匯款,轉賬申請書2022-12-09.pdf

Attended By 列印 ＰＲＩＮＴ 銀行專用 Approved By 東莞銀行股份有限公司 (於中華人民共和國註冊成立的股份有限公司) Bank of Dongguan Co., Ltd. (A joint stock company incorporated in the People’s Republic of China with limited liability) For Bank Use 重置 ＲＥＳＥＴ Tr. Ref: 匯款／轉賬申請書 Application for Outward Remittance/Fund Transfer 致: 東莞銀行股份有限公司 - 香港分行 (「銀行」) To: Bank of Dongguan Co., Ltd.- Hong Kong Branch (the “Bank”) 日期 (日/月/年) DATE (DD/MM/YYYY) 注意 NOTE: 1. 請用正楷填寫，在適當方格內加上“  ” ，填妥表格後交回本銀行。Please complete in BLOCK LETTERS, “  ” where appropriate, and return the completed form to the Bank. 2. 所收費用將列印在閣下的戶口結單內。 Charge levied on your instruction(s) will be reflected on your account statement. 甲部 Part A ─ 客戶資料 Customer Information 客戶號 Customer No. 客戶名稱 Customer Name 乙部 Part B ─ 付款及其他指示 Payment and Other Instructions 匯款／轉賬金額 Remittance/Transfer Amount 匯款／轉賬金額支賬賬號： Debit Account for Remittance/ Transfer Amount: 銀行費用(匯款)支賬賬號: Debit Account for Bank Charges (Remittance): 匯款費用付費方法 Remittance Bank Charges Option ** ( 丙部和丁部只可選用其中一項服務 ( ) □ 丙部 Part C ─ 貨幣 CCY □ 金額 Amount 各自承擔 Each party bears its own costs (SHA) □ 申請人 Applicant (OUR) □ 收款人 Beneficiary (BEN) Can only choose one of the services from Part C and Part D ) 銀行內部轉賬 Account Transfer within the Bank 轉賬貨幣及金額 Transfer Currency & Amount 貨幣 CCY 金額 Amount 收款人 Beneficiary 收款人賬號 Beneficiary Account No. 收款賬戶貨幣 Beneficiary Currency □ 丁部 Part D ─ 匯款 Remittance 匯款方法 Payment Method □ 電匯 Telegraphic Transfer □ 銀行電子過賬系統 CHATS 匯款代理行資料 Intermediary Bank 代收款銀行名稱及地址 Name & Address of the Beneficiary Bank 銀行代碼/銀行編號 SWIFT Code / CHATS Bank Code: 收款人名稱及地址 Name & Address of Beneficiary 收款人賬號 Beneficiary account no. 對收款人附言 Message to Beneficiary 匯款用途 (必須填寫) Purpose of Remittance (required) (中英文義如有歧異，請以英文本為準。The English version shall prevail if there is a discrepancy between the English & Chinese versions.) 客戶(等)簽署 Signature(s) of Customer(s) S.V. X__________________________________________________________ 請用留存本行印鑑/署名簽署 Please use signature(s)/chop(s) filed with the Bank 地址:香港中環金融街8號國際金融中心二期25樓2504-2511室 Address: Suites 2504-2511, 25thFloor, Two International Finance Center, 8 Finance Street, Central, Hong Kong 頁次 Page 1/2 條款 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 本人/吾等(申請人)同意承擔匯款/轉賬風險並同意: a) 倘因下列情形而引致之任何損失，包括:款項交付或通知延誤; 電報或任何與本申請有關的文件在寄發或傳送途中所發生錯誤、殘缺、遺漏、 中斷或延誤; 東莞銀行股份有限公司香港分行(「銀行」)的通訊員、代理人或員工之行為及其他難以控制之事故，銀行無須承擔任何責任。 b) 在銀行決定的某些情況下，在匯款匯出前，銀行可要求本人或吾等(申請人)當中任何一人或任何授權簽署人士或獲授權人士以電話確認此匯 款申請。如銀行未能獲得上述的確認，銀行可拒絕此匯款申請(在此情況下銀行有絕對酌情權決定如何處置有關匯款申請);銀行為拒絕或因此 延遲行事無須負任何責任。為免生疑問，銀行對本人或吾等或任何第三方因（a）銀行執行申請，（b）執行不當、延遲執行或不執行任何申 請而蒙受的任何損失、責任或費用概不負責。 銀行無須通知申請人有關收款國當地法律或規例所實施之外匯管制或其他類似限制，亦無須因為該等管制及限制而引致的任何損失或延誤負上任 何責任。申請人應自行查詢有關之管制或限制。 有關匯款之一切通訊，銀行可用文字或密碼發出; 而銀行將不會由於銀行之代理行錯誤翻譯或理解該等通訊而負上任何責任。 在銀行絕對的酌情權下認為需要的情況下，銀行有權在申請表之背頁所指定地點以外不同地點支付匯款。 除非申請人另有相反指示，匯款將以付款國之貨幣交付。 除另有說明外，在銀行以外引致之一切費用將由受款人支付。 若銀行未能提供一確定之匯率報價，則銀行得以臨時匯率辦理兌匯，並在確知實際匯率時作調整。任何臨時匯率與實際匯率間之差額，得在申請 人之賬戶中扣除或歸還(視當時情況而定)。 如付款須於指定日期執行，應於申請表上註明。 匯款申請須受目的地所在之地區域之截數時間限制。 如銀行根據其絕對酌情權下認爲匯款申請書中的資料不完整或不清晰或申請不符合香港金融管理局或有關結算銀行之不時規定，銀行有權不處理 有關之匯款/轉賬。 本人/吾等(申請人)授權銀行披露、提供及透露任何申請人的資料到: a) 任何已或將會與銀行建立業務盟係的任何其他的銀行、金融機構、代理人、信貸提供之公司、服務供應商或承判商; b) 任何監管機構、政府機關(包括稅務機關); c) 任何其他對銀行有保密責任的人士，包括銀行的總行及/或銀行的集團公司; 及 d) 任何其他人士，目的為遵從任何影響或約束銀行或銀行的總行的法律、條例或指示。儘管資料接收人位於香港以外或有關資料會在披露後由 接收人在香港以外收集、處理或利用，銀行可向上列之人士披露資料。對於已收集、保存或使用的任何符合個人資料(私隱)條例內個人資料 定義的資料，銀行將會嚴謹地遵循該條例內的條款。 因遵守 代理銀行或中轉銀行當地監管要求或法律或規則而就任何申請項下之任何資金作出之查詢或調查或扣押之情況下, 本人/吾等(申請人) 在 此同意及承諾於匯款前及後就任何申請向銀行提供所 要求及須要之所有資料及文件。本人/吾等(申請人) 在此授權及同意銀行披露本人/吾等個人 數據及所有與任何申請有關的資料予任何第三方以進行業務及遵守當地法律及規則包括但不限於防止洗黑錢或防止罪行、恐怖主義及逃税,及儘管 资料接受方之營业地方是在香港以外地方或該等數據及资料于披露後将被該接受方在香港以外之地方收集、持有、操作或供用。本人/吾等(申请 人) 亦在此授权及同意銀行有絕對酌情權終止及逆匯及相关賬户入數或採取其他行動。为免生疑问, 因上述事宜導致任何申请延誤或不完整或失败， 銀行無須承擔本人/吾等或任何第三方所招致之損失、責任或費用。