Application for foreign Money Transfer(UPDATED FROM 1ST APRIL 2015)

APPLICATION FOR FOREIGN TRANSFER (SWIFT) Date DD/MM/YYYY
Branch Mobile No.
Kindly e ect the following payments on my/ our behalf as follows
ORDERING CUSTOMER DETAILS
Account Title
Debit Account Number
Kindly advice Account No. to be Debited with Bank Charges
(If di erent firm Debit Account No.)
P.O.Box
Physical Address
TRANSFER INSTRUCTIONS

Currency & Amount Name
Amount in words P.O.Box
32A Value Date Country
56A Intermediary Bank SWIFT Code/ Chip ID/ Australia BSB Code/USA Fed Wire/ USA
(Optional) ABA/ UK Sort Code

57A Beneficiary’s Bank Name
P.O.Box
59 Beneficiary Country
SWIFT Code/ Chip ID/ Australia BSB Code/USA Fed Wire/ USA
ABA/ UK Sort Code

Name Mobile No.
P.O.Box
Physical Address

Country Account No./ IBAN

70 Remittance Information

71 (BEN) All local and overseas charges borne by beneficiary
(SHA) Local charges borne by the remitter and overseas charges by the beneficiary
(OUR) All local and overseas charges borne by remitter

72 Bank to Bank Information

It is understood that The Bank is not held liable either for loss or damage which may arise from any irregularity, delay or omission of the message or from the misinterpretation when received.

1. Name Signature Mobile

2. Name Signature Mobile

3. Name Signature Mobile

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CBA is regulated by the Central Bank of Kenya