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TT Application Form

This document is an application form for a wire transfer by AIA International Limited, requiring the insured to provide personal and banking information. The signer accepts full responsibility for any errors or omissions related to the transaction and agrees to indemnify AIA against any claims. Additionally, the signer acknowledges that all bank charges will be deducted from the transaction amount.

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Yu Hong Lin
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65 views1 page

TT Application Form

This document is an application form for a wire transfer by AIA International Limited, requiring the insured to provide personal and banking information. The signer accepts full responsibility for any errors or omissions related to the transaction and agrees to indemnify AIA against any claims. Additionally, the signer acknowledges that all bank charges will be deducted from the transaction amount.

Uploaded by

Yu Hong Lin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AIA International Limited

(Incorporated in Bermuda with limited liability)


友邦保險(國際)有限公司

Policy Number Agent code/ TR’s


Membership No.
保單號碼 營業員/業務代表會員號碼

Name of Insured Agent/TR’s Name


受保人姓名 營業員/業務代表姓名

HK I.D. Card/Passport
Number Agent/TR’s Tel. No.
營業員/業務代表聯絡電話
香港身分證/護照號碼
Transaction Currency &
Amount Area Code/Broker Code
區域組別/經紀號碼
匯款貨幣及銀碼

Account Number Agency/Broker Name


收款人賬號 營業員組別/經紀名稱

Account holder name


收款人姓名

Address & Telephone of


Payee ( )
收款人地址/電話

Bank Name Bank Swift Code


銀行名稱 環球銀行財務電信代碼

Bank Branch/Address
銀行分行/地址
Enclosed with copy of the front page of the bank passbook or bank statement for reference.
連銀行存摺首頁副本或月結單副本附上，以作資料記錄。
*TR=Technical Representatives

APPLICATION FOR TRANSFER OF MONEY BY WIRE TRANSFER


In consideration of your agreement to accept my instruction to AIA International Limited (herein called “AIA”) to transfer money by
wire transfer to the above bank account, (herein called “The Transaction”), I, the undersigned, hereby undertake to accept full
responsibility for any errors or omissions resulting from the Transaction and to hold AIA harmless and indemnified against all
actions, proceedings, claims and demands whatsoever which may hereafter be brought against AIA arising out of or in connection
with the Transaction and from all costs and expenses of whatsoever kind in connection therewith.
For the avoidance of doubt, I hereby acknowledge and agree to bear all risks of loss and that AIA will not be liable in any way
should there be any errors made and irrespective of whether the above money transfer is successful or not.
Besides, I agree that all bank charges in this connection will be deducted from the Transaction.

電匯付款申請表
鑒於友邦保險(國際)有限公司(以下簡稱”AIA”)已同意應我方要求將款項電匯至以上銀行賬號，(以下簡稱”電匯”)，我方作為此書
之簽署人，將會承擔由此電匯所產生的任何錯誤與遺漏所造成的責任，並賠償一切由此產生或與此相關而對 AIA 不利的行為、訴訟、
索賠以及要求所發生的成本與費用。

為避免疑慮,我方聲明並同意承擔一切損失、風險，不論上述轉賬成功與否，如若發生任何過失，AIA 無需承擔任何責任。特此說明。

同時， 我方亦同意有關之銀行費用從此電匯中扣除。

_______________________________________ on ________________________________
Signature of Owner 持有人簽名 MM 月/DD 日/YYYY 年

Name of Owner 持有人姓名 ____________________________

_______________________________________ on ______________________________
Signature of Witness/見證人簽名 MM 月/DD 日/YYYY 年

Name of Witness/見證人姓名 ____________________________ (English/Chinese name in Full 英文/中文全名)

Version.TT062017

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