The People's Own Savings Bank

Serial
S,;fQ si b 0 812 116
ZETSS-APPLICATION FORM ( To be completed by a customer)

The Manager
'pc:<'P Date \2 Cr-L Lq
1fll _-1
.::: rn, Branch To be completed in duplicate

Dear Sir,

APPLICATION FOR ELECTRONIC FUNDS

Kindly effect the following funds transfer via

A[\4OUNT IN FIGURES 3 ()L.<; (;.4, J

A[\4OUNT IN WORDS ( . .1
's'e-. ,\\r;*-
VALUE DATE \) ?-- *+
BENEFICIARY'S DETAILS:
)tL)\
NAIVE AND ADDRESS
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O
PEOFLE'S

BENEFICIARY'S BANKERS
BRANCH a^
BANK STAMP
ACCOUNT NUIVBER ar').5 t-:U( - 1,. i-
' -'^.1 i .-
;*
DETAILS OF PAYIVIENT 2- '.--"i'.:.--. -:- ';-) T\" 1
{

..,
.,..- ,,:, .. "' .t.-,1
{ {-l l-'- i
-:. r'" 1 ';1 {--l LOANS OTF'IC
i-f MVUMA
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Account Name
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Address

Contact Number

Debit Account No { t. qi .' .1-i '-,.- it- I

l/We understand that payments made via the ZETTS are irrecoverable and irreversible and l/we indemnify POSB
against any losses arising as a result of this transaction.
l/We hereby acknowledge that the bank is not liable for errors, omissions or delay in transmissions arising from
circumstances beyond its control
Authorised Signature(s) l'-- t)'1 ; 1: ;'5 ,\L \_r
,)

FOR BANK USE ONLY

Received
, ,, i, : -r
i .i.: :11.
lalo.:lau-"* *rlat= Amount Paid $ -B ;';*
Signature Verified LLJ"*1.* RTGS Fee $ 5l '*t{
?"t?'i
/ :Tax--- g t: .*'{;:,;
captrde'& &fi"t j .;," ")
.' :,". .... i
Authorised r i r i: :.r',r :,i.-l i--1
!r Total Debit $ 5 rrl L i-