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Barclays

The document is a form related to a refund request for insurance at Barclays Headquarters II, requiring specific information to be filled out in block capitals. It details the owner's capital amount of $32,550.00, outstanding attorney fees, and includes authorization signatures. The form also emphasizes the importance of legibility to avoid delays in processing.

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daniel.bookstaber
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131 views1 page

Barclays

The document is a form related to a refund request for insurance at Barclays Headquarters II, requiring specific information to be filled out in block capitals. It details the owner's capital amount of $32,550.00, outstanding attorney fees, and includes authorization signatures. The form also emphasizes the importance of legibility to avoid delays in processing.

Uploaded by

daniel.bookstaber
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Barclays Headquarters II insurance

Please complete this form in BLOCK CAPITALS. Fields highlighted in BLUE and with an asterisk must be
completed. Please ensure the information is captured within the respective boxes in each field. Please refer
to the Guide to completing this form overleaf. Illegible forms are likely to result in delays.

BANK USE ONLY Dispatch Date: 2022-11-01 Reference: 202486015 Originating Branch
055802608-73

Refund request / pending due to lack of legal


payments

Owner of the capital: Cristian Benítez

ID 16.305.138-9

Capital amount recorded: $32,550.00

Account Tracking Number:

Capital status - Released

Outstanding Attorney Fees: 340 USD

Confiscation Date: 2019-11-02 16-00-00 GMT

Authorized Signature: Authorized Customer (if applicable):

Daniel Kimmich Manager Cristian R. Benítez Q.

Code word (if applicable):


*BANK USE ONLY Date Received: 2022-05-18 Details to two forms of ID seen:
CONFIRMED FROM THE
GOVERNATOR OF UK CENTRAL BANK
Branch Contact Name, Barclays Fax Transmission
Number and Staff №. 40399 Check (Initial):
*All branch checks (including ID & V, Fraud and Money Laundering/POCA) Special Instructions: Bill payment
completed. will be
through the company CFT Partner
Branch Authorization: Financial Department Outlet Code: 43
Barclays

Barclays is a trading name of Barclays Bank PLC and its subsidiaries. Barclays Bank PLC is authorized by the Prudential Regulation
Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Financial Services Register №.
122702). Registered in England. Registered number is 1026167 with registered office at 1 Churchill Place, London E14 5HP. Ref №: 2272.
03/14.

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