Gairidhara - 2, Kathmandu, Email: info@riremit.com, Tel. No: 01-4535333, 4515850
Toll Free No: 16600100016
Date: 2021/05/24
Remittance Form
Code Number
Receiver's Name
Address
Type Of Id
Contact Number
Sender's Name
Address
Phone Number
Country
Expected Amount
Branch Office: ........................
Phone Number: .........................
FOR OFFICIAL USE ONLY
Denomination
Amount
Name
Identification
Telephone
ID Type
I Pay ID
Amount in words: Rs........................
...........................................
1000 X
500 X
250 X
100 X
50 X
25 X
20 X
10 X
5 X
2 X
1 X
Coins
Total Rs
