EFT Account Request Form English

Please note: Mandatory Fields are marked in bold* and must be filled in order to complete the Setup

TO BE COMPLETED BY THE CLIENT

Account Holder*

Full EFT Client Number*

Address*

Authorised EFT Contact*

Phone

E-Mail*

Request is also valid for Company or Subsidiary specified in the Mandate Letter.

Company Name

Full EFT Client Number

Address

EFT Contact

Phone

E-Mail

The account holder requests Fides Treasury Services AG to execute the instructions regarding the ARS access of the bank accounts indicated below according to the required action for the specified user numbers.

BIC Bank (Client–to–Fides)*

Sending BIC Fides* (Fides-to-bank)

CRESCHZFEFT

Corporate BIC

Action*	Account Number Format deliverd by Client*	Account Currency*	Account Limit Amount*	Reference Currency*	Beneficiary Acct. Group
Action*	Account Number Format deliverd by Client*	Account Currency*	Account Limit Amount*	Reference Currency*	Beneficiary Acct. Group
Action*	Account Number Format deliverd by Client*	Account Currency*	Account Limit Amount*	Reference Currency*	Beneficiary Acct. Group
Action*	Account Number Format deliverd by Client*	Account Currency*	Account Limit Amount*	Reference Currency*	Beneficiary Acct. Group
Action*	Account Number Format deliverd by Client*	Account Currency*	Account Limit Amount*	Reference Currency*	Beneficiary Acct. Group

Alternatively – According to the attached document

If checked, please attach the document when you email the completed form PDF.

Place, Date*

Name, Surname*

Place, Date*

TO BE COMPLETED BY THE BANK

Relationship Manager*

Swift Contact*

Phone*

E-mail*

Account Number Format required by the Bank (e.g. field 50H)*	Curr.*	Receiver BIC*	Message Type*
Account Number Format required by the Bank (e.g. field 50H)*	Curr.*	Receiver BIC*	Message Type*
Account Number Format required by the Bank (e.g. field 50H)*	Curr.*	Receiver BIC*	Message Type*
Account Number Format required by the Bank (e.g. field 50H)*	Curr.*	Receiver BIC*	Message Type*
Account Number Format required by the Bank (e.g. field 50H)*	Curr.*	Receiver BIC*	Message Type*

The bank confirms the acceptance and the processing of the payments in connection with the above accounts.

Alternatively – According to the enclosed bank document

If checked, please attach the document when you email the completed form PDF.

Place, Date*

After submitting the form, forward the PDF file to the bank. The bank will fill in the gray hatched part. After that, the form will be sent to Fides.

EFT Account Request Form English

TO BE COMPLETED BY THE CLIENT

TO BE COMPLETED BY THE BANK

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