Remittance Application Form ‫اس فارم یک کاپی ا ردو‬

Effective from: Dhu al-Qidah 1444 / June 2023 ‫ب ےہ ی۔‬‫میی بیھ دستیا ی‬

Date: __________________________ Branch Name and Code: ____________________________________________________________

Note: (i) Please fill the form in BLOCK letters (ii) Customer’s Signature may include his/her signature, thumb impression, or company stamp (as
applicable). All accountholders must sign in case of Joint Operating Instructions. (iii) Charges applicable as per Bank’s latest Schedule of Charges.

Please process my/our remittance request as per the details given below:

REMITTANCE DETAILS
 Payment Order (PO)  RTGS (PRISM)  Foreign Remittance / Foreign Telegraphic Transfer (FTT)
Mode of Transaction:
 Foreign Demand Draft (FDD)  Other _________________________________________
Remitting Currency:  PKR  USD  GBP  EUR  AED  CAD  JPY  AUD  Other ____________
Amount (in figure):
Amount (in words):
 Education  Family support – living abroad  Medical treatment
Purpose of Remittance:
 Other (please specify) ______________________________________________________

BENEFICIARY DETAILS (address is mandatory for Foreign Remittance/FTT)

Name: _____________________________________________________________________________ Contact Number: ____________________
Address: _________________________________________________________ City: ____________________ Country: ____________________
Individual: ID Number (CNIC/Passport/etc.): ________________________________________________________________________________
Company: NTN/Registration Number/etc.: __________________________________________________________________________________
Additional Beneficiary Details (as applicable for RTGS and Foreign Remittance/FTT only):
Account Number/IBAN: __________________________________________________________________________________________________
Bank Name and Address: ___________________________________________ City: _______________________ Country: __________________
SWIFT Code: _________________ SORT (UK) | BSB (AUS) | Fedwire/Chips ID/UID (USA) | Transit/Institution ID (CA): __________________
Nationality: ______________________ Date of Birth: _________________ Relationship with Beneficiary: ________________________________
Intermediary Bank (optional):
Bank Name and Address: ___________________________________________ City: _______________________ Country: __________________
SWIFT Code: _________________ SORT (UK) | BSB (AUS) | Fedwire/Chips ID/UID (USA) | Transit/Institution ID (CA): __________________

APPLICANT DETAILS
Account Title: _______________________________________________________________________________ Currency: __________________
Account Number (14 Digits): Cheque Number: _________________ Dated: __________________

DECLARATION
I/We hereby declare that the information provided above is correct and verifiable with all risks
and responsibilities on my/our part. I/We hereby authorize you to debit my/our account for the
transaction amount including any applicable charges for the execution of this request and I/we Customer
also confirm having read, understood and accepted the Terms and Conditions printed overleaf. Signature:

AUTHORITY TO THIRD PARTY TO COLLECT (PO & FDD only)

I/We authorize ________________________________________________________________

having ID# (CNIC, etc.) ___________________________________ to collect above PO/FDD on
my/our behalf. Authorized Customer
Person Signature: Signature:

ACKNOWLEDGEMENT
• I/We acknowledge receipt of above PO/FDD# _________________ on date _____________.
OR
Customer/
• I/We accept above Foreign Remittance/FTT on exchange rate __________. Receiver’s Signature:

FOR BANK USE ONLY Processed by: Authorized by:

We confirm processing instrument/transaction no. _____________________________ after
verifying Customer’s Account No., Signature and recovered charges as per SOC.

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 Terms & Conditions Applicable on Remittance Processing Service Provided by Meezan Bank Limited

