Seafarer's General Information

Seafarer's Name
Email
Home Address
Date of Birth

Beneficiary Bank Details

● Beneficiary Name
● Account No. / IBAN
● SWIFT Code / BIC
● Bank Name
Bank Address

Branch Details

Branch Name
City / Country

Correspondent Bank Details (If Any)

Bank Name
SWIFT Code
Account No. / IBAN

Additional Info

Details of Payment

Wages for Seafarer:

* Red markers indicate compulsory fields. Any expenses resulting from improper declaration in this form, including bank charges or exchange rate losses, shall be the seafarer's responsibility.