本人/吾等(申请人) 進一步同意及承诺赔偿銀行（以完全彌償基準）所有因著 或基於任何申请而招致之所有債務、損害、支付、賠償、請求、索賠、支出和費用（包括律師費） 、法律行動、訴訟及其他後果（由銀行的故意行 為或欺詐導致除外） 。 如該匯款是跨境匯款至中國大陸，本人(等)於此聲明: (i) 該匯款是符合中國大陸所有有關及適用的規則及要求; (ii)該匯款可能需要獲得內地有關當 局的批核，否則內地有關當局或內地銀行可能拒絕有關的對外匯款及可能涉及相關費用。 若此等條款之中英文本有任何差異，概以英文本為準。 Conditions 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) I/We (applicant) agree that the risk of remittance/fund transfer is to be entirely borne by me / us and agree that: a) It is clearly understood that Bank of Dongguan Co., Ltd. Hong Kong Branch (the “Bank”) will not be liable for any loss or damage due to delay in payment or in giving advice of payment; error, omission, mutilation, interruption or delay in transmission of any item in connection with the application made hereunder; or the actions of the Bank’s correspondents, agents or staff, or any act or event beyond the Bank’s control b) The Bank may, under circumstances determined by the Bank, require from me/us or any of my/our authorized signatories or authorized persons, confirmation of the application by means of telephone before acting on the same. The Bank may refuse to act on the application in the absence of such confirmation (in which event the Bank shall have the absolute discretion to determine the disposal of the relevant application), without responsibility or liability on the Bank for any such refusal or delay in so acting. For avoidance of doubts, the Bank shall not be liable for any losses, damager, liabilities or costs suffered or incurred by me/us or any third party as a result of (a) the Bank’s executing the application, (b) the improper execution, delayed execution or non-execution of any application. The Bank is not responsible to advise the Applicant of any foreign exchange control or other similar restriction which may be imposed by the laws or regulations of the country where payment of the remittance is to be effected and shall not be liable for any loss or delay resulting from such control and restriction. Applicant is advised to make his own enquires as to any such control or restriction. The Bank may send message(s) relating to the remittance either in text or in cipher and shall not be liable for any misinterpretation of the messages, or any part thereof, by any of the Bank’s correspondents. The Bank may make payment of the remittance at a place different from that specified by the Applicant in the application form overleaf if the circumstances, in the Bank’s sole and absolute discretion, so require. In the absence of any instructions of the Applicant to the contrary, payment of the remittance will be effected in the currency of the country in which the payment is actually made. All charges incurred outside the Bank are paid by the beneficiary unless otherwise specified. Where the Bank is unable to provide a firm exchange rate quotation the Bank shall effect the remittance on the basis of a provisional exchange rate which shall be subject to adjustment when the actual exchange rate is ascertained. Any difference between the provisional rate and the actual rate shall be debited/ credited (as the case may be) to the Applicant’s account. If payment is to be made on a particular date, this date should be indicated on the application form. Applications are subject to cut-off times related to the geographical location of the destinations. The Bank reserves the right not to process this application for outward remittance/fund transfer if in its sole discretion that the information or instructions given is incomplete or is not sufficiently clear or this application does not fulfill the requirements as designated by the Hong Kong Monetary Authority or the relevant clearing bank from time to time. I/We (applicant) authorize the Bank to disclose, provide and divulge any