Form / Phieu Chuyen Tien

Form / Phieu

Xin danh vao day du chi tiet nguoi goi & nguoi nhan voi so dien thoai de chung toi co the giao tien nhanh chong. Neu goi tren $1,000, can MA SO / PIN tu chon de nguoi nhan thong bao cho nhan vien cong ty khi nhan tien.

Nguoi Goi / Sender
Ten / Name:
Dia Chi / Address:
City:
Zip Code:	(5 digits)
State:
Phone:
Nguoi Nhan / Recipient
Ten / Name:
Dia Chi / Address:
Quan Thanh Pho/ City Province:
Phone:
So Tien Goi / Amount
So Tien / Amount (USD):
Fee / Le Phi:
Ma So / PIN:	(6 so, tu chon neu goi tren $1,000 / 6-digits, self-selected & required for amount over $1,000)
Bank Information
Bank Name:
Routing Number:
Account Number:
Other Information
Chi Dan, Ghi Chu / Instructions:
	Toi yeu cau cong ty chuyen so tien tren & chiu trach nhiem tra so tien nay cho cong ty. I authorize the company to process the above transaction & agree to pay the company for the full amount.

Xin kiem ky cang truoc khi bam submit de chuyen cho Cong Ty. Cong ty so khong chiu trach nhiem neu chi tiet danh tren day khong dung.
Please check carefully before submitting. We are not responsible for incorrect information entered.