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DollarsAUDForm of remittanceSterling amountCurrAruban GuildersAWGAzerbaijani ManatsAZMRemit a amount in currency )Bosnia and Herzegovina, Convertible MarkaBAMRemit in SterlingPounds SterlingGBPBarbadian DollarsBBDBangladeshi TakaBDTBulgarian LevaBGLBahrain DinarsBHDBurundi FrancsBIFBermudan DollarsBMDBrunei Darussalam, DollarsBNDBolivian BolivianosBOBBrazilian Brazil RealBRLBahamas DollarsBSDBhutan, NgultrumBTNBotswanan PulasBWPBelarus, RublesBYRBelize, DollarsBZDCanadian DollarsCAD Congo/Kinshasa, Congolese FrancsCDF*Shared (we pay ours, beneficiary pays his)SHA Swiss FrancsCHF(INDICATE 'X' AS REQUIRED) We pay bothOUR Chilean PesosCLPBeneficiary pays bothBENChina, Yuan RenminbiCNYColombian, PesosCOPCosta Rican ColonesCRC Cuban PesosCUPCape Verde, EscudosCVE Cyprus PoundsCYPFOR GIROBANK USE: RATE:Czech Republic, KorunyCZKC.I.Djibouti, FrancsDJF GBP DEBIT Danish KronerDKKDominican Republic, PesosDOPAlgerian DinarsDZDEstonian KrooniEEKEgyptian PoundsEGPEritrean NakfaERNEthiopian BirrETBFijian DollarsFJD#Falkland Islands (Malvinas), PoundsFKPPounds sterling Georgian LariGELGuernsey PoundsGGP Ghanaan CedisGHCGibraltar PoundsGIPGambian DalasiGMD Guinea FrancsGNFGuatemalan QuetzalesGTQGuyana DollarsGYDHong Kong DollarsHKDHonduras LempirasHNL Croatian KunaHRK Haiti GourdesHTGHungarian ForintsHUFIndonesian RupiahsIDRIsraeli New ShekelsILSIsle of Man PoundsIMP Indian RupeesINR Iraqi DinarsIQD Iranian RialsIRRIcelandic KronurISK Jersey PoundsJEPJamaican DollarsJMDJordanian DinarsJOD Japanese, YenJPYKenyan ShillingsKESKyrgyzstan, SomsKGSCambodian RielsKHRComoros, FrancsKMFKorea (North), WonKPWKorea (South), WonKRWKuwaiti DinarsKWDCayman Islands, DollarsKYDKazakstan, TengeKZT Laos, KipsLAKLebanese PoundsLBPSri Lankan RupeesLKRLiberian DollarsLRDLesotho MalotiLSLLithuanian LitaiLTL Latvian LatiLVLLibyan, DinarsLYDMorocco, DirhamsMAD Moldova, LeiMDLMadagascar, Malagasy FrancsMGFMacedonia, DenarsMKDMyanmar (Burma), KyatsMMKMongolia, TugriksMNTMacau, PatacasMOPMauritania, 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Pa'angaTOP Turkish LirasTRLTrinidad and Tobago, DollarsTTDTuvalu, Tuvalu DollarsTVDTaiwan, New DollarsTWDTanzania, ShillingsTZSUkraine, HryvniaUAHUganda, ShillingsUGXUruguay, PesosUYUUzbekistan, SumsUZSVatican City, LireVALVenezuela, BolivaresVEBViet Nam, DongVND Vanuatu, VatuVUV Samoa, TalaWST!Communauté Financière AfricaineXAFEast Caribbean DollarsXCD'Comptoirs Français du Pacifique FrancsXPFPlatinum, OuncesXPT Yemen, RialsYERYugoslavia, New DinarsYUMSouth Africa, RandZARZambia, KwachaZMKZimbabwe, Zimbabwe DollarsZWD$DIRECT DEBIT ACCOUNT NUMBER 221 6620 Department:Name to appear on draft: SECTION A/Please enclose fully addressed airmail envelope#Draft returned to Dept. = 1 invoice&Draft posted to Payee = invoice + copy+Cost of draft deducted from amount of draft*Cost of draft added to the amount of draftCurrency SECTION BBeneficiary address:Beneficiary name:(Town / Country) Bank Name: Bank Address:Account Number / IBAN:Message to Beneficiary: Bank Charges: Special Instructions / 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