SAT Remittance Form For BRAC Bank

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See Chapter 5 Para 10 Form ‘C’ APP.

5 6

Declaration for remittance received from foreign


Country of amount equivalent to US $ 10,000/- and above

I/We do hereby declare that I/we have received remittance of BDT 9,849.95 (In words: Nine thousand
(Amount and Currency in figures and in words)
eight hundred and forty nine taka only) remitted or

to be remitted by ETS Honoraria Department on account of


(Name and address of remitting bank)
1526104372902001 for the purpose of SAT Exam Proctoring Service Fee
(Name and address of remitter) (Purpose of remittance)
Mahmuda Ali Zerin
(Name of Applicant)
Nationality Bangladeshi
Date 24.10.2021 Address SAT Center Name: Green Dale International
School, Center No.: 74113, House No. 08, Road
No. 83, Gulshan -2, Dhaka 1212, Bangladesh.

Signature and Stamp of the


applicant

From-‘C’: Inward Remittance of Tk. Equivalent to US $ 10,000/- and above.


Amount in
Month Country of making payment Purpose
(State Currency)

Coded by

Checked by

Purpose of remittance
We hereby certify that we are satisfied as to the identity of the applicant and that we have seen documentary
evidence which satisfies us as to the bonafides of the declaration made on this form.

Date…………………… Signature and Stamp of the


Authorized Dealer

(Space for use by the Bangladesh Bank)

BANGLADESH BANK
Foreign Exchange Policy Department Assistant Director

Dated ……………………
Note: Full details must be given for all remittances which are of capital nature. In the case of amounts for investment
in Bangladesh in shares or business, the reasons why the investment is required must be clearly indicated. In the
case of the remittance of the sale proceeds of securities the name of the true owner of the securities must be given
and also the approximate date of purchase.

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