DECLARATION OF REMITTER ( Please read carefully )
* I hereby authorise to register my personal information and, upon actual receipt of funds, to implement my remittances to the specific beneficiary registered.
* I certify the information written on this application form is true and hereby confirm that the General Provisions and Privacy Policy and Customer Date Protection stated on the separate paper hereof will govern all remittances.
* I also give my consent to AUSSPEED to disclose my address and account number or any or all of the information provided on this application form, to relevant financial institutions, including beneficiary bank involved in my transaction as a measure to prevent money laundering and terrorist funding.
* l hereby certify that the remittance applied for by this application, and all subsequent remittances I will transact thru AUSSPEED, will NOT correspond to transactions with the following countries: Iran, North Korea, Cuba, Myanmar (Burma), Sudan, Syria and Zimbabwe.