Remittance Form
Thisal Business Services Inc
1315 Lawrence Ave. E
Suit #509
Toronto, ON, M3A 3R3
Canada
Phone: 416 546 4488
* Required
Customer Information
Senders First Name
*
:
Senders Last Name
*
:
Senders Email Address
*
:
Senders Address
*
:
Senders Post Code
*
:
Senders Phone Number
*
:
Senders ID Number
*
:
ID Type
*
:
Government Issued Photo ID only
Passport
Drivers License
Photo Card
Issued At
*
:
Country, State (if applicable) it is valid for
I.D Expiry Date
*
:
Date of Birth
*
:
Transaction Type
:
* Please note: For online customers 'Cash Pickup' is only available for remittances to Sri Lanka (Colombo Area), at this stage. For more information please contact us
Account Deposit
Cash Pickup
Beneficiary's First Name
*
:
Beneficiary's Last Name
*
:
Beneficiary's Details
*
:
Including address and telephone
Account Name
:
Account Number
:
Including IBAN to payments made to Europe and UK
Bank details
:
Including bank name, branch and bank address (if applicable)
Swift Code
:
Branch code/ Routing Number
:
Not needed for all banks
Extra Information
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Payment Method
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This information allows us to identify your payment quickly
Thisal Financial CIBC ANZ account
Other :
Payment credited via
:
Online Banking
Email
Amount (Canadian Dollar)
:
I hereby authorise Thisal Financial to process the above transaction on my behalf. I understand that Thisal Financial is not responsible for any delays in payment caused by circumstances beyond its control. I have made sure that all the details I have provided are true to the best of my knowledge and ability. *
Correspondent bank fees may apply.
Please tick to acknowledge that you have read the above and agree