Transfer Form

FUNDS TRANSFER AND INTERNATIONAL REMITTANCE.

NatWest

FREEPOST NAT 12685 BOREHAMWOOD- WD6-IBR LONDON - UNITED KINGDOM:

(INTERNATIONAL REMITTANCE DEPARTMENT)

APPLICATION FOR TRANSFER OF FUND

Applicant’s First Name:.................................................................................................................................................... Surname:........................................................................................................................................................................... Nationality:........................................................................................................................................................................ Occupation................................................................................................................................................................... Contact Address:................................................................................................................................................................ Telephone:.......................................................................................................................................................................... Beneficiary’s Bank Details:................................................................................................................................................ ............................................................................................................................................................................................ ............................................................................................................................................................................................ Account Number:............................................................................................................................................................... Swift Code:.......................................................................................................................................................................... Aba No. (If any):........................................................................................................................................................................ Details of Payment:.............................................................................................................................................................. Choose Currency: US Dollars or Others. Specify Currency:........................................................................................... Applicants are liable for any false declaration or statement made in respect of this application form and wrong payment if made based on the information herein. APPLICANT’S DECLARATION. I the undersigned hereby apply for the payment of $.......................... being my entitlement sum deposit with your bank. I declare that the information given in this application is correct to the best of my knowledge and believe.

Signature:_______________________________

Date:___________________

FOR BANK USE ONLY All Documents Verified:......................................... Date:...................... Reference obtained/verified:.................................. Date:....................... General remarks by verifying:............................... Payment of opening account fee:........................... Signature:..........................Remarks:................................Date:............................. Copy Foreign Operations Department:.................................................................

CERTIFIED TRUE COPY