Branch Brand Paylink Euro

1 AIB Paylink Euro Payment Application Form1 of 4 Paylink EuroPayment Application FormBranch BrandAIB/FT8A 03/19 Customer (Sender) DetailsReceiver DetailsPayment Details3. Sender Name5. Receiver Name8. Payment Amount ( )4. Sender Address6. Receiver IBAN7. Receiver Bank BIC10. Credit Narrative2. Sort Code- - Account Ccy CodeAccount to be debitedBIC is not required for Paylink Euro is only required for Paylink Euro only1. Paylink Euro Standard*Full product description available in the Schedule of International Transactions Charges booklet and on *Please see reverse of this form for explanation of payment service types and instructions on completion of this no Payment Service is selected, the payment will be sent as Paylink Euro Standard where may only be sent to the qualifying destinations, details of which are set out at paragraph 7 on the reverse of this Euro only8 or 11 characters onlyE U R9.

2 Payment Amount in Words in Euro only11. Additional Information (optional) ( Invoice No.)NBP Payment NumberAny Payment Amount AIB Charge 0 Any Payment Amount AIB Charge 25 Paylink Euro Urgent*ORPlease print in BLOCK CAPITALS-ChargesSHARED: This payment may only be made on a charges shared basis (See overleaf for explanation).Customer Acknowledgement and AuthorisationTerms and Conditions relating to international payments apply (the Terms ). The Terms are set out in the Terms and Conditions issued by Allied Irish Banks, (the Bank ) for the account to be debited. Please read the Terms carefully, copies of which are available at any Branch of the Bank and on : Allied Irish Banks, carry out the above international payment instruction on my/our behalf.

3 I/we acknowledge that I/we have read the Terms and agree to be bound by them. 12. Customer Authorised Signature(s) Inputter/Teller1st Approver2nd SignatureType of VerifiedPost/CounterBranch DetailsFor Branch use onlyAllied Irish Banks, is regulated by the Central Bank of and Conditions Service (Cut-off time for receipt of payment application form in an AIB Branch is 1:00pm)AIB Paylink Euro Payment Application Form2 of 4 Branch CopyPaylink EuroPayment Application FormBranch BrandCustomer (Sender) DetailsReceiver DetailsPayment Details3. Sender Name5. Receiver Name8. Payment Amount ( )4. Sender Address6. Receiver IBAN7. Receiver Bank BIC10. Credit Narrative2.

4 Sort Code- - Account Ccy CodeAccount to be debitedBIC is not required for Paylink Euro is only required for Paylink Euro only1. Paylink Euro Standard*Full product description available in the Schedule of International Transactions Charges booklet and on *Please see reverse of this form for explanation of payment service types and instructions on completion of this no Payment Service is selected, the payment will be sent as Paylink Euro Standard where may only be sent to the qualifying destinations, details of which are set out at paragraph 7 on the reverse of this Euro only8 or 11 characters onlyE U R9. Payment Amount in Words in Euro only11.

5 Additional Information (optional) ( Invoice No.)NBP Payment NumberAny Payment Amount AIB Charge 0 Any Payment Amount AIB Charge 25 Paylink Euro Urgent*ORPlease print in BLOCK CAPITALS-ChargesSHARED: This payment may only be made on a charges shared basis (See overleaf for explanation).Customer Acknowledgement and AuthorisationTerms and Conditions relating to international payments apply (the Terms ). The Terms are set out in the Terms and Conditions issued by Allied Irish Banks, (the Bank ) for the account to be debited. Please read the Terms carefully, copies of which are available at any Branch of the Bank and on : Allied Irish Banks, carry out the above international payment instruction on my/our behalf.

6 I/we acknowledge that I/we have read the Terms and agree to be bound by Irish Banks, is regulated by the Central Bank of and Conditions 03/1912. Customer Authorised Signature(s)Inputter/Teller1st Approver2nd SignatureType of VerifiedPost/CounterBranch DetailsFor Branch use onlyPayment Service (Cut-off time for receipt of payment application form in an AIB Branch is 1:00pm)AIB Paylink Euro Payment Application Form3 of 4 Customer CopyPaylink EuroPayment Application FormBranch BrandAIB/FT8A 03/19 Customer (Sender) DetailsReceiver DetailsPayment Details3. Sender Name5. Receiver Name8. Payment Amount ( )4. Sender Address6. Receiver IBAN7. Receiver Bank BIC10.

7 Credit Narrative2. Sort Code- - Account Ccy CodeAccount to be debitedBIC is not required for Paylink Euro is only required for Paylink Euro only1. Paylink Euro Standard*Full product description available in the Schedule of International Transactions Charges booklet and on *Please see reverse of this form for explanation of payment service types and instructions on completion of this no Payment Service is selected, the payment will be sent as Paylink Euro Standard where may only be sent to the qualifying destinations, details of which are set out at paragraph 7 on the reverse of this Euro only8 or 11 characters onlyE U R9. Payment Amount in Words in Euro only11.

8 Additional Information (optional) ( Invoice No.)NBP Payment NumberAny Payment Amount AIB Charge 0 Any Payment Amount AIB Charge 25 Paylink Euro Urgent*ORPlease print in BLOCK CAPITALS-ChargesSHARED: This payment may only be made on a charges shared basis (See overleaf for explanation).Customer Acknowledgement and AuthorisationTerms and Conditions relating to international payments apply (the Terms ). The Terms are set out in the Terms and Conditions issued by Allied Irish Banks, (the Bank ) for the account to be debited. Please read the Terms carefully, copies of which are available at any Branch of the Bank and on : Allied Irish Banks, carry out the above international payment instruction on my/our behalf.

9 I/we acknowledge that I/we have read the Terms and agree to be bound by Irish Banks, is regulated by the Central Bank of and Conditions apply. 12. Customer Authorised Signature(s) Inputter/Teller1st Approver2nd SignatureType of VerifiedPost/CounterBranch DetailsFor Branch use onlyPayment Service (Cut-off time for receipt of payment application form in an AIB Branch is 1:00pm)AIB Paylink Euro Payment Application Form4 of 4 Instructions to assist you when completing a Paylink Euro Application Form If you have any queries when completing this form, please refer to instructions below or contact our Customer Service Unit at (01) 611 APPLICATION FORM IS ONLY TO BE USED IF.

10 YOUR PAYMENT INSTRUCTION IS IN EURO YOUR PAYMENT IS GOING TO A QUALIFYING DESTINATION, DETAILS OF WHICH ARE SET OUT IN PARAGRAPH 7 BELOW YOUR PAYMENT IS GOING TO A RECEIVER BANK IN IRELAND, INCLUDING AIB YOU HAVE COMPLETE VALID RECEIVER S IBAN AND BIC (BANK IDENTIFIER CODE) DETAILS (FOR Paylink EURO URGENT ONLY) OR Y OU HAVE COMPLETE VALID RECEIVER S IBAN (FOR Paylink EURO STANDARD ONLY SEPA PAYMENT)Payment Service1. Pa ylink Euro is a euro payment to a SEPA zone country or territory. (Refer Paragraph 7 for list of qualifying destinations). T hey can be sent on a standard or urgent basis. To qualify for the Paylink Euro Standard option the receiver s bank must be reachable via the SEPA Credit Transfer (SCT) Scheme.