Withdrawal_Request

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‫‪One Route 17 South‬‬ ‫062 ‪Suite‬‬ ‫0122-543-102 :‪Phone‬‬ ‫‪Saddle River, NJ 07458 USA‬‬ ‫0252-543-102 :‪Fax‬‬ ‫ﻧﻤﻮذج ﻃﻠﺐ ﺳﺤﺐ‬ ‫ﻳﺘﻮﺟﺐ اﺗﻤﺎم اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﺎﻟﻴﺔ ﺑﺎﻟﻜﺎﻣﻞ.‬ ‫ﻧﻮع اﻟﺤﺴﺎب:‬ ‫‪FX‬‬ ‫رﻗﻢ اﻟﺤﺴﺎب :‬ ‫اﺳﻢ اﻟﻤﺴﺘﺨﺪم:‬ ‫اﺳﻢ اﻟﺰﺑﻮن :‬ ‫□ أﻋﻤﺎل‬ ‫□ ﻣﺸﺘﺮك‬ ‫ﻓﺮدي‬ ‫□‬ ‫ﻗﻴﻤﺔ اﻟﺴﺤﺐ ﺑﺎﻟﺪوﻻر اﻻﻣﺮﻳﻜﻲ:‬ ‫ﻣﻌﻠﻮﻣﺎت اﻟﺰﺑﻮن )ﻳﺠﺐ أن ﺗﻄﺎﺑﻖ ﺗﻠﻚ اﻟﺘﻲ ﻋﻠﻰ ﻧﻤﻮذج ﻃﻠﺐ اﻟﺤﺴﺎب(‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬ ‫اﻟﺒﻠﺪ‬ ‫اﻟﺮﻣﺰ اﻟﺒﺮﻳﺪي‬ ‫ﻋﻨﻮان اﻟﻤﺮاﺳﻠﺔ‬ ‫اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﻮﻻﻳﺔ/ اﻟﻤﻘﺎﻃﻌﺔ‬ ‫ﻋﻨﻮان اﻟﺒﺮﻳﺪ اﻹﻟﻜﺘﺮوﻧﻲ‬ ‫اﻟﺒﻨﻚ اﻟﻮﺳﻴﻂ : )اذا آﺎن ﺿﺮورﻳﺎ(‬ ‫اﻟﺒﻨﻚ اﻟﻤﺴﺘﻔﻴﺪ:‬ ‫ﺷﻴﻔﺮة ‪ABA‬او ﺳﻮﻳﻔﺖ‬ ‫اﺳﻢ اﻟﺒﻨﻚ‬ ‫ﻋﻨﻮان اﻟﺒﻨﻚ‬ ‫اﺳﻢ اﻟﻤﺴﺘﻔﻴﺪ‬ ‫رﻗﻢ اﻟﺤﺴﺎب‬ ‫‪FX Solutions LLC‬‬ ‫ﺷﻴﻔﺮة ‪ABA‬او ﺳﻮﻳﻔﺖ‬ ‫اﺳﻢ اﻟﺒﻨﻚ‬ ‫ﻋﻨﻮان اﻟﺒﻨﻚ‬ ‫اﺳﻢ اﻟﻤﺴﺘﻔﻴﺪ‬ ‫رﻗﻢ اﻟﺤﺴﺎب‬ ‫● ﺻﺎﺣﺐ اﻟﺤﺴﺎب هﻮ اﻟﻤﺮاﺳﻞ اﻟﻮﺣﻴﺪ اﻟﻤﻌﺘﻤﺪ ﻟﺪى‬ ‫● ﻗﺪ ﻻ ﺗﺠﺮي دﻓﻌﺎت ‪ FX Solutions LLC‬ﻟﻄﺮف ﺛﺎﻟﺚ‬ ‫ﻃﺮﻳﻘﺔ اﻟﺪﻓﻊ‬ ‫هﻞ ﺳﻴﺘﻢ اﻏﻼق ﺣﺴﺎﺑﻚ؟