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L',u'e do hereby declare that lAMe have reccivcd renrirrance of usD 1.00.000 (one l,acusDonty).
(Amount and Currency in figures and in rvords)
TCNIittCTJ OT TO bC TCMittEd bY SUMITOI}TO MITSUI BANKING CORPORATIQN. TOKYO {I.B.O.D.)
lName and address of'rcmirting bank)
on account ol' ['UJI'IA CORpORATION tirr rhe puryrse of
(Name and address of remitter)
See Chapter 5
Ooerrtional
( Purposc o f rem ittance)
Mr. Tomokazu Nitta
(Name of Applicant)
Nationality: JaDanese
Address:
Dhaka Branch Office Signature and Stamp applicant
Form C: Inward Reminance exceeding USD 10,000/- Thousand) or
Purpose of remittance Onerationll
We hereby certiry that we are satisfied as to the identity of the applicant and that we have seen documentary
evidence which satisfies us as to the bonafides of the declaration made on this form.
Amount in (State Currency) Country of ordering
Customers
Purpose