I am making this International Telegraphic Transfer on behalf of: X Myself -Complete Section A Someone else - Complete Sections A & B
Payer information
NAME: GARY RAGSDALE C/O ALG INVESTMENT LLC
STREET: Collins Ave Suite 2136 CITY: Fresno ZIP CODE: 16485 COUNTRY: United States Customer Number: 8405161434 Phone no. +1 352 900 8651
INTERNATIONAL TELEGRAPHIC TRANSFER DETAILS
International TT Currency: USD Amount: $1,175.00
Exchange Rate (selling) Amount: $ 0.00 Cash Account Cheque Local Currency: USD Payment from account: 78213280100 Charges Currency Amount: $ 0.00 Fee/Charges from account: 0.00 Total payment Currency Amount: $1,175.00
PURPOSE OF PAYMENT (MANDATORY)
Gift/payment Expatriate payment Payment of services Payment of goods Market settlement
Other (Please Specify)
Beneficiary account number: 63003429014
SWIFT code: CHASHKHHXXX Beneficiary country/region: HongKong Beneficiary name: Shenzhen Everycom Technology Company Limited Beneficiary address: Units 1260, 12/F, Emperor Group Centre, 288 Hennessy Road, Wan Chai, Hong Kong Beneficiary bank: JPMorgan Chase Bank N.A., Hong Kong Branch JPMorgan Beneficiary bank address: CHARTER HOUSE, 8 CONNAUGHT ROAD, CENTRAL, HONG KONG Bank code: 007 Branch code: 863 Remark: 237358567501023393
BANK USE ONLY BANK USE ONLY
OET Code: N/A Pre-payment Branch name and No. : SWEDSESSXXX Telegraphic Transfer no. SE-78213280100 Branch: SWEDSESSXXX Sign: Verified by: Sign:
