PDF《71A》

境外汇款申请书申报号码电汇 票汇 信汇 发电等级 普通 加急 日期收电行/付款行汇款币种及金额金额大写其中现汇金额 账号 购汇金额 账号 其他金额 账号 汇款人名称及地址 对公 组织机构代码 对私 个人身份证件号码 中国居民个人 中国非居民个人 收款银行之代理行 名称及地址 收款人开户银行名称及地址收款人开户银行在其代理行账号 收款人名称及地址 收款人账号 汇款附言只限140个字位 国内外费用承担汇款人 收款人 共同 收款人常驻国家(地区)名称及代码 请选择: 预付货款 货到付款 退款 其他 最迟装运日期 交易编码 相应币种及金额 交易附言是否为进口核查项下付款是否发票号外汇局批件/登记表号报关单经营单位代码报关单号 报关单币种及总金额 本次核注金额 银行专用栏申请人签章银行签章购汇汇率请按照贵行背页所列条款代办以上汇款并进行申报 等值人民币手续费电报费合计支付费用方式 现金 支票 账户 申请人姓名 电话 核准人签字 日期 核印经办复核填写前请仔细阅读各联背面条款及填报说明报关单号 报关单币种及总金额 本次核注金额 Currency &

Interbank Settlement Amount Receiver/Drawn on T/T D/D M/T Priority Normal Urgent Date Amount in Words BOP Reporting No.

Amount in FX Amount of Purchase Amount of Others Remitter'

s Name &

Address Unit Code Correspondent of Beneficiary s Bank Name &

Address Bene s Bank A/C No Beneficiary s Bank Name &

Address '

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Beneficiary s Name &

Address Remittance Information Not Exceeding

140 Characters Bene s A/C No Advance Payment BOP Transac. Code Resident Country/Region Name &

Code Payment Against Delivery Refund Others All Bank s Charges If Any Are To Be Borne By OUR BEN SHA Transac. Remark Currency &

Amount Applicant s Signature Please Effect The Upwards Remittance , Subject To The Conditions Overleaf : For Bank Use Only Rate @ RMB Equivalent Commission Cable Charges Total Charges In Payment of the Remittance by Cash by Check from Account Maker Please read the conditions and instructions overleaf before filling in this application. Date Checker Authorized Person Sig. Ver. Name of Applicant Phone No Bank s Signature '

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. Account No./Credit Card No. Account No./Credit Card No. Account No./Credit Card No Individual ID NO Resident Individual . . Non ˉ Resident Individual '

, . APPLICATION FOR FUNDS TRANSFERS (OVERSEAS) 银行业务编号Bank Transac. Ref.No.

20 A

32 50a A 54/56a 57a 59a

70 71 第一联银行留存联合同号致:中国光大银行 TO: CHINA EVERBRIGHT BANK 一)汇款人应小心审阅本申请书所列之各项条款内容,将收款人详细资料正确填写在有关栏目内,如因填写错误或字迹不清 而引起迟付或错付款,中国光大银行(以下简称 本行 )概不负责. 二)倘因下列情况而引致之任何损失,包括:款项交付或通知延误;

书函、电报或其它文件在寄发或传送途中遗失、残缺、错误、 遗漏、中断或延误;

战争、检查、封锁、政变或骚乱;

本地或外国政府或其他行政机构所施行之一切法律、规定、条例、管制、制 裁及其它难以控制之事故,本行概不负责. 三)本行有权选择委托解付汇款的代理行或同业银行,不受汇款人的指定限制,对于委托解付汇款的代理行或银行同业之一切 错误,疏忽或过失,本行概不负责,但本行将会负责跟进. 四)汇款人应注意代理行可能收取不同之费用,所需费用,由收款人支付.如由汇款人负担,须事先向本行特别申明.另外,本 行有权要求汇款人支付所有因汇款而引起之一切费用. 五)如有要求修改汇款内容或退汇,汇款人须携带有效证件或证明文件到本行办理.要求退款者,需本行接到有关银行同业证 实汇款已取消后方能办理退汇手续,所有因此而引起之费用,概由汇款人承担. 六)为了防止汇款人资金因某些国家的制裁政策被冻结,本行将对涉及国外制裁名单的汇款业务采取特殊处理方式,如果因此 对汇款造成延误,本行不承担责任. 七)请保存好客户收据以备日后查询. 注意事项ATTENTIONS 1. ALL PAYMENT INSTRUCTIONS SHOULD BE CHECKED CAREFULLY BY THE REMITTER IN EACH CASE AND FILL ALL THE DETAILED INFORMATION OF THE BENEFICIARY IN EACH PROPER BLANK SPACE. CHINA EVERBRIGHT BANK (HEREAFTER CALLED THE BANK)SHALL NOT BE LIABLE FOR ALL DELAYED PAYMENT OR INCORRECT PAYMENT CAUSED BY THE WRONG INSTRUCTION GIVEN OR UNCLEAR WRITING. 2. THE BANK SHALL NOT BE LIABLED FOR ANY LOSS OR DAMAGE DUE TO DELAY IN PAYMENT OR IN GIV- ING ADVICE OF PAYMENT LOSS OF ITEMS IN TRANSIT OR OTHERWISE,MUTILATION,ERROR,OMISSION, INTERRUPTION OR DELAY IN TRANSMISSION OR DELIVERY OF ANY ITEM,LETTER,TELEGRAM OR CA- BLE,OR DECLARED OF UNDECLARED WAR,CENSORSHIP,BLOCKADE,INSURRECTION,CIVLL COMMOTION, OR ANY LAW DECREE,REGULATION,CONTROL,RESTRICTION,SANCTION OR OTHER ACT OF DOMESTIC OR OF FOREIGN GOVERNMENT OR OTHER GROUP OR GROUPS EXERCISING GOVERNMENTAL POWERS, WHETHER DE JURE OR DEFACTO,OR ANY ACT OR EVENT BEYOND OUR CONTROL. 3. THE BANK HAS ITS OWN DISCRETION TO SELECT THE CORRESPONDENTS SUB-AGENTS OR OTHER AGENTS TO EFFECT THE PAYMENT AND IS NOT TO BE LIABLED FOR ERRORS,NEGLECTS,OR DEFAULTS OF ANY CORRESPONDENTS,SUB-AGENTS,OR OTHER AGENTS,BUT THE BANK IS TO BE LIABLED TO FOLLOW UP THE CASE. 4. REMITTER SHOULD NOTE THAT CHARGES MAY BE LEVIED BY THE BANK'