PAYMENT INSTRUCTIONS FORM

Please complete the form by typing or using capital letters, sign it and send it to the SSC to AP-Services@fao.org via email
or pouch. Please note that incomplete or illegible information will delay your payment.

DETAILS:
Staff member Non Staff Traveler
Name: DARMAWAN SIDIK
Index number:      
Responsible division: FIAO Room n. na Extension: na
Email address: darmawansidik@yahoo.com
Home address: Jl.Batanghari No. 77a Rt.013 Rw.003 Kelurahan Nusa Indah Kecamatan Ratu
Samban Kota Bengkulu
     
     

BANKING INSTRUCTIONS:
Bank name (*): BANK NEGARA INDONESIA
(*) One bank only, i.e. FAO does not accept routings to a second bank
Branch name: KOTA BENGKULU
Street: JALAN S. PARMAN NO 36 BENGKULU

City: BENGKULU Post code: 38223

Country: INDONESIA
Name of account holder (must be the same as Currency of account (i.e. USD, EUR, etc.):
the beneficiary, i.e. SM or CST):
IDR
DARMAWAN SIDIK

Please fill out your bank details on page 2

STAFF MEMBER/NON STAFF TRAVELER:

Please ensure you have filled out both pages of this form prior to signing it

Signature:
Date: FEBRUARY, 22 2019

ADM :CSF236e 2018/03

 PAYMENT INSTRUCTIONS FORM (PIF) FORM
Account holder’s name: Darmawan Sidik Index No. :      
Account details (Please only fill out the boxes relevant to the country in which the bank account is held)
USA
Bank routing (ABA)                   Swift code                      
Account number                                  

Canada
Bank routing (transit)                 Swift code                      
Account number                                  

Italy
CIN   ABI           CAB           A/c Nr                        
IBAN I T                                                  
Swift code                      

France
Code           Code Guichet                                    
Banque A/c Nr Clé RIB
IBAN F R                                              
Swift code                      

United Kingdom
Sort code                            
− − A/c Nr
IBAN G B                                        
Swift code                      

Germany
BLZ - Bankleitzahl                 A/c Nr                    
IBAN D E                                        
Swift code                      

Other Counties, please specify : INDONESIA

Account 7 1 8 4 5 7 3 0                                                  
number
Bank routing 0 2 6 0 8 7 4 7 2                                    
IBAN                                                                    
if applicable
Swift code B N I N I D J A B K L

Correspondent bank information (if applicable):      

ADM :CSF236e 2018/03