BRACBANK
*Customer Presence at Service Outlet is Mandatory
RTGS /EFT Authorization Form
Date: ...J...... EFT (BEFTN) RTGS (BD-RTGS)
The Branch Manager Time: AM/PM Available Amount:
BRAC Bank Limited
Branch:
I/We hereby authorize BRAC Bank Limited to Debit my (our) account indicated below and to credit the following credit account
through BEFTN/BD-RTGS if the transaction detail (each) found acceptable by BRAC Bank Limited.
Debit Account's Information
Account Title
Account Number
Type of Account
Amount (In Numbers) & Currency OBDT DUSD O GBPOEURO CAD O JPY OAUD
Amount (In words)
Date of Execution DD MM YYYY Mobile No
Credit Account's Information
Account Title
Account Number
Rewrite Account Number
Bank's Name Branch
City
Routing Number/sWIFT Code
Reference/Purpose of Payment
I/We hereby confirm as per the EFT/RTGS Instruction, Receiving Bank shallhave full rights and title over the fund transmitted by
way of the BEFTN/BD-RTGS system and /We permit BRAC Bank Limited to initiate electronic credit entries for payment(s) to
accounts maintained with other Banks. We also acknowledge that initiating bank shall have no legitimate control/liability over the
fund once transmitted. I/We also confirm that the transaction wil! be subject to BEFTN/BD-RTGS operating rule as issued by
Bangladesh Bank.
Olamcompletely aware of the RTGS transaction,and I knowthat the RTGS payment is Final and Irrevocable in nature. (RTGS Only).
Accountholder's Signature 2nd Accountholder's Signature (if joint)
FOR BANK USE ONLY
Customer's Physically Presence confirmed
Verified By Approved By
Signature & Date : Signature & Date:
Name Name
PIN PIN
[Link]
DBRACBANK
O EFT (BEFTN) DRTGS (BD-RTGS) *Customer Copy
Debit Credit
Name Name
A/CNo: A/C No:
Amount Amount:
Branch: Bank Name:
City: Routing No:
Mobile Branch:
Time City:
Mobile: