Dostrim Banking Information Form

Your Name *

Please enter your name.

Your Email Address *

The email you use to communicate with Dostrim.

Name of Financial Institution *

Please enter the full name of your bank.

Full Name of Account Owner *

Your name as it appears on your bank account statements

Branch Name of Bank *

Please enter the branch name of your bank.

Branch code of Financial Institution *

Please enter the banking code of your bank.

Account Number *

Please enter your account number.

Phone number

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