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Formulario Gustazos
Formulario Gustazos
I
I hereby authorize GUSTAZOS PANAMA, S. DE R.L. to initiate direct deposits and/or wire transfers to my account at the financial
institution below. Additionally, I understand that GUSTAZOS PANAMA, S. DE R.L. direct deposits and/or wire transfers are made
through Banistmo, S.A. and may require the use of intermediary banks to process any such transaction. Further, I agree not to
hold GUSTAZOS PANAMA, S. DE R.L. responsible for any delay or loss of funds due to incorrect or incomplete information
supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my
account.This agreement will remain in effect unless GUSTAZOS PANAMA, S. DE R.L. receives written notice of cancellation from
me or my financial institution, or until I submit a new wire transfer form to GUSTAZOS PANAMA, S. DE R.L., and GUSTAZOS
PANAMA, S. DE R.L. has reasonable opportunity to act on any such notice.
Firma/Signature(s)
Firma autorizada: (Primaria) /
: Fecha/Date:
Authorized Signature (Primary)