Kapruka The Tree of Wealth

Remittance Details Form

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Please fill in the form below and press the Submit button to send an email with your remittance details to us.

Remitter Details

Name of your bank (If internet transfer)

 

Deposited in which Bank?

Sender's Name

Amount to be Remitted (A$)

 

Address in Australia

Charges:

 

Phone

 

Mobile

 

Total amount paid (A$)

 

Fax

 

BH Phone

 

Email:

Date Deposited

Receipt No.

New Customers from 01.01.2008

(Please post certified copy for our records)

 DL or Passport

ID No:

Date of Issue

Expiry Date

 Date of Birth:

Beneficiary Details

Country

Beneficiary Account Details

Name of Recipient

Account No:

Address

Bank

Branch

Phone (country & area codes)

Mobile

Payment Method