(光票)托收申请书(样本)

票据托收申请书

APPLICATION FOR COLLECTION

致：杭州市商业银行

To: HANGZHOU CITY COMMERCIAL BANK

兹附上下述票据委托代收。收妥票款请按以下打“╳”条款解付：

I/we enclose herewith the under mentioned bill(s) for collection. Please effect the proceeds when collected in

请划收本单位在贵行第__________________________号账户，

Please credit our A/C No.__________________________ with your bank,

托收费用请划付本单位在贵行第________________________号账户。

For your charges debit our A/C No._________________________ with your bank.

如有费用请扣除后，划收本人/

本单位在贵行第_________________________号账户。

After deducting your charges if any, please credit my/our A/C No._____________________ with your bank.

于_________天后，由本人/代办人凭收据在贵行第_____________________号柜台商洽取款。

After ________ days, at your bank ’s counter No(s) __________ contact for drawing funds against the receipt.

本人（等）/本公司特此声明，日后如上述票据遭受退票或有其他情况发生致

贵行受损，贵行可无需征求本人（等）/本公司同意，立即有权由本人（等）/本公司账户内扣回上述票据及有关费用（包括外汇买卖差价和利息）。若账户存款不足扣付，本人（等）/本公司自当立即如数清还。 I/We

understand and agree that you are authorized to debit my/our account without obtaining my/our confirmation with the above amount together with any expenses or loss (including exchange and interest) that you may suffer in the event of the above being returned or in any way dealt with at any time. I/We undertake to repay you on demand any unpaid portion in case the balance remaining on my/our account is insufficient to meet the refund of payment. 申请人签章（印章） Signature of the applicant

________________________________________________ 地址

Address:___________________________________________________________________ 联系电话

Tel. No. :___________________________________________________________________ 身份证件及号码

ID Card No. :_______________________________________________________________

日期 Date:______________ 银行编号 Bank Ref:_____________