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P A Y M E N T T O B A N K ( F O R B A N K U S E O N L Y ) Refer to page 3 fo r
instructions and definitions necessary for completion o f this request. Pl e ase
complete all mandatory fields to a v oid processing delays. Enter Type of
Request: Company I D : Customer Name: Completed By: T e mplate I D : Payment T y
pe: Payment Currency: Payment Destination: N O N - T D A C C O U N T ( O T H E R
B A N K ) I N T E R N A T I O N A L T R A N S F E R S Beneficiary Name: Benefic
iary Account No: Street Address: Street Address: Country: Country: Bank Name:
City: City: Prov/State: Prov/State: Prov/State: Prov/State: Foreign Foreign
Payment amount: Bank I D : Date: Phone No: ext: MM / DD / YYYY A D D 66190 T R U
E S I G H T P T E . L TD . Charlie Song +14242489328 Mandatory fields are
denoted with an asterisk "*" when a Request Type is chosen on the form. PL E ASE
B E A W ARE THAT PROCESS I NG TIM E IS 5 BUS I NE S S DA Y S . C U S T O M E R I
N F O R M A T I O N B E N E F I C I A R Y D E T A I L S B E N E F I C I A R Y B
A N K D E T A I L S Page 1 of 5 14686 (0520)
CUSTOMER INFORMATION Company ID : Template ID : INTERNATIONAL TRANSFERS 66190
None Payment for advertising services Truesight V e ntures Limi t ed will cover
all S W I F T paym e nt fees F o r B e n e fi c i a r y : F o r T D B a n k : R
e a s o n f o r P a y m e n t : B r a n c h C o n t a c t N a m e B r a n c h S
i g n a t u r e T h e P a y m e n t T y p e fi e l d i f i t h a s b e e n i n c
o r r e c t l y p o p u l a t e d a n d t h e P a y m e n t T y p e s h o u l d
b e a P a y m e n t t o B e n e fi c i a r y o r a P a y m e n t t o B a n k T h
e P a y m e n t D e s t i n a t i o n fi e l d i f P a y m e n t D e s t i n a t
i o n s h o u l d b e t o a N o n T D a c c o u n t o r a n o t h e r T D A c c
o u n t , d e t e r m i n e d b a s e d o n t h e B e n e fi c i a r y B a n k D
e t a i l s T h e B a n k I D fi e l d , i f t h e B a n k I D fi e l d i s i n
v a l i d o r i n c o m p l e t e b a s e d o n t h e B e n e fi c i a r y B a n
k D e t a i l s ; T D w i l l r e j e c t a n y fi x e d t e m p l a t e r e c e
i v e d i f i t d o e s n o t c o n t a i n a l l o f t h e i n f o r m a t i o
n r e q u i r e d b y T D . N o t w i t h s t a n d i n g t h e f o r e g o i n
g , i f T D i s a b l e t o p o p u l a t e / c o r r e c t t h e fi x e d t e m
p l a t e w i t h s u ffi c i e n t i n f o r m a t i o n i n o r d e r f o r i
t t o b e a c c e p t e d , T D m a y , b u t i s n o t o b l i g a t e d t o d
o s o . Y o u a u t h o r i z e T D t o p o p u l a t e / c o r r e c t t h e fi
e l d s i d e n t i fi e d b e l o w w i t h o u t n o t i c e t o y o u : S i g
n a t u r e o f S i g n i n g A u t h o r i t y N a m e C h a r l i e S o n g N
a m e S i g n a t u r e o f S i g n i n g A u t h o r i t y A u t h o r i z e d
S i g n i n g A u t h o r i t y ( s ) o f C o m p a n y B r a n c h P h o n e N
u m b e r T r a n s i t N u m b e r D a t e ( M M / D D / U Y Y Y ) T o b e c o
m p l e t e d b y B r a n c h INSTRUCTIONS Page 2 of 5 14686 (0520)