Branch code where the account is held *: , please make the following transfer:

Third-party order Interbank transfer Urgent transfer

1
Check
1
Other currency*:
Amount in numbers * : Amount in letters * :



ORIGINATOR
Date: Last/First Name or corporate name *: For
the debit of my/our account in euros * OU in * currency:

Originator's signature *
Comments:


Space reserved for BNP Paribas
Label stamp, payment voucher, name of signature of the account manager:Execution date:
E
T
.

0
0
1
5
-
0
4
/
2
0
0
6















DISTRIBUTION OF CHARGES
By default, BNP Paribas charges are the responsibility of the originator and all potential transaction charge are the responsibility of the
beneficiary.
OTHER OPTIONS:
All charges are the responsibility of the originator
2
OR All charges are the responsibility of the originator
3
.
BENEFICIARY
IBAN *
4
:
International bank account number / 34 character maximum
Otherwise, complete account number *:

Last/First name or corporate name *:
Address:
City: Country:





BENEFICIARY'S BANK
BIC / SWIFT Code*
5
: Name:
8 or 11 characters mandatory
Complete bank address:
City: Country:
REASON FOR THE PAYMENT









1 If the box is checked, an additional fee will be charged to the originator upon the issue.
2 No charges to the beneficiary.
3 No fees to the originator, except for exchange, urgent service or additional fees.
4 In the European economic space (Germany, Netherlands, Italy, Austria, Belgium, Denmark, Spain, Finland, Greece, Portugal, Ireland, United Kingdom, Cyprus,
Estonia, Hungary, Latvia, Lithuania, Luxembourg, Malta, Poland, Slovakia, Slovenia, Czech Republic, Norway, Iceland, Liechtenstein, Sweden) and in Switzerland, if the
IBAN i is not indicated, and additional fee will be charged to the originator upon issuance. A missing IBAN may lead to a rejection from the foreign bank.
5 If the BIC SWIFT of the beneficiary's bank is missing, and additional fee will be charged to the originator upon issuance.
BNP PARIBAS - corporation with capital of 1 849 294 770 euros - Headquarters: 16, boulevard des Italiens, 75009 Paris Registered at n 662 042 449 RCS Paris - C.E. Inditification
FR76662042449 www.bnpparibas.net





INTERNATIONAL TRANSFER ORDER
Please fill out this form in capital letters
Fields marked with a * are mandatory
Branch code * Account number *