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1、TaiwanCooperativeBankLtd13F,DahSingFinancialCentre,108GloucesterRoad,Wanchai,HK香港分行HONGKONGBRANCH表格寫好之後，請回傳：(852)25981028匯出匯款申請書 ※如傳真通知請補寄回正本APPLICATIONFOROUTWARDREMITTANCE日期Date_________________收款人名稱(Beneficiary’sname)收款銀行名稱及地址(市-省-國家)Name/AddressofBeneficiary’sban
2、k(city-province-country)*請提供SWIFTCODE：收款人地址(Beneficiary’saddress)收款人帳號(Beneficiary’sAccountNo.)附言Message幣別/金額(Currency/Amount)手續費(DetailsofCharge)“a”或(Or)“X”¡內扣-匯款金額包括手續費(AmtIncludingCharges)¡外扣-從扣款帳號(DebitingFromA/c)¡全額到匯（FullPayment）中間銀行及收款銀行會額外收取費用，本人／本公司授權貴行同意逕自本帳號扣
3、款匯費(Commission)PAYMEMTTYPE付款形式Regardingthispayment、handlingcharges、cablefeesandotherforeigncharges,Pleasedebitmy/ouraccount有關上述匯款、手續費、電報費及國外相關費用等，請逕自本帳戶或以下方式扣款□扣款帳號DebitA/Cno.Remark：匯出匯款將依據背面所列條款處理Outwardremittancesubjecttotheconditionoverleaf.(必須與原留底印鑑相符)AuthorizedSign
4、ature：匯款申請人簽章：s.v.Applicant申請人：Address地址：Telephone電話：Forbankuseonly銀行專用欄位□已與___________先生／小姐,時間_________ 電話確認上述資料正確無誤□戶主／簽字人員親臨簽章辦理ForbankuseonlySupervisorACCT.MarkerS.V.2/2TaiwanCooperativeBankLtd13F,DahSingFinancialCentre,108GloucesterRoad,Wanchai,HK香港分行HONGKONGBRANCH
5、CONDITIONSOFCABLETRANSFER1.TAIWANCOOPERATIVEBANK,HONGKONGBRANCH,(thereinafterCalled“thebank”)shallnotbeliableforanylossordamageduetodelayinpaymentoringivingadviceofpayment,lossofitemstransitorotherwise,mutilation,error,omission,interruptionordelayintransmissionordeliver
6、yofanyitem,letter,telegramorcableortheactionsofourcorrespondents,sub-agents,orotheragencies,ordeclaredorundeclaredwar;censorship;blockade;insurrection;civilcommotion;oranylaw,decree,regulation,control,restrictionorotheractofadomesticorofforeigngovernmentorothergrouporgr
7、oupsexercisinggovernmentalpowers,whethergaugecommand,ordinance,restrain,oranyactoreventbeyondourcontrol.2.Allpaymentinstructionswhicharewrittenhereonshouldbecheckedcarefullybytheapplicantineachcase.3.TheBankmaysendanymessagerelativetothistransferinexplicitlanguage,code,
8、orcipherandisnottobeliableforerrors,neglects,ordefaultsofanycorrespondents,sub-agents,orotheragencies.4.Anyreq
