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<asp:Content ID="Content1" ContentPlaceHolderID="MainContent" runat="server"> <div class="detailInfo"> <div class="page-wrapper"> <table class="tg table-borderless" runat="server"> <tr> <td colspan="6" style="text-align: center; font-weight: bold; font-size: 20px;">Japan Money Express Co. Ltd</td> </tr> <tr> <td class="tg-7btt" colspan="6" style="text-align: center">Remittance Request</td> </tr> <tr> <td colspan="6"> </td> </tr> <tr> <td class="tg-7btt" colspan="6">Customer Information</td> </tr> <tr> <td colspan="4" class="tg-fymr"></td> <td style="white-space: nowrap" class="tg-fymr">Customer Id Number :</td> <td class="tg-0pky" runat="server" id="idNumber"></td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Customer Full Name:</td> <td colspan="5" class="tg-0pky" runat="server" id="custFullName"></td>
</tr> <tr> <td class="tg-7btt" colspan="6">Receiver Information</td> </tr> <tr> <td class="tg-fymr">Receiver Fullname:</td> <td class="tg-0pky" runat="server" id="recFullName" colspan="5"></td> </tr> <tr> <td class="tg-fymr">Address :</td> <td colspan="2" class="tg-0pky" runat="server" id="recAddress"></td> <td class="tg-fymr">Mobile:</td> <td colspan="3" class="tg-0pky" runat="server" id="recMobile"></td> </tr> <tr> <td class="tg-7btt" colspan="6">Transaction Information</td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Payout Country:</td> <td colspan="2" class="tg-0pky" runat="server" id="pCountry"></td> <td class="tg-fymr">Payment Mode :</td> <td colspan="2" class="tg-0pky" runat="server" id="pmode"></td> </tr> <tr> <td class="tg-fymr">Agent/Bank:</td> <td style="white-space: nowrap" colspan="2" class="tg-0pky" runat="server" id="pAgent"></td> <td class="tg-fymr">Agent/Bank Branch:</td> <td colspan="2" class="tg-0pky" runat="server" id="pBranch"></td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Bank AccountNo:</td> <td colspan="2" class="tg-0pky" runat="server" id="accountNo"></td> <td class="tg-fymr">Collect Amount:</td> <td colspan="2" class="tg-0pky" runat="server" id="cAmt"></td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Transfer Amount:</td> <td colspan="2" class="tg-0pky" runat="server" id="tAmt"></td> <td class="tg-fymr">Service Charge:</td> <td colspan="2" class="tg-0pky" runat="server" id="serviceCharge"></td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Purpose Of Remittance:</td> <td colspan="2" class="tg-0pky" runat="server" id="purpose"></td> <td class="tg-fymr">Other Purpose:</td> <td colspan="2" class="tg-0pky" runat="server" id="otherPurpose"></td> </tr> <tr> <td style="white-space: nowrap" class="tg-fymr">Relation:</td> <td colspan="2" class="tg-0pky" runat="server" id="relationship"></td> <td class="tg-fymr">Other Relation</td> <td colspan="2" class="tg-0pky" runat="server" id="otherRelation"></td> </tr>
<tr> <td class="tg-7btt" colspan="6"> <small class="custom-control-label" style="float: left; text-align: left;">外国送金依頼書」 私は、本依頼書に記載されているジャパンマネーエクスプレス株式会社の「海外送金利用規約」の内容に同意します。 私の依頼する送金は、北朝鮮及びイランとは関係無い取引であり、反社会勢力と一切の関りはありません。 私は「外内国の重要な公的な地位にある者」ではありません。 また申込書に表示された内容について間違いが無い事を確認した上で、JME送金サービスの利用を依頼します。 <br />
「Application for Remittance」 I understand and agree to the ”Terms and Conditions for Overseas Remittance” of Japan Money Express Co., Ltd. (JME). I confirm that this remittance has nothing to do with North Korea nor Iran、and have no relation to any Anti-Social Forces nor engagement in any illegal activities. I am not Politically Exposed Persons(PEPs). I confirm the information shown in this application to avail the remittance service is true and correct.
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