Transfer Authorization Form

Transfer Authorization Form

This form is required to authorize the transfer of funds from your account to the specified destination account. By completing and signing this form, you confirm that the information provided is accurate and that you authorize the transaction. This process ensures compliance with regulatory requirements and maintains the security of your account. Please provide all requested information and attach any necessary supporting documents to facilitate the transaction.

Applicant Name:

Transaction Details

Source of Funds Declaration

Authorization and Confirmation

Signature (Primary Account Holder): ___________________________ Date: ___________________

Signature (Secondary Account Holder / Beneficiary): ___________________________ Date: ___________________

Bank use only

  • Received By (Bank Staff Name): ___________________________ Date Received: ___________________
  • Verification Completed By (Bank Staff Name): ___________________________ Date Verified: ___________________
  • Comments / Notes: ___________________________________________________________________