オーダーフォーム / ORDER FORM
会員番号/Customer ID.
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氏名/Name *
Your answer
電話番号/mobile *
Your answer
送金額/Amount *
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入金情報/Payment info *
送金初回ですか?/Is remittance first time? *
送金受取人/Beneficiary *
※( Full Name )
Your answer
送金人との関係/Relationship *
送金理由/Purpose Of Remittance *
送金資金/Source Of Funds *
送金方法/Method Of Transfer *
Account Name
※Please do not forget to fill the bank info completely
Your answer
BANK
※Please do not forget to fill the bank info completely
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Branch
※Please do not forget to fill the bank info completely
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Account Number
※Please do not forget to fill the bank info completely
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領収書の有無/receipt
住所変更はありますか?/Change Address? *
※Please kindly send a copy of your updated ID thru fax ( 03-5820-0345 )
備考
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