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BANK INFORMATION FORM
(WIRE TRANSFER FORM)
SIRCA Reference #________________
Part I: (To be completed by Account Holder)
Bank Account Name:If Bank Account Name is different from the Recipient Legal Name, please explain:Bank Name :Branch :
Street Address:Country:Account Currency :
Account #:Other instructions: Bank Routing # / ABA # / Transit # / Sort Codes / etc. if applicableBIC (SWIFT):The Bank Identifier code (BIC) is a unique address (8 or 11 characters) which identifies the financial institutions.IBAN #:The International Bank Account Number is a European Standard for identifying an account held by a financial institution.
I certify that the above information is complete and current.
Signature: ____________________________ Date: _____________ (dd/mm/yyyy)
Print Name and Title: ____________________________________________________________
____________________________________________________________________________________________________________
Part II (To be completed by Account Holders Bank specified above)
To: Nanyang Technological University
We hereby certify the signature suffixed in Part I above is/are consistent with our records and the particulars of the account are correct.
_______________________________ _________________________
Name of Bank & Official Stamp Authorised Signature & Date
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