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مجوز برداشت از حساب بانکی

ریفت » مرکز خرید > فروشگاه آنلاین > مجوز برداشت از حساب

Please fill in this form completely. Afterwards, please print it and then mail or fax it signed to us.

Herewith I/we authorize noted company, to debit my account using debit direct. Should my account not have the required coverage, the bank shall not be required to allow the debit. Partial payments will not be conducted.

Payment receiver:

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رشت خیابان لاکانی مجتمع پاسارگاد طبقه 2 واحد 5
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Payment description:

Account Owner:

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