Request for CHAPS Transfer (Shipley)

Request for CHAPS TransferThe Transfer Request form below uses Javascript. Your browser is unable to use it because either: (a) Your browser version does not support Javascript; or
(b) You have Active Scripting disabled on your browser. You will need to print the PDF Version of the CHAPS Transfer Request form (PDF 82K) and fill it in manually.

Please complete the form below. When you indicate whether or not you are making a composite payment, you will be able to press the 'Create' button below to make a printable copy of this form.

BANK DETAILS

Bank

Date Payment to be made (ddmmyyyy)

CUSTOMER DETAILS

Account Name To Be Debited

Customer Address

Line 1

Line 2

(optional) Line 3

(optional) Line 4

Account Number To Be Debited

Sort Code (Account Holding Branch) (e.g. '20 33 51')

Currency Code (GBP or Eur)

Amount (eg: 1234.56)

Amount in words

ADDITIONAL MANDATORY INFORMATION Accounts Office Reference A001 remaining characters of reference

Is this a composite payment?

(Select Yes or No. You will then be able to print the completed form.)

Yes No

The Transfer Request Form has been tested on the PC versions of Microsoft Explorer 5 and above and Netscape 4.0 and above.

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