Premium transfer by Bank



Beneficiary:

HealthCare International SA
London
United Kingdom		 Bank of the Beneficiary:

HSBC
20 Eastcheap
London EC3M 1ED


Currency: USD GBP EUR
Account 59763170 11365320 59763197
Sort Code 400515 400231 400515
IBAN GB79MIDL40051559763170  GB47MIDL40023111365320 GB29MIDL40051559763197
SWIFT/BIC MIDLGB22 MIDLGB2106G MIDLGB22



   Important:
   Directive to the Bank of the Sender:   "transfer cost to be borne by the sender"
   Information to the Beneficiary:   Policy HCI-. ...................................., Year 20XX / 20XX