Payment Method Authorization Form

Payment Method Authorization Form
Name & Personal Information
3-5 letter code
(Optional)
I am*
Full Name*

First NameLast Names
Company Name Legal Name
(Optional)
your e-mail*
Payment Options
Payment Method*

PaypalDirect DepositInternational Wire TransferWestern UnionPayoneer
.
Bank Name
Routing Number
9 digits
Account Number
Account type
International Bank Name
SWIFT/BIC code
Account Number or IBAN
IBAN is mandatory for European countries.
Account ID
Payment to other beneficiaries must be authorized by signed letter. Contact vendor_manager@trustedtranslations.com for information
Name of the Account Holder
Payment to other beneficiaries must be authorized by signed letter. Contact vendor_manager@trustedtranslations.com for information.
Other comments
Empty
Authorized Signature*

Clear
I declare that I have completed this form myself. I authorize you and the financial institution listed above to initiate electronic credit entries, and if necessary, debit entries and adjustments for any credit entries in error.
Should be Empty:

Name & Personal Information