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Gairidhara - 2, Kathmandu, Email: info@riremit.com, Tel. No: 01-4535333, 4515850
Toll Free No: 16600100016
Date:
2021/05/24
Remittance Form
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I herevy declare that the above information is true and correct. I would indemnify RFL in the event of third party claim arising out of loss form the above transaction.
Sender/Receiver's Signature
Branch Office: ........................
Phone Number: .........................
FOR OFFICIAL USE ONLY
Denomination
Amount
Name
Identification
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ID Type
I Pay ID
Amount in words: Rs........................
...........................................
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100 X
50 X
25 X
20 X
10 X
5 X
2 X
1 X
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Naxal -2, Gairidhara
Kathmandu, Nepal
Phone: +977-1-4535139, 4535158
Email:
info@ipayremittal.com
info@riremit.com
URL:
www.ipayremittal.com
Toll Free: 16600100016
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