銀行振込依頼書

＜Ｙ８＞
Date
yyyy / mm / dd
核融合科学研究所管理部財務課経理・資産係宛
To the National Institute for Fusion Science
氏名(First Name / Last Name) (이름 / 성)( 姓/名)( Vorname / Nachname)( Prénom / Nom)：
㊞
銀行振込依頼書
Bank Transfer Request Form
貴研究所から支払われる旅費・謝金は、下記銀行口座へ振り込み下さるようお願いします。
I hereby request that you deposit all the expenses to be reimbursed pertaining to compensation and travel
expenses covered by the National Institute for Fusion Science into the account detailed below.
1 /New registration
Bank
2/ Change request of the registered contents
Information
金融機関
Name of the Bank
(Bank Name)
預金種別
番
(Branch Name)
普通預金(savings
Type of account
店
(Japan Post Bank, Citibank, or another)
号
accounts)
口座番号
Brunch Number
(Account Number)
フリガナ
(If any, in KATAKANA letters)
口座名義
Name of Account
Holder
※ゆうちょ銀行を指定する場合、支店名・店番号・口座番号は、通帳の「記号・番号」ではなく、「振込用の店名・店番・口座番号」
を記入して下さい。
If you designate the Japan Post Bank (Yucho Bank,) to receive the money, do NOT use the numbers
at the top of the double-page information on your bankbook in filling out the above cells.
Please attach a copy of the relevant pages of your bankbook to this request form.
Affiliation information
機関名称
(Institute)
所属部局名
(Department)
職
名
(Position)
〒
勤務先住所
－
(Work Address)
Contact Information
電話番号
(Phone number)
(
)
Postal code(
自宅住所
Ｅメールアドレス
(e-mail)
)
(Home Address)
大学卒業年月
Year of Graduation from university
（ Sep,2014 ）
/month
/year
Notes for the Bank Transfer Request Form
A) Please note that the surname should be filled in capital letters .
For ex; ； Michael Joseph Jackson → Michael Joseph JACKSON
； Bruce Lee → Bruce LEE
； Bae Yongjun → BAE Yongjun
B) This form needs to be stamped with your seal if you have a Japanese bank account, then
submit it by as a PDF after you stamped it or by as the original document.
C) KATAKANA letters are print of the information required to transfer your payment.
However, if you have no bank account in Japan, please fill in the katakana phonetic
reading.
For ex; ；Michael Joseph JACKSON → マイケルジョセフジャクソン
；Bruce LEE → ブルース・リー
;BAE Yong Joon → ペ・ヨンジュン
D) If you are Chinese or Korean, we would like to request the Japanese KANJI (繁
体字) for the ‘Name of Account Holder’ if possible.
For ex, ；Bruce LEE (李小龍)
；BAE Yong Joon (裵勇浚)
We appreciate your corporation.
A
B
C
Name ( D )

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