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Final Protocol to the Postal Payment Services Regulations

At the moment of proceeding to approval of the Postal Payment Services Regulations the Postal Operations Council has agreed the following:

Article RP I (existing reservation)
Instalments

In order to ensure normal payments to payees in its country, Viet Nam requires all countries exchanging money orders with it to automatically pay it an instalment, without it being necessary to wait to invoke the procedures set out in article RP 2509.2.

Article RP II (existing reservation)
Sending of postal payment orders

Thailand shall be authorized not to apply the provisions of article RP 1614.2 with respect to the obligations of the sending designated operator.

This Protocol shall have the same force and the same validity as if its provisions were inserted in the actual text of the Regulations to which it refers.

Done at Berne, on 24 November 2021.

For the Postal Operations Council:

Chair: France Represented by Jean-Paul Forceville

Secretary General  Bishar A. Hussein

 

Annexes: Forms

Counterfoil (Country)

INTERNATIONAL POSTAL MONEY ORDER

MP 1 (cf. tfp 1) Stamp of issuing service

Full name and address of sender [ ] cash [ ] outpayment [ ] inpayment Payee's account
Family name________________    

Giro centre and account No. or BIC/IBAN_______

Given name________________

___________________________

Advice of payment

[ ] yes

[ ] no _______________________________________

_________________________________________

Address____________________     Family name and given name of holder__________ Postal item No.__________
Postcode_____ Town_______ Payee [ ] Mr [ ] Ms ____________________________________ Issuing service___________
Country____________________ Family name________________ Giro account/Bank Date __________________

Giro account No.1 ___ Centre___

Given name_________________

or company name_______________

Name______________________________

___________________________________

 
Communications  
 
___________________________ Address of payee___________________________________________________________  
___________________________

_________________________________ Telephone number of payee______________

 
___________________________ Postcode_____________ Town________________ Country__________________  

1 If outpayment money order

Currency Amount in figures   Exchange rate
                ___________________________________
Currency Amount in figures Amount in figures Currency Sum deposited
                           
  Stamp of issuing service

Reference No.

Standardized identification No. of money order (barcode)  
         
         
DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW
         
         
           

Size 210,8 mm x 101,6 mm

MP 1  (back)

 
 
     
  Space for endorsements, if any
 

 

Receipt
 

     
  Identity document presented_________________________________________________ No. _____________________

  place of issue_____________________________ issuing authority_______________________ date of issue___________

  name of holder_____________________________________________ date and place of birth________________________

  Received the sum of1_____________________ Place and date__________________________________________

      Stamp of paying service
  In-register Signature of payee
  No.  
     
  ________________________ ___________________________________
 

1 Indicate amount and currency of payment

 
         
Counterfoil (Country)

INTERNATIONAL COD POSTAL MONEY ORDER

MP 1bis (cf. tfp 3)

Stamp of issuing service:

Identification/

No. of item __________

Identification/

No. of item ____________

[ ] inpayment Payee's account
Giro centre and account No. or BIC/IBAN _________
Full name and address of payee of COD amount [ ] cash [ ] outpayment _________________________________________

_________________________________________

Full name, given name ______________

________________________________________

Advice of payment Family name and given name of holder __________

_________________________________________

[ ] yes [ ] no
 
Full name and address of sender (receiver of item)

Family name ______________________________

Given name ________________________________

Payee of COD amount [ ] Mr [ ] Ms

Family name __________________________

Given name ____________________________

or company name ___________

Giro account/Bank

Name ______________________________

___________________________________

Addresse _______________________________   Postal item No.________ _____________
Postcode ________ Town ___________ Issuing service_________
Country _______________________________ Address of payee __________________________________________________________ Date_________________
Giro account No.1 _________ Centre __________ ________________________________________ Telephone number of payee ______________  

1 if outpayment money order

Issuing charge  
Currency Amount in figures      
Postcode _______ Town ________________ Country ____________________ No issuing charge    
Currency   Amount in figures   Exchange rate________
               
Amount in words Currency Sum deposited
                           
  Stamp of issuing service

Reference No.

