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Subhida UK Ltd.

Registration No.: 06432399, FCA Registration No.: 576127

HMRC Registration No.: XYML00000119350

Registered Address : Pentax House South Hill Avenue, South Harrow, HA2 0DU, London

Tel: 02088660307, 07984713677

Email:info@imelondon.co.uk

https://imelondon.co.uk/

Remittance Receipt Customer Copy

SENDER INFORMATION
Sender Name		Membership ID
Address
Nationality		Occupation
Telephone No.
Date of birth		Visa Status

BENEFICIARY INFORMATION
Payout Country	Purpose
Beneficiary Name	Mode of Receipt
Telephone No.	Bank Name
Deposit Type:
Relation with Beneficiary	Branch Name	Address
	Account No.
	Correspondent
Payout Amount:

Reference NO:

Collect Amount

Service Charge

Transfer Amount

Exchange Rate

Payout Amount

Serial:

署名及び宣誓 Signature and Declaration
(1) I understood and agreed to the Terms and Conditions of JME published on the website. (2) I read and understood the Privacy Policy of JME published on the website. (3) I confirmed the information provided above is true and correct. (4) I declare that - This request has nothing to do with Democratic People`s Republic of Korea (DPRK) and Islamic Republic of Iran; - I have no relation to Anti-Social Forces; - I do not engage in any illegal activities. - This beneficiary is not Politically Exposed Person (PEPs).		(1) ウェブサイト上で公開されている当社の「海外送金規約」を理解し合意しています。 (2) ウェブサイト上で公開されている当社の「個人情報保護方針」を確認し理解しました。 (3) 上記の記載内容に相違がないことを確認しました。 (4) 更に、以下の点につき表明します。 - 本件依頼は朝鮮民主主義人民共和国及びイラン・イスラム共和国とは一切関わりがないこと。 - 私は反社会的勢力とは何ら関わりがないこと。 - 私は一切違法行為を行っていないこと。 - 本受取人は外国の政府等において重要な地位を占める者 (PEPs)ではありません

署名及び印鑑 Signature or Stamp	..................................................	Operator:()	..................................................

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Signature and Declaration
This is the digital copy generated from the IME London Remittance System hence no signature is required. Please do contact IME London for further information.
Signature or Stamp
Signature or Stamp

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Subhida UK Ltd.

Registration No.: 06432399, FCA Registration No.: 576127

HMRC Registration No.: XYML00000119350

Registered Address : Pentax House South Hill Avenue, South Harrow, HA2 0DU, London

Tel: 02088660307, 07984713677

Email:info@imelondon.co.uk

https://imelondon.co.uk/

Remittance Receipt Customer Copy

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SENDER INFORMATION
Sender Name		Membership ID
Address
Nationality		Occupation
Telephone No.
Date of birth		Visa Status

BENEFICIARY INFORMATION
Payout Country		Purpose
Beneficiary Name		Mode of Receipt
Telephone No.		Bank Name
Relation with Beneficiary		Branch Name
Deposit Type:
		Account No.
		Correspondent
Payout Amount:

Reference NO:

Collect Amount

Service Charge

Transfer Amount

Exchange Rate

Payout Amount

Serial:

This is the digital copy generated from the IME London Remittance System hence no signature is required. Please do contact IME London for further information.
Company Stamp		Operator:()	..................................................

-----------------------------------------------------------------Cut From Here-----------------------------------------------------------------

Subhida UK Ltd.

Remittance Receipt Customer Copy

SENDER INFORMATION

BENEFICIARY INFORMATION

Reference NO:

Subhida UK Ltd.

Remittance Receipt Customer Copy

SENDER INFORMATION

BENEFICIARY INFORMATION

Reference NO: