FOREIGN CURRENCY PURCHASE ORDER FORM
For American Savings Bank checking or savings account customers only
MINIMUM PURCHASE (USD $100)
Customer’s Name:
Phone: Cell:
Last 5 Digits of Account No:
Debit Account Type:
Checking
Savings
Select and Complete One of the Following:
I want US $: in
(Amount in US $) (Foreign country and type of currency)
I want: Amount:
(Foreign country and type of currency)
(Amount in foreign currency)
Currency to be picked-up
at:
Pick-up - Subject to the type of currency and amount, please allow three to six business days for pick-up. If there are any
questions, contact the International Services D
epartment.
Customer Request by Fax/Order Confirmation - Provide a current phone number so American Savings Bank can verify
your order; we are unable to complete orders if we cannot contact you. If you do not receive a confirmation call within one
business day, contact the International Services Department.
Oahu: 808 539.7884 or 539.7887
Neighbor Islands: 800 272.2566 (Select 5 & the ext # 7884 or 7887)
Order cancellation - If you cancel your order, you may sell the currency back to American Savings Bank; however, it
will
be at the then
prevailing exchange rate. American Savings Bank will conduct the buyback within three business days of
receipt of your cancellation. For orders that you do not pick-up three business days after American Savings Bank
notifies
you, American Savings Bank will conduct the buyback as a cancellation of the order at the then prevailing
exchange rate. In
either situation, American Savings Bank will deduct a cancellation fee from the buyback.
By signing below, you agree to the terms above and authorize American
Savings Bank to debit the account above in
equivalent U. S. Dollars, plus any fees, for this foreign currency order.
SCAN/EMAIL TO INTERNATIONALSERVICES@ASBHAWAII.COM
Rate: _________
Rate as of: __________
US $
Equivalent: _____________
Total Due US $: ___________________
Date Currency is Needed By:
Best Contact Phone Numbers:
For Branch Use Only
Accepted By (n
ame): ______________________ Branch: ________________
Ext:_________
Date: ____________
Customer’s Sig
nature
Date
DELIVER COMPLETED
FORM TO ANY BRANCH OR FAX TO (808) 495-0572
Branch
For International Services Department Use Only:
INTL 007 10/16
Handling Fee: $ _________