Standardized identification No. of money order (barcode)  
DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW - DO NOT WRITE BELOW
         
         

Size 210,8 mm x 101,6 mm

MP 1bis (back)

   
 
   
  Space for endorsements, if any
 

 

Receipt
 

     
  Identity document presented _________________________________________________ No. _____________________
  place of issue _____________________________ issuing authority _______________________ date of issue ___________
  name of holder _____________________________________________ date and place of birth ________________________
  Received the sum of1 _____________________ Place and date ___________________________________________________

      Stamp of paying service
  In-register

Signature of payee
  No.  
     
  ________________________ ___________________________________
 

1 Indicate amount and currency of payment

 
     
Issuing designated operator

INTERNATIONAL POSTAL MONEY ORDER SERVICE

MP 2
(cf. TFP 6)
    [ ] Inquiry

[ ] request for withdrawal

 
Post office or giro centre of destination Date of MP 2 form
 

 
Our reference
 
Your reference

Description of money order [ ] Cash [ ] Outpayment
 
[ ] Inpayment
Method of transmission [ ] Mail

[ ] Fax/e-mail

   
Issue Issuing service No. of money order Date
 

Amount [ ] In currency of paying country [ ] In currency of issuing country
 

 
Amount of money order (in figures)
Sender Full name and address
 

Giro centre1
 

  Account No. (BIC/IBAN1)
Payee Full name and address
 


 
Giro account No.
IBAN/BIC

  Centre
Person making inquiry or request Full name and address
 


 
Additional information
 
Reason for inquiry or request [ ] The sender/payee (delete as appropriate) states that the amount has not been received.

Please investigate this matter and communicate the findings to us

[ ] Please return the above-mentioned money order to me for delivery to sender
[ ] The sender wishes to know whether the money order has been paid to the payee
Other reasons
 

If the money order has been lost, the amount is to be [ ] paid to the original payee   [ ] reimbursed to the sender
Method of transmission of reply [ ] Priority mail

[ ] Fax/e-mail

The present form must be returned to the service issuing the request

Place and date Stamp of office originating the request
Signature

 
Signature of person making the inquiry or request

Size 210 mm x 297 mm

_____________

1 If outpayment money order

Office sending the reply

reply to inquiry or request

MP 2 (back)
   
Post office or giro centre of destination of the reply Date of reply
  Our reference
  Your reference

Treatment of money order in question

[ ] Duly paid to the payee Date of payment
[ ] Credited to the payee's account Date of credit
[ ] Still being dealt with at the post office or giro centre Name of office
[ ] Delivered to the payee, who has not yet claimed payment
[ ] Returned to the country of issue Date
[ ] Not arrived at the post office or giro centre Name of office
Other reasons for non-payment of the money order or for not crediting the amount to the account

Declaration of payee (if possible) (art. RP 1904)

Stamp of office sending the reply

Signature

     
Issuing designated operator

request for rectification
of an international POSTAL money order

MP 3
cf. SFP 1)
     
Office or giro centre of issue of money order Date of request
Our reference
Your reference
Description of money order [ ] Cash [ ] Outpayment [ ] Inpayment
Issue Issuing service No. of money order Date
Amount [ ] In currency of country of payment [ ] In currency of country of issue
Amount of money (in figures)
Senders Full name and address
Giro centrs1 Account No. (BIC/IBAN1)
Payee Full name and address
Giro account No.

