3 Mariobo Blvd
Mariobo, PA Argentinstan
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Welcome account holder,
Use the following to manage your account, deposit funds, withdraw funds, and transfer funds. Have your account number in hand.
*Please fill in all fields except the comment field (optional)
DEPOSIT FUNDS
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Account holder name:
Account #:
Funds to be deposited:
Comments?:
WITHDRAW FUNDS
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Account holder name:
Account #:
Funds to be withdrawn:
Comments?:
TRANSFER FUNDS
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Acount holder name:
Recipient account holder name:
Account # of originator:
Account # of recipient:
Funds:
Comments?:
IBA INTER-TRANSFER
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Bank of origin:
Bank of recipient:
Origin account name:
Receiving account name:
Funds:
Comments?:
REQUEST A PAYMENT
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Account holder name:
Your account name:
Account # of originator:
Account # of your account:
Funds requested:
Request details (why):
Comments?:
DELETE/REMOVE/FREEZE ACCOUNT
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Account holder name:
Account #:
Funds within:
Action (delete/remove/freeze):
Comments:
[i][ ] I hereby agree to Ban of the Atlantic doing the action prescribed by I, the account holder, and any consequences or losses that come within.[/i]