‬ ‫ﻻ )05 دوﻻرا آﺤﺪ ادﻧﻰ ﻟﻠﺮﺻﻴﺪ ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﺤﺴﺎب(‬ ‫□‬ ‫ﻧﻌﻢ‬ ‫□‬ ‫□ ﺷﻴﻚ □ ﺣﻮاﻟﺔ‬ ‫) ﻣﻼﺣﻈﻪ: ﻓﻲ ﺣﺎل اﻏﻼق اﻟﺤﺴﺎب ﻓﺎن ‪ FX Solutions‬ﺳﻮف ﺗﻐﻠﻖ ﺟﻤﻴﻊ اﻟﻤﺮاآﺰ اﻟﻤﻔﺘﻮﺣﻪ وﻓﻘﺎ ﻟﺴﻌﺮ اﻟﺴﻮق اﻟﺤﺎﻟﻲ اذا ﻟﻢ ﻳﺘﻢ ذﻟﻚ ﻣﻦ ﻗﺒﻞ اﻟﻌﻤﻴﻞ.(‬ ‫ﺳﻴﺘﻢ ﺗﻨﻔﻴﺬ ﺟﻤﻴﻊ ﻃﻠﺒﺎت اﻟﺴﺤﺐ ﺧﻼل ﻳﻮﻣﻲ ﻋﻤﻞ ﺑﻌﺪ اﺳﺘﻼم هﺬا اﻟﻨﻤﻮذج.‬ ‫ﻳﺘﻮﺟﺐ اﺗﻤﺎم اﻟﻤﻌﻠﻮﻣﺎت ﺑﺎﻋﻼﻩ ﺑﺎﻟﻜﺎﻣﻞ ﻣﻦ اﺟﻞ اﺟﺮاء هﺬا اﻟﺘﻌﺪﻳﻞ‬ ‫اﻧﺎ / ﻧﺤﻦ اﺻﺮح / ﻧﺼﺮح هﻬﻨﺎ ﺑﺎن اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﻗﺪﻣﺘﻬﺎ/ ﻗﺪﻣﻨﺎهﺎ ﺣﻘﻴﻘﻴﻪ وﺻﺤﻴﺤﻪ. آﻤﺎ اﻧﻨﻲ/ اﻧﻨﺎ اﻗﺮ/ ﻧﻘﺮ ﺑﺎﻧﻨﻲ / ﺑﺎﻧﻨﺎ ﺳﺎﻗﻮم/ ﺳﻨﻘﻮم ﺑﺎﻋﻼم ‪ FX Solutions‬ﺣﻮل اﻳﺔ ﺗﻌﺪﻳﻼت ﻣﺎدﻳﻪ ﺧﻄﻴﺎ. آﻤﺎ ﺗﺤﺘﻔﻆ ‪FX‬‬ ‫‪ Solutions‬ﺑﺤﻖ، وﻟﻜﻦ ﻻ ﻳﺘﻮﺟﺐ ﻋﻠﻴﻬﺎ، اﻟﺘﺄآﺪ ﻣﻦ دﻗﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﻘﺪﻣﻪ واﻻﺗﺼﺎل ﻣﻊ ﻋﺪة ﻣﺼﺎدر آﻤﺎ ﺗﺮاﻩ ﻣﻨﺎﺳﺒﺎ .‬ ‫اﻟﺘﺎرﻳﺦ‬ ‫ﺗﻮﻗﻴﻊ اﻟﺰﺑﻮن اﻟﻤﺸﺘﺮك‬ ‫اﺳﻢ اﻟﺰﺑﻮن اﻟﻤﺸﺘﺮك‬ ‫اﻟﺘﺎرﻳﺦ‬ ‫ﺗﻮﻗﻴﻊ اﻟﺰﺑﻮن اﻷﺳﺎﺳﻲ‬ ‫اﻷﺳﻢ‬ ‫ﺗﻌﻠﻴﻘﺎت:‬ ‫اﻟﺮﺟﺎء إرﺳﺎل ﺟﻤﻴﻊ اﻟﻄﻠﺒﺎت ﻟﻠﺘﻨﻔﻴﺬ ﻋﻠﻰ ﻓﺎآﺲ: 5252543102‬ ‫ﺷﻜﺮ ﻟﺘﻌﺎﻣﻠﻚ ﻣﻊ ‪FX Solutions‬‬

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