| Default collection amount (optional): |
$0.00 |
| Transaction type code:
|
Annuity
|
| Bank ID type:
|
BIC |
| Bank ID:
|
122203950 |
| Bank name:
|
National Bank of Australia |
| Bank branch country code:
|
Australia |
| Collection recipient company name: |
Metro Screen |
| Collection recipinet account:
|
12345678
|
| Collection recipient identification number: |
87654321 |
| Collection recipient street address:
|
PO Box 299 |
| Collection recipient city:
|
Paddington |
| Collection recipient state/province:
|
NSW |
| Collection recipient country: |
Australia |
| Collection recipient postal code: |
2021 |
| Collection initiator name: |
Parker's Box |
| Collection initiator street address: |
193 Grand Street |
| Collection initiator city:
|
Brooklyn |
| Collection initiator state:
|
NY |
| Collection initiator country: |
USA |
| Collection initiator postal code: |
11211 |
| Additional information for recipient (optional):
|
|