of my/our information to a) any other banks, financial institutions, agents, credit providing companies, service providers or contractors who have established or will establish any business relationship with the Bank; b) any local or foreign judicial, administrative, public or regulatory body, any government, any Tax Authority, court, central bank or law enforcement agency and any of their agents with jurisdiction over any part of the Bank’s Head Office and/or a group company of the Bank; c) any other person under a duty of confidentiality to the Bank, including the Bank’s Head Office and/or a group company of the Bank; and d) any other persons for the purposes of being in compliance with any laws, regulations or directions affecting or binding on the Bank or its Head Office. The Bank may disclose data to any of all the parties stated above and may do so notwithstanding that the recipient’s place of business is outside Hong Kong or that such information following disclosure will be collected, held, processed or used by such recipient outside Hong Kong. The Bank shall adhere strictly to the provisions of the Personal Data (Privacy) Ordinance in so far as the data collected, maintained or used are personal data as defined in that Ordinance. In the event any of the funds under any application is under enquiry or investigation or sequestrated by correspondent banks or intermediate banks in compliance with their local regulatory requirements or laws or regulations, I/we (applicant) hereby agree and undertake to provide the Bank with all information and documents so requested and required for any application both before and after the remittance. I/we (applicant) hereby authorize and consent that the Bank may disclose my/our personal data and all information related to any application to any third parties for conducting the business and complying with the local laws and regulations including but not limited to anti-money laundering, or preventing crime, terrorism and tax evasion and may do so notwithstanding that the recipient's place of business is outside Hong Kong or such data and information following disclosure will be collected, held, processed or used by such recipient outside Hong Kong. I/We (applicant) hereby also authorize and consent that the Bank may, in its sole and absolute discretion, terminate and reverse the remittance and related account entries or take such other actions. For avoidance of doubt, the Bank shall not be liable for any losses, damages, liabilities or costs suffered or incurred by me/us or any third party as a result of any delay or incomplete or failure of any application due to any of the above-mentioned matters. I/we (applicant) further agree and undertake to indemnify the Bank (on a full indemnity basis) against all liabilities, losses, payments, damages, demands, claims, expenses and costs (including legal fees),proceedings, actions and other consequences which the Bank may suffer or incur under or in connection with any application (except caused by the Bank’s willful misconduct or fraud). If the remittance is a cross-border remittance to mainland China, I/we hereby declare that: (i) the remittance adheres to all relevant and applicable rules and requirements of mainland China; (ii) approval from the relevant Mainland authorities may need to be obtained, otherwise the remittance may be rejected by the Mainland authorities or Mainland banks and charges maybe incurred. The conditions herein contained are written in English and Chinese. In case of conflict, the English version shall prevail. 地址:香港中環金融街8號國際金融中心二期25樓2504-2511室 Address: Suites 2504-2511, 25thFloor, Two International Finance Center, 8 Finance Street, Central, Hong Kong 頁次 Page 2/2