提款单提交填写说明
Customer Information
Full Name:
姓 名
Street Address:
街道 地址
City:
State/Province:
ZIP/Postal Code:
Country:
选择国家
United States of America
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Possessions
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China中国
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czechy
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
European Trading
Faeroe Islands
Falkland Islands (Malvinas)
Fiji
Finland
France
French Polynesia
French Southern Territories
French West Indies
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey, C.I.
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast (Cote D"Ivoire)
Jamaica
Japan
Jersey, C.I.
Jordan
Kampuchea (Cambodia)
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Malagasy (Madagascar)
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Metropolitan France (ex overseas)
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Panama Canal Zone
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Lucia
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts-Nevis-Anguilla
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates/Dubai
United Kingdom
Uruguay
Uzbekistan
Vanuatu (New Hebrides)
Venezuela
Vietnam
Wallis and Futuna Islands
Western Sahara
Western Samoa
Yemen
Yugoslavia
Zambia
Zimbabwe
Telephone Number:
Withdrawal Information
Trading Account ID Number:
Withdrawal Amount:
USD
EUR
JPY
AUD
NZD
CAD
CHF
GBP
Beneficiary Name:
受益人(帐户所有人,需与交易帐户一致)
Close Account?:是否消户
No, do not close my account(不消户)
Yes, please close my account(消户)
NOTE: Beneficiary must be the trading account owner.
Capital Market Services, LLC trading account owner (or one of the joint account owners) only.
Capital Market Services, LLC may not make or receive payments via a third party.
Withdrawal Type:取款方式
Check 支票(美加地区)
Wire Transfer 银行汇款
Your Bank Information
NOTE: Fill out this section only if you chose "Wire Transfer" above.
Account Number:
ABA Number or Swift Code:
Bank Name:
收款银行名称
Bank Address:
收款银行地址
If you do not know your bank information, please contact your bank to obtain it.
Intermediary Correspondent Bank Information
(If applicable. Contact your bank officer if unsure.)
Intermediary Account Number:
ABA Number or Swift Code:
Bank Name:
Bank Address:
Date:
07-24-08 04:20:11