Bank Detail Form

A form for collecting a supplier's or payee's bank details in order to process payments and transfers.

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Name:

Nombre

Apellido

Company Name (if applicable):

Address:

Dirección

Ciudad

Estado / Provincia

Código postal

Telephone:

Mobile:

Herd No:

Email:

I hereby declare that

I hereby declare that the information provided in this form is correct

VAT Registration No:

SIGNED

Sign here

Date

Bank Details: Account Holder Name (as above) or

Bank Name:

Bank Name

Account Name: (this name must match the account details that are submitted)

Account type:

Account Type

Bank Address:

Dirección

Ciudad

Estado / Provincia

Código postal

Account No:

IBAN:

Sort Code:

BIC:

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