Wire Information Form - Mizrachi Canada

Please fill out the form in English

Institution Name שם העמותה(Required)

Name of Contact Person שם איש קשר(Required)

First Last

Email מייל(Required)

Phone מספר טלפון(Required)

Address of Institution כתבות עמותה(Required)

Street Address Address Line 2 City ZIP / Postal Code Country

Name on Bank Account שם על חשבון הבנק(Required)

Bank Name שם הבנק(Required)

Bank Address כתובת הבנק(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Account Number מספר חשבון(Required)

IBAN(Required)

SWIFT(Required)