Outward Fund Transfer to E-wallet Application Form

Outward Fund Transfer to E-wallet Application Form

For Individual Account
SENDER DETAILS
Full Name*
Full Name
Passport No. OR National ID No.*
Please enter your Passport or ID Number above. National ID are only accepted for Malaysians.
Nationality
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Telephone Country Code*
Country Code
Sender Telephone Number
Phone Number
Sender's E-mail*
This will be our main mode of communication. Please ensure that it is accurate.
Sender's E-mail*

CATEGORY OF PAYMENT
Please select one:

Direct Payment to Child's BerryPay Account/e-WalletDirect Payment to Own BerryPay Account/e-walletDirect payment for Education, Medical and Tourism in Malaysia

AUTHORISATION / DECLARATION
1. I shall give full authorization to Waafi Bank Ltd. (“Waafi” OR “the Bank”) to debit my account for the fund transfer amount and related charges.
2. I declare the information provided in this document, is true and accurate and hereby authorize the Bank to make this information available to Bank Negara Malaysia (BNM) in compliance with the Foreign Exchange Notices, if required.
3. As specified and declared here, I request the Bank to effect the remittance on my behalf without risk and responsibility to the Bank and subject to the set Terms and Conditions.
APPLICANT AUTHORISATION

By signing and submitting this form, you hereby agree that all the information provided in this form is true and correct.
Authorised Signature*

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Date

MonthDayYear
Date Signed by Authorised Signature
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SENDER DETAILS