6070
www.bnb.bt
Thimphu, Bhutan
Real Time Gross Settlement (RTGS) FORM * This form is to be used for remittance requests to India only
Please complete in CAPITAL LETTERS and the appropriate boxes. All the fields marked * are mandatory.
Date:
To,
The Branch Manager,
Bhutan National Bank Limited,
.....................................................................
Dear Sir/Madam,
By debiting my A/c No: maintained with your bank,
please transfer a sum of INR.............................................................. (Amount in words ...............................................
................................................................................................................................................ ) only as per the details below:
Beneficiary Details:
Name: .....................................................................................................
Address: .....................................................................................................
A/c no.: ................................................................................... Phone no.: ...............................................................
Email ID: ..........................................................................................................................
Bank Name: ....................................................................................................................
Bank location (city & PIN code): ..............................................................
IFSC code: .....................................................................................................
Purpose of remittance (attach relevant supporting documents): .................................................................................
.........................................................................................................................................................................................................
* Transfer charges for the above transaction, if any, may be debited from my account (mentioned above)/ deducted from the
remittance amount.
Signature: ................................................
Remittance amount: .............................................
Name of the Remitter: ............................................................
.. Charges: .............................................
....................................................................................................... Total: .............................................
Mobile No.: .......................................................................
Bhutan National Bank 1
6070
www.bnb.bt
Thimphu, Bhutan
Real Time Gross Settlement (RTGS) FORM * This form is to be used for remittance requests to India only
Please complete in CAPITAL LETTERS and the appropriate boxes. All the fields marked * are mandatory.
Terms of Transfer:
a) Remitter shall be responsible for the accuracy of the details given in the form.
b) Remitter shall ensure availability of funds in the Account.
c) Remittance instruction shall become irrevocable once it is executed by the Bank.
d) Remittance request received after cut-off time will not be accepted/entertained.
Disclaimer: This funds transfer transaction is solely affected based on the account number of
the beneficiary and amounts furnished by you on this form. The bank shall not be held liable for any
incorrect details that you have provided on the form, and the transaction shall be affected at your
sole risk &responsibility.
Consent: I acknowledge that I have read, understood, and agree to the terms outlined in BNBL’s
Privacy Policy. I hereby grant my explicit consent for the collection, use, storage, and sharing of my
personal data as described in the Privacy Policy. The information I provide may be used for contacting me
for service-related or marketing communications, Enhancing and personalizing my customer experience
with BNBL and to comply with legal and regulatory obligations.
Application Reference Number:
.........................................................................................................
Type of payment: Advance Final Payment
Custom Declaration Number:
Bank Application Remittance Refer ence Number : .........................................................................
FOR BANK USE ONLY
Particulars Name of the staff Date/Month/Year Signature
Input done by
Verified/Approved by
Bhutan National Bank 2
Version No. 1.2 | Release Date: 14/05/2024
6070
www.bnb.bt
Thimphu, Bhutan
PRIVACY POLICY
BNB-PO-002-Privacy-Policy
Version No. 1.0 | Release Date: 01/06/2023
Bhutan National Bank