By requesting Remittance/Transfer of Funds, the applicant agrees that such transactions shall be subject to following terms
and conditions:
1. This funds transfer/remittance is for legitimate personal or business purpose and is not related to money laundering or any illegal
activity.
2. Meezan Bank Limited (the “Bank”) may take its customary steps for issuance of drafts or for remittance according to this application
and in doing so, the Bank shall be free on behalf of the Applicant to make use of any correspondent, sub-agent, or other agency.
3. Where any funds received from the Applicant are to be converted into any foreign currency for transfer, the Bank shall convert the
funds received from the Applicant at Bank's selling rate on the day of conversion.
4. The Bank will use reasonable endeavors to process application received by it during banking hours and on the same day. It should also
be noted that due to cut-off timings for transmission imposed by international convention, this payment may not be affected on the date
of request and the Bank shall not be liable for any loss as a result of delays in transmission or payment by its agents, employees,
correspondents, or third parties.
5. The Bank shall take reasonable measures to protect Applicant’s provided instructions and/or information and shall not, at any time,
share, sell, or release Applicant’s provided instructions and/or information in favor of any third party except with the
drawee/correspondent bank to meet their due diligence inquiries. The Applicant also undertakes to provide and authorizes the Bank to
share any additional information of the Applicant and/or the Beneficiary as requested by the competent authorities in any country or
by an international organization.
6. Cancellation/Refund of any Remittance/Instrument (the “Cancellation/Refund”) shall be subject to Bank’s discretion and the fact that
the Bank is in possession of such funds. For Cancellation/Refund transaction(s), the current prevailing exchange rate shall be applied.
Such rate would be subject to the Cancellation/Refund transaction request being received before or after Bank’s daily cut-off time.
7. All Remittances and Cancellation/Refunds, in any currency, are subject to applicable charges/fees/taxes/duties (the “Charges”) applied
by correspondent(s), sub-agent(s), any other agency(ies), and/or as per Bank's Schedule of Charges (available in Bank’s Branches and
at www.meezanbank.com), and/or Charges imposed by any court, law enforcement agency, tax authority, or other Governmental
authority. These Charges may be revised/amended from time to time and shall be directly debited by the Bank from Applicant's
Account(s) without requiring any further consent/prior intimation to the Applicant.
8. Correspondent fees charged by Applicant’s and Beneficiary’s respective bank correspondent(s) shall be shared by both (i.e., Applicant
and Beneficiary) unless any specific instructions have been conveyed by the Applicant at the time of submitting this application form.
Acceptance of such instructions if so, given by the Applicant, shall be subject to Bank’s discretion and/or any particular arrangements
with its correspondent(s) in this regard.
9. If the Remittance Instrument, i.e. PO, DD/FDD, etc. (the “Instrument”) is lost, stolen or destroyed, the Bank shall be provided with a
bond/indemnity on bond paper as per Bank’s prescribed format, protecting the Bank against any liability whatsoever with respect to
the lost, stolen or destroyed Instrument and any other document as required by the Bank, in connection with any request that may be
made for refund or duplicate issuance of the Instrument.
10. The Bank shall not be held liable in case the proceeds of any remittance/PO/FDD/FTT/RTGS, etc. be confiscated/questioned by the
authorities in Pakistan/Beneficiary’s country, or the proceeds are delayed/lost during transit under circumstances beyond the
reasonable control of the Bank.
11. The Customer shall surrender the original Instrument(s) and provide a written request on Bank’s prescribed form for
Cancellation/Refund of the issued Instrument(s). Furthermore, no objection certificate (the “Lawful Discharge”) would be required in
case the beneficiary is other than an Individual. Cancellation/Refund of duplicate Instrument(s) shall require Lawful Discharge from all
type of beneficiaries (including an Individual).
12. In case, the issued Instrument is lost, the Customer shall furnish a copy of the FIR/ Police Report (Roznamcha), Lawful Discharge, and
a written request on Bank’s prescribed form for Cancellation/Refund of the lost Instrument(s).
13. In addition to this Application Form, the Applicant is obligated to execute all other related documents and also to provide all necessary
supporting documents as and when required by the Bank.
14. The performance of this contract mentioned herein by the Bank is conditional to all prevailing laws, rules, regulations, by-laws, decrees,
orders, guidelines, and circulars of Government of Pakistan/Beneficiary’s country, State Bank of Pakistan (the “SBP”), other Competent
Authorities, the Bank and its Resident Shariah Board Member/Shariah Board now or hereinafter affecting the same and any events
beyond the control of the Bank including but not limited to war, political disturbance, civil disorder, expropriation, etc. If, for any of the
aforementioned reasons, any Applicant/Beneficiary/counter-party suffers any loss or damage or incurs any cost or expense, the Bank
shall not be responsible for the same.
15. Issued Instrument is valid for six (06) months from the date of issuance after which, revalidation is required from the issuing branch of
the Bank.
16. Remittance/Instrument remaining outstanding for a period of ten (10) years shall be considered as unclaimed deposit and
would be surrendered to the SBP as per the provisions of Banking Companies Ordinance, 1962.
17. Timely execution of this contract is subject to its compliance with SBP’s Anti-Money Laundering, Combating Financing of Terrorism &
Countering Proliferation Financing (AML/CFT/CPF) Regulations and prevailing laws, rules, regulations, by-laws, decrees, orders,
guidelines, and circulars of Government of Pakistan/Beneficiary’s country, SBP, and other Competent Authorities.
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