IBAN/BIC

Centre
Additional information

I. Request for rectification of a money order

The money order described above, which is attached herewith2, cannot be paid for the following reason:

[ ] Incorrect, incomplete or unclear indication or omission of the name or address of the payee

[ ] Number of giro account is missing or wrong

[ ] Discrepancies in or omission of amounts

[ ] Exceeding the maximum amount agreed to between the designated operators

[ ] Money order for an amount less than the minimum agreed to between the designated operators

[ ] Erasures or alterations in the entries

[ ] Omission of stamp or other service indications

[ ] Indication of the amount to be paid in a currency other than that which is accepted

[ ] Omission of the name of the currency unit

[ ] Obvious error in the ratio between the currency of the issuing country and that of the paying country

[ ] Use of non-regulation form

[ ] Expiry of validity date

Other reasons
Please return the money order, under cover, immediately after rectification, together with this form
Stamp of paying service

Signature

Stamp of issuing service

Signature

Size 210 mm x 297 mm

______________

1 If outpayment money order

2 Only if it is a letter-post money order

II. Request

MP 3 (back)

The money order described on the front

[ ] was destroyed before payment

[ ] was lost before payment

   
Stamp of paying service

Signature

Stamp of issuing service

Signature

     
Designated operator printing the report DAILY REPORT

Postal money orders issued

MP 4
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator

1 A.R. - Acknowledged received

Remarks
Issued
Date and time
Postal money order identifier Amount in currency of issuing country (xxx) Amount in issuing currency (xxx) A.R.1
           
Totals Number of postal money orders issued Amount in currency of issuing country (xxx) Amount in issuing currency (xxx) A.R.1  
           
Prepared by:   Time:    

Size 210 mm x 297 mm

Designated operator printing the report DAILY REPORT

Postal money orders reimbursed

MP 5
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator
Issued
Date and time
Reimbursed
Time
Postal money order identifier Amount in currency of issuing country (xxx) Amount in issuing currency (xxx) Remarks
       
Totals Number of postal money orders reimbursed Amount in currency of issuing country (xxx) Amount in issuing currency (xxx)
Prepared by:     Time:

Size 210 mm x 297 mm

Designated operator printing the report DAILY REPORT

Postal money orders paid

MP 6
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator
Received
Date and time
Payment
Time
Postal money order identifier Amount in issuing currency (xxx) Amount in currency of payment (xxx) Remarks
Totals Number of postal money orders paid Amount in issuing currency (xxx) Amount in currency of payment (xxx)
Prepared by:     Time:

Size 210 mm x 297 mm

Designated operator printing the report DAILY REPORT

Postal money orders received

MP 7
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator
Received
Date and time
Postal money order identifier Amount in issuing currency (xxx) Amount in currency of payment (xxx) Remarks
Totals Number of postal money orders received Amount in issuing currency (xxx) Amount in currency of payment (xxx)
Prepared by:     Time:

Size 210 mm x 297 mm

Designated operator DAILY SUMMARY REPORT

Postal money orders issued, reimbursed, received and paid

MP 8
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No.
 
     
Postal money orders issued Acknowledged received Remarks
Number of postal money orders      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx      
     
Postal money orders reimbursed Remarks  
Number of postal money orders      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx      
     
Postal money orders received Remarks  
Number of postal money orders      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx      
     
Postal money orders paid Remarks  
Number of postal money orders      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx      
Prepared by:     Time:

Size 297 mm x 210 mm

Paying designated operator international postal money order service
summary list of money orders paid
MP 104
(cf. SFP 2)
     
Issuing designated operator Date of list No.
Month Year
Category1 [ ] Cash [ ] Outpayment [ ] Inpayment
Serial No. Issue Amount issued
currency _______
Amount paid2
currency ______
Remarks
Year Month Office No.
1 2 3 4 5 6 7 8
Total (to be summarized on the last list or carried forward to the PP 1 periodical account

________________

1 This section to be completed only if the agreement concluded provides for such categories

2 If payment in a currency different from currency of issue

Size 210 mm x 297 mm

Issuing designated operator

advice of international postal transfer

VP 1
(cf. TFP 2)
Giro centre    
   
Full name and address of sender  
   
Giro centre and account No.

