Transcript
CONSUMER REINSTATEMENT QUESTIONNAIRE 1 Dear Consumer, Western Union values your business. We closely monitor the use of our money transfer services by our consumers to comply with industry standards and regulations. In this case we will need some additional information from you to proceed with your reinstatement request. Step 1- “COMPLETE” Please complete the Consumer Questionnaire below and email the completed form to
[email protected]. Please include supporting documents such as additional information about your source of funds, the purpose of your transaction and the sender(s)/receiver(s) of the money. These documents will be used to support your responses in the questionnaire. Step 2- “ Review ” Once we receive the completed Consumer Questionnaire and supporting documents we will review your information and make a decision regarding your reinstatement request. This process typically takes between 5-7 business days. Step 3- “EMAIL /FAX ” We will inform you of the outcome using the email provided on the Consumer Questionnaire. Please make sure the contact information you provide on the Consumer Questionnaire is accurate so that we are able to reach you for follow up. See details on page 5. We will only be able to perform the review if all information is complete and all supporting documents are provided. Please also note that we may need to contact you for additional information before a final decision can be made. All documents received will remain confidential and will only be used for Western Union internal purposes. Thank you for choosing to be a Western Union consumer. CONSUMER REINSTATEMENT QUESTIONNAIRE 2 I. Please provide your personal information: Recent MTCN: 7437020256 Full Legal Name (First, Middle, Last/Family/Surname): EFE ONOMAKE A.K.A.s (Also Known As, Nickname): Street Address ONNUT SOI 20 SUKHUMVIT City BANGKOK State/Province/County BANGKOK Postal Code/Zip Code 10250 Country THAILAND Email address:
[email protected] Primary Phone #: 0826331748 Secondary Phone #: Date of Birth (mm/dd/yyyy): 8/30/1980 Occupation: student II. Please provide the following information for the people that you have sent to or received from the most frequently or recently: Name What is your relationship with this individual? What was the purpose of the transaction(s)? Have you met him/her in person (face to face)? Y/N 1 Lea hernandez macawili Purchaser/Seller of Goods/Services Purchase of Goods No 2 : : : 3 Indriyani Purchaser/Seller of Goods/Services Purchase of Goods No 4 : : : 5 : : : 6 : : : CONSUMER REINSTATEMENT QUESTIONNAIRE 3 III. What is your primary source of funds? We need this information in order to better understand how you are funding your transaction(s). Source of Funds If other, explain here: www.efewest.com fashion apparel and garments and sales : Please attach to this request the necessary documentation to support your source of funds. IV. Business or Individual Details Are any of the transactions being conducted on behalf of a Business or an Individual other than yourself? ☐ No If the answer is “Yes” , please provide the information below: Describe your relationship with the business or other individual Explain why are you acting on behalf of the business or other individual Individual’s full legal name or Business Name: Street Address City State/Province/County Postal Code/Zip Code Country Phone #: Date of Birth (Not applicable for business): Click here to enter a date. Individual’s Occupation or Business Type: CONSUMER REINSTATEMENT QUESTIONNAIRE 4 V. Please check the relevant boxes for any documents that you are attaching to your request. 1 . Invoices 2 ☐ Bank Statement 3 . Receipts to validate the expenses 4 ☐ Travel Itinerary 5 ☐ Contracts 6 . Business/Non-Profit License 7 ☐ Paystubs/W2-Form 8 ☐ Other, specify below If you selected other, please specify: VI . Please include any additional information that may assist in our decision . INSTRUCTIONS – GUIDELINE OF DOCUMENTS TO PROVIDE Please provide documents to support your use of Western Union Money Transfer Services. Below are examples of various documents that you may consider providing, however any other relevant documentation to support the purpose of your transactions would be useful: Based on the following transaction scenarios the nature of the documentation may vary: Purpose Possible Expenses Examples of Supporting Documents Financial Support/Personal Expenses/Charity/Business a. Mortgage Payment Invoices b. Sending to Self Bank Statement c. Travel/Vacation Expenses Receipts to validate the expenses d. Personal/Business Expenses e. Payroll Travel Itinerary Contracts Business/Non-Profit License
