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Transhorn Money Transfer Services
Money Withdrawal Request Form Please, fill out this form and send it to the following address or fax number: TMT, P.o.Box 3155, Renton WA98056 or FAX:1-425-255 0345 |
Account Holder
Information:
Full
Name:__________________________________________
Address:
___________________________________________
___________________________________________
Tel
1:_____________________Tel 2:_____________________
E-mail:_______________________
Withdraw from the
following Bank:
Bank
Name: _____________________________________
Bank Account: ____________________________________
Withdrawal Amount: ________________________US Dollar
Amount
in Words: ________________________________
Requested Payment
method:
Send
me a check to my address:
YES NO
Deposit
to my Bank account:
YES NO
Bank
name:___________________________
Bank
Account: _________________________
Bank
Route number: _____________________
Deposit to bank accounts may not be possible if your bank is not active in Washington State.
Account Holder (S) Signature:
