可疑交易报告
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c. 舉報補充
,,,.f)美元USD,,,. ,,,.g)加元CAD,,,. ,,,.h)澳洲元AUD,,,. ,,,.i)紐西蘭元NZD,,,. ,,,.j)其他 ,,,.
______________
17.交易細節及懷疑原因(如有需要，可於附件表格加以詳述)：
__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 18. 舉報機構聯絡人簽署:
日期:____________________ ________________________________________
請為每個被舉報之個人填寫一份副表A
請為每個被舉報之機構填寫一份副表B
A07.身份證明文件 (請選擇一項或多項，如可以，請提供複印本):
證件類別 證件編號 簽發地
/省份 有效期至(年 / 月 / 日)
a.澳門居民身份證
不適用
/ /
b.香港居民身份證
不適用
/ /
c.內地居民身份證/ /
d.護照/ /
e.通行證/ /
f.其他身份證明文件:___________________/ / A08. 被舉報人地址