BIC/IBAN

Date
Full name and address of payee  
Postcode Town
Country  
Giro centre and account No.

BIC/IBAN

Giro centre
Advice of crediting to account

[ ] yes [ ] no

Messages Stamp of issuing
designated operator

 
Amount in figures
       

Size 148 mm x 105 mm

Requesting designated operator INQUIRY OR REQUEST FOR CANCELLATION

INTERNATIONAL POSTAL TRANSFER ORDER

VP 2
(cf. TFP 7)
     
     
Giro centre of origin [ ] inquiry

[ ] request

 
     
Giro centre of destination Date of VP 2 form
Date of transfer
[ ] Confirmation of a request sent by fax/e-mail

Notes. To be returned by registered mail

Concerning sender Giro centre of origin
Giro account No. Centre
BIC/IBAN
Full name and address
Postcode Town Country
Amount In figures, in currency of issuing country
Concerning payee Giro account No. Centre
BIC/IBAN
Full name and address
Postcode Town Country
Reason for inquiry or request [ .] The sender/payee (delete as appropriate) states that the payee has not been credited. Please investigate this matter and communicate the findings to us
[ ] Please cancel order described below and return the relevant advice to us, crediting the corresponding amount to our account1.1
Other reasons
 

 
Advice dispatched. Dispatch by the giro centre of origin Giro centre
Office of exchange of origin
List No. Date
Stamp of giro centre of origin

Date and signature

Dispatch by the giro office of exchange of the issuing designated operator Office of exchange of origin
Office of exchange of destination Summary list No.
List No. Date Serial No.
Stamp of the office of exchange of the issuing designated operator

Date and signature

__________

1 If applicable

Size 210 mm x 297 mm

Paying designated operator REPLY TO INQUIRY OR REQUEST FOR CANCELLATION VP 2 (back)
     
Giro centre of destination of the reply

(Giro centre of origin)

Date of reply
Our reference
Your reference
     
Dispatch by the office of exchange of the paying designated operator Exchange office of destination
Giro centre of destination Stamp

List No. Date
Signature
Reply from the giro centre of destination
Stamp of the giro centre of destination

Date and signature

     
Paying designated operator REGULARIZATION LIST

INTERNATIONAL POSTAL TRANSFERS

VP 3
(cf. SFP 7)
     
Postal giro centre [ ] Transfers not made

[ ] CORRECTION
to a daily dispatch of transfers

[ ] NOTIFICATION

of irregularity

     
Dispatching office of exchange Date of the VP 3
Number of annexes
Date of daily dispatch of transfers No.
Payee Sender
List No. Serial No. Giro centre and account No. or BIC/IBAN

Full name and address

Giro centre and account No. or BIC/IBAN

Full name and address

Amount
1 2 3 4 5
Reason

Reason

Reason

Reason

Reason

Total/carried forward

Size 297 mm x 210 mm

VP 3 (back)

Payee Sender
List No. Serial No. Giro centre and account No. or BIC/IBAN

Full name and address

Giro centre and account No. or BIC/IBAN

Full name and address

Amount
1 2 3 4 5
Carried forward
Reason

Reason

Reason

Reason

Reason

Total

 

Total of the daily dispatch described above after correction1
In figures In words
Stamp of giro centre of exchange

Date and signature

1 Only if daily dispatch corrected

     
Designated operator printing the report DAILY REPORT

Postal transfers issued

VP 4
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator

1 A.R. - Acknowledged received

Issued
Date and time
Postal transfer identifier Amount in currency of issuing country
xxx)
Amount in issuing currency
(xxx)
Remarks
A.R.1
         
Totals Number of postal transfers issued Amount in currency of issuing country
(xxx)
Amount in issuing currency
(xxx)
A.R.1
Prepared by:     Time:  

