Wire Out

AMID FINANCIAL CENTRE

Please complete this form in it sentirety. Your request will not be honored unless avalid photo ID is submitted with this form. For your protection verbal validati on may be required. Once completed please, scan &email the for mand ID to info@amidfinancialcenter.com

Wire Information (please type orprint)

*Date :

*AMID Account#:

*Amount:

*AMID Account Name:

*Beneficiary Bank Name:

*SWIFTCode or ABA Routing #:

* Bank Address (street, city, state, zip code, country):

*Beneficiary Bank Account#:

Beneficiary Bank Account Name:

*For Further Credit Account#:

* For Further CreditName:

*IBAN # (Required for European Banks):

*Reason for WireRequest:

*Phone#:

E-mail address:

Print Name(s):

Signature(1):

Date:

Joint Signature(2):

Date:

The amount you may request is based upon your available cash adjusted to reject any open orders on your account. Curren to penorders canaffect how much you are all owed torequest. Upon enteringa request, your available cash will be debited in the amount of the funds request.

Funds recently deposited by check or wire will only be available for withdrawal 10 business days after the date of deposit.Funds request cut off time is 1:00 PM EST.

We will only wire for final credit to an account in the exact same name as the account you hold with our firm. We DO NOT allow third party wires. Wire Fee within the United States: $30.00.International Wire Fee: $60.00.

NOTE:If you are wiring to another brokerage firm, under “BankAccountName” you would put either that firm’s name or their clearing firm’s name, depending on their wiring in structions, and their bank account number. Then you would put FFC(For Further Credit)to your name and account number with that other firm. If you are wiring directly to a bank account in your name, then there is no FFC necessary.

AMID Financial Centre, 1st Floor, Ebene Tower, 52 Ebene Cybercity, Ebene 72201, Mauritius.Phone #: +442036959566