Treaty Annuity Payment Request Form
Company Name
Global Treaty Solutions
Form Reference Number
TAPF-2024-004
Date of Request
December 20, 2024
Requestor Information
Name of Requestor: Jonathan Reed
Department: Treaty Administration
Contact Details:
- Phone: +1-456-789-1234
- Email: jonathan.reed@treatysolutions.com
Beneficiary Information
Name of Beneficiary: Margaret Collins
Treaty Reference Number: TR-2023-9876
Contact Details:
- Phone: +1-321-654-7890
- Email: margaret.collins@domain.com
Bank Details: - Account Name: Margaret Collins
- Bank Name: Heritage Trust Bank
- Account Number: 654789123
- IFSC/Swift Code: HTB123456
Payment Details
Annuity Amount: $12,000
Currency: USD
Payment Period: January 1, 2025 – December 31, 2025
Purpose of Payment: Treaty annuity disbursement as per agreement TR-2023-9876.
Payment Due Date: January 5, 2025
Supporting Information
Attached Documents:
- Copy of the Treaty Agreement
- Beneficiary Identification Proof
- Previous Payment Records
Authorization Section
Requested By:
- Name: Jonathan Reed
- Signature: _______________________
- Date: December 20, 2024
Approved By:
- Name: Elizabeth Harper
- Signature: _______________________
- Date: December 21, 2024
Remarks/Comments
Timely processing of annuity payment requested to meet the treaty obligations for the specified period.
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