Bank Transfer Payment Instruction

Please complete the form below for payment by bank transfer. Please note we can only pay into an account in the name of the consignor per your letter of engagement/consignment receipt. Please complete all fields. The information is readily available on your bank statement, alternatively contact your bank. We may contact you to verify the particulars submitted.

Your Details:

Title:*

First Name: *

Surname: *

Company Name:

Email Address:*

Telephone Daytime:

Telephone Landline

Telephone Mobile:*

Address:

Address Line 1:*

City:*

County/State/Region:

Postcode:

Country:*

Bank Account Details:

Bank Name:*

Bank Address:*

Bank Account Number:*

Bank Sort Code / Routing Number:

Bank Identifier Code (BIC):

International Bank Account Number (IBAN):

Account Name:*

Account Currency:*

Is this a permanent payment instruction?

Yes

Notes:

Date

*I am duly authorised to submit this form as the vendor principal per my letter of engagement/consignment receipt

James Adam & Sons Ltd, 26 St Stephens Green, Dublin 2 Ireland
Phone (353)-1-6760261 Fax (353)-1-6624725 www.adams.ie

Thank you. Your submission has been received, we will contact you shortly.
We hope to reply within 24 hours of receiving your application.

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Bank Transfer Payment Instruction

Your Details:

Address:

Bank Account Details:

Useful links

Get in touch

Address

Bank Transfer Payment Instruction

Your Details:

Address:

Bank Account Details:

Useful links

Get in touch

Address

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