheremittanceandchargesbelow,youareauthorizedtodebitmy/ourA/CNo.2710800-借 , 方 , 扣款金额(币别/大写): ,,

ERROR 传 , debitamount(incharacters)票 , Bank'

sCopy , (金额:币别/小写)(infigures) ,,

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申请人同意顾客留存之汇出汇款约定书(编号OR201903) (本金额,授权贵行自上开帐户支取) (servicechargesincluded/excluded) ,,

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存户/申请人签章Signature(s)/Chop(s)ofApplicant ,,

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, ,,

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请签盖扣款帐户留存印鉴 汇款人 NameinEnglish ,,

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汇出编号Reference , ASOUOR ,,

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1 ,,

地址:Address ,,

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汇款方式RemittanceMethod ,,

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电话:Tel 收款人:Beneficiary ,,

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汇率@ExchangeRate ,,

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, 地址:Address ,,

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手续费ServiceCharges ,,

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电话:Tel ,,

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汇款金额RemittanceAmount 帐号A/CNo. ,,

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代理银行费用将在汇款内扣除Correspondent'

schargeswillbedeductedfromtheamountremitted ,,

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, 收款银行 A/Cwith Bank ,,

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汇款性质NatureofRemittance(1)进口货款ImportProceeds ,,

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, 银行代号Bankcode ,,

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(2)其他Others: ,,

(如有需要请於此输入资料) ,,

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, 地址Address ,,

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银行签章ForBankUseOnly验印经办覆核主管 ,,

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, 备注Remarks 依式鹑谝滴裉趵娑:境内个人、法人、政府机关於OBU之外汇存款,不得办理汇款与提领外币现金之规定,本户已同意遵守.I/WeagreetocomplywiththeOffshoreBankingActstipulatingthatlocalindividual,corporatebodyandgovernmentinstitutionareprohibitedfromremittingorwithdrawingforeigncurrenciesfromtheirOBUaccounts.版本:01-OURE-501-3-003 请沿线裁剪) ,,

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上海商业储蓄银行国际金融业务分行 THESHANGHAICOMMERCIAL&

SAVINGSBANK,LTD.OBUBRANCH 汇出汇款暨收取手续费证明书 CERTIFICATEOFOUTWARDREMITTANCEANDSERVICECHARGES ,,

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日期Date: , 02-28-23 ,,

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2) 本笔汇款业已受理,手续费并已自下述帐号扣取Theapplicationforoutwardremittancehasbeenacceptedand 顾客留存 , theservicechargeshasbeendeductedfromyourA/CNo.2710800- , ERROR Customer'

sCopy 汇款人:NameinEnglish , ,,

, 汇出编号Reference , ASOUOR ,,

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地址:Address , ,,

, 汇款方式RemittanceMethod ,,

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,

电话:Tel 收款人:Beneficiary , ,,

, 汇率@ExchangeRate ,,

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地址:Address , ,,

, 手续费ServiceCharges ,,

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电话:Tel , ,,

, 汇款金额RemittanceAmount ,,

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帐号A/CNo.代理银行费用将在汇款内扣除Correspondent'

schargeswillbedeductedfromtheamountremitted ,,

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收款银行 A/Cwith Bank , ,,

, 汇款性质NatureofRemittance(1)进口货款ImportProceeds ,,

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银行代号Bankcode 2)其他Others: ,,

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地址Address , ,,

, 银行签章ForBankUseOnly验印经办覆核主管 ,,

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备注Remarks 依式鹑谝滴裉趵娑:境内个人、法人、政府机关於OBU之外汇存款,不得办理汇款与提领外币现金之规定,本户已同意遵守.I/WeagreetocomplywiththeOffshoreBankingActstipulatingthatlocalindividual,corporatebodyandgovernmentinstitutionareprohibitedfromremittingorwithdrawingforeigncurrenciesfromtheirOBUaccounts.版本:01-OURE-501-3-003 ,,

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