Size 210 mm x 297 mm

Designated operator printing the report

DAILY REPORT

Postal transfers reimbursed1

VP 5

1 Credited to the sender's account

[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator
Issued
Date and time
Reimbursed
Time
Postal transfer identifier Amount in currency of issuing country
(xxx)
Amount in issuing currency
(xxx)
Remarks
Totals Number of postal transfers reimbursed Amount in currency of issuing country
(xxx)
Amount in issuing currency
(xxx)
Prepared by:     Time:

Size 210 mm x 297 mm

Designated operator printing the report

DAILY REPORT

Postal transfers credited1

VP 6

1 Credited to the payee's account

[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x.
  Service
Issuing designated operator
Paying designated operator
Received
Date and time
Payment
Time
Postal transfer identifier Amount in issuing currency
(xxx)
Amount in currency of payment
(xxx)
Remarks
Totals Number of postal transfers paid Amount in issuing currency
(xxx)
Amount in currency of payment
(xxx)
Prepared by:     Laiks:

Size 210 mm x 297 mm

Designated operator printing the report DAILY REPORT

Postal transfers received

VP 7
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No. Page x/x
  Service
Issuing designated operator
Paying designated operator
Received
Date and time
Postal transfer identifier Amount in issuing currency
(xxx)
Amount in currency of payment
(xxx)
Remarks
       
Totals Number of postal transfers received Amount in issuing currency
(xxx)
Amount in currency of payment
(xxx)
Prepared by:     Time:

Size 210 mm x 297 mm

Designated operator DAILY SUMMARY REPORT

Postal transfers issued, reimbursed1, received and credited2

VP 8
     
[Organizational unit]
(e.g. service access point, region, exchange office, country)
Date of report Serial No.
 

1 Credited to sender's account

2 Credited to payee's account

Issued postal transfers Acknowledged received Remarks
Number of postal transfers      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx)      
     
Reimbursed postal transfers Remarks  
Number of postal transfers      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx)      
     
Received postal transfers Remarks  
Number of postal transfers      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx)      
     
Paid postal transfers Remarks  
Number of postal transfers      
Amount in currency of issuing country (xxx)      
Amount in issuing currency 1 (xxx)      
Amount in issuing currency 2 (xxx)      
Amount in issuing currency n (xxx)      
Prepared by:   Time:

Size 297 mm x 210 mm

Issuing designated operator LIST OF INTERNATIONAL POSTAL TRANSFERS VP 104
(cf. SFP 5)
     
Postal giro centre of destination Date of the list
No. on VP 105 form
Number of transfers
Payee Sender
No. Account No. Full name and address Amount
issued
local currency Account No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14 Total/carried forward

Size 297 mm x 210 mm

VP 104 (back)

Payee Sender
No. Account No. Full name and address Amount
issued
local currency Account No.
Carried forward
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Total
     
Issuing designated operator daily dispatch of international

postal transfers

VP 105
(cf. SFP 6)
     
Postal giro centre    
     
Postal giro centre of destination Date of dispatch
Dispatch No.
Number of VP 104 lists attached

Please carry out the orders appearing on the attached VP 104 lists, the amount of which are the following

Serial No. Amount Serial No. Amount Serial No. Amount
1 2 3 4 5 6
1     Carried
forward
    Carried
forward
   
2     15     28    
3     16     29    
4     17     30    
5     18     31    
6     19     32    
7     20     33    
8     21     34    
9     22     35    
10     23     36    
11     24     37    
12     25     38    
13     26     39    
14     27     40    
Carried
forward
    Carried
forward
    Total    
   
  In words
Total sum of  
 
Stamp of the giro centre

Date and signature

Size 210 mm x 297 mm

     
Paying designated operator INTERNATIONAL POSTAL PAYMENT SERVICE
PERIODICAL ACCOUNT OF ORDERS
(MONEY ORDERS AND TRANSFERS)
PP 1
(cf. SFP 3)
     
Issuing designated operator Date of account
Period Year
     
Account

Number Amount
1 2 3
(Carried forward from MP 104 and VP 105 forms)

