Request for payment form – Christina Chia Law Chambers (CCLC)

Request for payment formCY Yong2023-05-11T16:23:08+08:00

HIEN YEONG TRUST

REQUEST FOR PAYMENT IN ACCORDANCE TO CLAUSE 4.4 OF DEED OF TRUST DATED 19 APRIL 2023

TO: CHRISTINA CHIA LAW CHAMBERS

TRUSTEES FOR HIEN YEONG TRUST

Mezzanine Floor,

Menara Goldstone (Holiday Inn Express),

No. 84, Jalan Raja Chulan,

50200 Kuala Lumpur

PARTICULARS OF REQUEST:-

DATE OF REQUEST: *

NAME: *

CONTACT NUMBER:

RELATIONSHIP WITH BENEFICIARY:

REASON FOR REQUEST FOR PAYMENT:

SUPPORTING DOCUMENTS FOR PAYMENT:

AMOUNT OF FUNDS REQUIRED:

CURRENCY:

PAYEE’S DETAILS:-

PAYEE’S NAME:

PAYEE’S NRIC NO. / COMPANY ID:

PAYEE’S ADDRESS:

PAYEE’S CONTACT NO.:

PAYEE’S EMAIL ADDRESS:

MODE OF PAYMENT:-

Please Choose One *

PAYMENT DATE:

REQUESTOR SIGNATURE

5

CONSENT FROM PROTECTOR:-

DATE CONSENT APPROVED:

DATE CONSENT OBTAINED FROM PROTECTOR:

MODE OF CONSENT OBTAINED FROM PROTECTOR:

6

ADMINISTRATION BY TRUSTEES:-

AMOUNT:

TRANSACTION DATE:

NAME OF RECIPIENT OF PAYMENT:

MODE OF PAYMENT:

( )

BY CHEQUE

( )

BY INTERBANK GIRO

( )

BY TELEGRAPHIC TRANSFER

…………………………………….

SIGNATURE OF TRUSTEE