TELEGRAPHIC TRANSFER
Date: APPLICATION FORM
PLEASE MARK WITH () THE APPLICABLE BOX/ES. WRITE IN UPPERCASE LETTERS
Domestic Telegraphic Transfer Foreign Telegraphic Transfer (FXTT) APPLICANT DETAILS Individual Corporate MSB
RTGS (Real-Time Peso Transfer) NAME (First Name/Suffix, Middle Name, Last Name)
PESONet (BatchTransfer
GSRT (Real-Time Dollar Transfer)
Validation DATE OF BIRTH/BUSINESS REGISTRATION (For RTGS Only)
ADDRESS (Bldg. No., Street Village, Town City, Country)
SOURCE OF FUNDS
ACCOUNT NUMBER
BENEFICIARY INFORMATION
BANK NAME
BANK ADDRESS (Optional if SWIFT BIC is provided)
AMOUNT Currency In figures
In words
BANK CODE (SWIFT BIC/FW/ABA/CHIPS/BSB)
BENEFICIARY A/C (OR IBAN)
MODE OF PAYMENT – PRINCIPAL MODE OF PAYMENT – BANK CHARGES
PESO FXCY PESO FXCY BENEFICIARY NAME Individual Corporate
Cash Cash
Debit Account No. Debit Account No.
BENEFICIARY ADDRESS
______________________________ ______________________________
MBTC Check No. MBTC Check No.
______________________________ __________________________
RELATIONSHIP OF APPLICANT TO THE BENEFICIARY
CHARGE METHOD PURPOSE OF TRANSACTION
(Only applies to FXTT transactions) Payment of Purchased Allowance Business SPECIAL INSTRUCTION
Remitter (OUR) Transaction Item (i.e.
goods,car, etc.) to Others, please specify
Shared (SHA)
Supplier/Seller ____________________
Beneficiary (BEN) ____________________
ORIGINATOR’S INFORMATION (FOR FX Dealers and Money Changers Only) FOR FOREIGN TELEGRAPHIC TRANSFER ONLY
NAME INTERMEDIARY BANK NAME
ADDRESS INTERMEDIARY BANK ADDRESS (Optional if SWIFT/BIC is provided)
ACCOUNT NO./TYPE OF ID AND NO. INTERMEDIARY BANK CODE (SWIFT BIC/FW/ABA/CHIPS/BSB)
SUBJECT TO THE TERMS AND CONDITIONS ON THE REVERSE SIDE HEREOF TO WHICH I/WE
REPRESENTATIVE AUTHORIZATION AGREE. THIS WILL AUTHORIZE THE BANK TO (1) DEBIT MY/OUR ACCOUNT FOR THE PAYMENT AND
This will authorize my/our representative whose specimen signature appears below to transact on APPLICABLE BANK CHARGES ABOVE, AND (2) DISCLOSE MY/OUR CONTACT DETAILS, ACCOUNT
my/our behalf. NUMBER AND IDENTIFICATION PAPERS. FURTHER, I/WE DECLARE UNDER THE PENALTY OF
PERJURY THAT MY/OUR CO-DEPOSITOR(S) IS/ARE STILL LIVING.
___________________________________ ______________________________
SIGNATURE OF APPLICANT(S) SIGNATURE OF AUTHORIZED ___________________________________________
OVER PRINTED NAME REPRESENTATIVE OVER PRINTED NAME SIGNATURE OF APPLICANT(S) OVER PRINTED NAME
FOR BANK’S USE ONLY
SUMMARY OF CHARGES PAID TR NO.
FX Rate:_____ FXCY Amount PHP Amount PRINCIPAL ______________________________
Face Amount BANK CHARGE ______________________________
Commission
CORR. BANK CHARGES ______________________________
Documentary Stamp
Cable
Others (e.g. notarial, handling/swap) REFERENCE NO. PURPOSE CODE
Total Charges
PROCESSED BY: APPROVED BY: PERFORMED NAME SCREENING YES NO
MB-I-M-170.1-t/Sept. '24
TERMS AND CONDITIONS
In this Terms and Conditions, Metropolitan Bank & Trust Company refers to “Metrobank” “us,” “we,” “our,” or “Bank” and “you,”
“your,” “Customer,” or “Accountholder/s” refers to you as an Individual or Commercial accountholder of any of our deposit and loan
products and/or user of our services and/or facilities.
1. We may use any of our correspondents/agents to implement the telegraphic transfer payment.
2. We may send any message in explicit language, code, or cipher, consistent with industry practice and we shall not be
responsible for any loss, delay, error, omission or mutilation, which may occur in the transmission, or for any
misinterpretation.
3. We may refuse a telegraphic transfer if: (a) we believe on reasonable grounds that such might constitute a breach of
any law or regulation, such as anti-money laundering and counter-terrorism financing laws; (b) your account balance
is insufficient; (c) you provided unclear, false, or erroneous information; or (d) you failed to submit the required
additional information or supporting documents. We will notify you of our refusal as soon as practicable.
4. Unless otherwise agreed in writing, the exchange rate to be applied to the transaction shall be the Bank’s selling rate
at time it receives the funds.
5. In the absence of any specific instructions to the contrary, a telegraphic transfer will be payable in the currency of the
country in which payment is to be made. If it is a different currency, it shall be payable using the Bank’s correspondent’s
or agent’s buying rate.
6. Unless finally adjudged by a court of competent jurisdiction that we acted in bad faith, gross negligence, or contrary
to our fiduciary obligation, we shall not be liable for any loss, claims, damages, or expenses of any kind or nature,
arising from or in connection with any delay, interruptions, errors, non-transmission, or refusal in implementing an
outgoing telegraphic transfer, in case: (a) you failed to provide the required additional information or supporting
documents of the Bank or any regulatory agency, within the prescribed period; (b) of delay or non-performance of our
correspondents or agents; or (c) of other factors beyond our reasonable control.
7. The Customer ensures the accuracy and completeness of details provided. The Bank is not liable for delay or rejection
of payment due to inaccurate or incomplete information provided in this form.
8. In case of a Foreign Telegraphic Transfer where the country of the Beneficiary Customer differs from the country of
the Beneficiary Bank, the Customer is confirming to proceed with the processing of this payment instruction.
9. In case of where the Charge Method is “Remitter” or “Shared”, the customer is willing to pay for the possible comeback
charges from the beneficiary, intermediary, and/or correspondent bank, on top of the Correspondent Bank Charges
already collected upfront for this transaction.
10. We may only grant refund upon (a) submission of your signed written request; and (b) our confirmation of the effective
cancellation of the telegraphic transfer. Refund is further subject to our exchange rate and applicable fees and
charges. We shall not responsible for any fluctuations in the exchange rate.