Form tất toán tài khoản tiết kiệm của Ngân hàng Vietcombank

WITHDMT4/AL APPLICATION FROM FIXED DEPOSIT ACCOUNT Ngdy Date ..../.../.... a nar aor rnAN rfiN n rAr rolN rAt rutoiN roracn tlaxc cusToMER,s DETAIL T6n kh6ch hing Customer's name: S6 hO

WITHDMT4/AL APPLICATION FROM FIXED DEPOSIT ACCOUNT

Ngdy (Date) / / a nar aor rnAN rfiN

n rAr rolN rAt rutoiN

roracn tlaxc (cusToMER,s DETAIL)

T6n kh6ch hing (Customer's name):

S6 hO so (CIF Number):

T€n ngudi lintr tidn ( Receiver's Name)

Dia chi (Address):

CMT/II6 ctuEr ( ID/PP No.)

vfiu cAu trlr{N TIiN (MoNry REcrEpr RE7aTREMENT)

n Tidn mItAJFTT/Y€u cdu khdc ( Cash/Time bank note/Others)

lO TAI KI{OAN (A/C No.)

;OrGNn6r

Withdrawal amount)

VND

16 Tr*N RiN(} r-I{it Amount in words)

E Chuy6n vdo tai khodn s6 @y frf rc,4/C No.)

Tdn tdi \,J:roin (,UC name:

S6 tiAn (Amount):

Tai NH (At bank ):

xfroAnrnUdNc

(Chief accountant)

CIIU TK TVIOONC NAU NCUOT ITHAN TIEN

(Account holder & Stamp) (Receiver)

DANII CHO IIANG (FOR BANK'S USE ONLY) MA VAT

THAMITOAN VIEN TI.ruQUY KITM SoAT rnTJONc pIroNc