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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
Please ensure you have filled out both pages of this form prior to signing it
Signature:
Date: FEBRUARY, 22 2019
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