Currency in which the account is prepared

   
Cash money orders (optional)    
Outpayment money orders (optional)    
Inpayment money orders (optional)    
Subtotal (money orders)    
Transfers    
Corrections relating to previous account(s), as annexed [ ] To be added    
[ ] To be deducted  
Total sums owed by the issuing designated operator    

The undersigned certifies that the present monthly account corresponds to the annexed money orders

Date and signature Full bank account details for payment

Account No. (BIC/IBAN)

Size 210 mm x 297 mm

Paying designated operator periodical account of remunerations

postal payment ORders

PP 2
(cf. SFP 3)
     
Issuing designated operator Date of account
Period Year
   
Cash money orders SDR
1 2
Total amount of money orders paid  
Correction/previous periods  

Bonus-malus

 
   
Inpayment money orders SDR
Total amount of money orders paid  
Correction/previous periods  

Bonus-malus

 
   
Outpayment money orders SDR
Total amount of money orders paid  
Correction/previous periods  

Bonus-malus

 
   
Transfers SDR
Total amount of money orders paid  
Correction/previous periods  

Bonus-malus

 
Total  
   
Seen and accepted by the paying designated operator

Stamp, date and signature

Seen and accepted by the issuing designated operator

Stamp, date and signature

Size 210 mm x 297 mm

Designated operator preparing the account GENERAL ACCOUNT OF ORDERS

(MONEY ORDERS AND TRANSFERS)

PP 3
(cf. SFP 4)
     
Corresponding designated operator Date of account
Period
     
Period Credit of designated operator preparing the account Credit of corresponding designated operator
Money orders Money orders
1 2 3
Totals
Deduction after conversion

_____________________
Conversion rate



___________________________


____


____________________


____
Totals
Balance
Instalments
Balance

Breakdown of instalments

Date Our reference Amounts
   
Stamp of designated operator preparing the account

Date and signature

Seen and accepted by the corresponding designated operator

Stamp, date and signature

Size 210 mm x 297 mm

Corresponding designated operator GENERAL ACCOUNT OF REMUNERATIONS PP 4
(new)
     
Issuing designated operator Date of account
Period Year
     
Period Remuneration of designated operator preparing the account (SDR) Remuneration of corresponding designated operator (SDR)
1 2 3
  PP 2 PP 2
Balance    
   
Designated operator preparing the account

Stamp, date and signature

Seen and accepted by corresponding designated operator

Stamp, date and signature

Size 210 mm x 148 mm

     
Paying designated operator INTERNATIONAL POSTAL MONEY ORDER SERVICE

PERIODICAL ACCOUNT OF INTERNATIONAL

POSTAL MONEY ORDERS

PPM
(cf. SFP 3)
     
Issuing designated operator Date of account
Period Year
     
Amount

Number Amount
1 2 3
Carried forward from MP 104 forms)

Currency in which the account is prepared

   
Cash money orders (optional)    
Outpayment money orders (optional)    
Outpayment money orders (optional))    
Subtotal    
Corrections relating to previous account(s), as annexed [ ] To be added    
[ ] To be deducted  
Total of sums owed by the issuing designated operator    

The undersigned certifies that the present monthly account corresponds to the annexed money orders.

Date and signature Full bank account details for payment

Account No. (BIC/IBAN)

Size 210 mm x 297 mm

     
Paying designated operator international postal transfer service

periodical account of international

postal transfers

PPV
(cf. SFP 3)
     
Issuing designated operator Date of account
Period Year
     
Amount Number Amount
1 2 3
Carried forward from MP 104 forms)

Currency in which the account is prepared

   
Transfers    
Corrections relating to previous account(s), as annexed [ ] To be added    
[ ] To be deducted  
Total of sums owed by the issuing designated operator    
   
Date and signature Full bank account details for payment

Account No. (BIC/IBAN)

Size 210 mm x 297 mm

01.07.2022