The Hongkong and Shanghai Banking Corporation Limited
HSBC Building, 968 Rama IV Road,
Silom, Bangrak, Bangkok 10500
Attn: Service Delivery
Date: ________________________
We refer to our payment instruction details following:
Transaction Reference Number: (if any)
Amount:
Value Date (DD-MM-YYYY):
Beneficiary Name:
Beneficiary Account Number
Beneficiary Bank:
Please check where applicable
Please urgently cancel and return funds to our a/c with you being [Please provide reason of cancellation] ______________________________________________________________________
If there is any charge, please debit from our account number ________________ with you.
Please amend the beneficiary’s details as below [Please input where appropriate]
Beneficiary Account Number
Beneficiary Name (only when account number remains unchanged)
All other details remain unchanged. If there is any charge, please debit from our account number ________________ open with you.
Please re-affect the payment with details as below:
Beneficiary Name:
Beneficiary Account Number:
Beneficiary Bank Name:
(SWIFT/ Fedwire/ Sortcode)
Beneficiary Correspondent Bank:
Payment details:
Charge Option (Pls select one): • BEN • SHA • OUR
Please remit (currency and amount) _________________________ and transfer to the above mentioned details. If there is any charge, please debit from our account number __________________________ open with you.
Yours Sincerely
[Authorised Name and Signature and company seal (if any)]