副提單背書申請書

APPLICATION FOR B/L ENDORSEMENT

日商瑞穗銀行股份有限公司	Mizuho Bank, Ltd.

臺北分行	臺中分行	高雄分行	國際金融業務分行

Taipei Branch	Taichung Branch	Kaohsiung Branch	Offshore Banking Unit Taiwan

日期

Date：

敬 啟 者
Dear Sirs：

申請人 Applicant	貨品名稱 Description of Goods
信用狀號碼 L/C No. / B/C BASIS	發票金額 Invoice Amount
船名 / 航班 Name of vessel/ flight	提單號碼 B/L/AWB No.

上列交易申請人因逕自託運人處直接收到提單正本壹份，爰請 貴行先將此提單背書俾使申請人於該裝運單據未寄達 貴行之前得向海關申請辦理提貨手續。

申請人茲向 貴行保證，倘若 貴行因提單背書所引起之任何糾紛概由申請人自行負責與 貴行無涉。申請人並保證日後國外裝運單據寄達 貴行時，申請人對單據上任何瑕疵、短缺、不完整或其他問題均予無條件接受，並授權 貴行逕付通匯銀行款項，決無異議。申請人依本申請書之約定，對 貴行負有任何給付責任時，貴行得逕就申請人之款項及對 貴行之債權為期前清償，並將期前清償之款項抵銷，申請人對 貴行所負之一切債務。

In connection with the above mentioned transaction, we have received one original Bill of Lading from the shipper directly for which we request you to endorse the original Bill of Lading. This is in order for us to take possession of the merchandise at the customs house before original set of shipping documents reach your bank.

For your endorsement of the relative Bill of Lading, we hereby indemnify and hold you harmless in the event of any dispute should it arise from our taking possession of the merchandise covered under the original Bill of Lading. We further guarantee that we shall unconditionally accept the shipping documents received by you at the later date under this Bills of Lading notwithstanding any discrepancies, deficiencies; in-completions or matters otherwise open to question contained herein and authorize you to effect payment to your correspondent bank. In the event that we are responsible for any payment to you under this application, you may set off and apply towards such payment any and all amount held by you or you may make payment before the maturity of any and all credits retained by you.

Applicant (申請人) 申請人茲此簽署本申請書，並確認申請人確已收到，了解並同意 貴行與本交易相關一切之文件及資料。 __________________________________________ Authorized Signature有權人簽章 (請蓋對本行進口約定章)

FOR BANK USE ONLY
NO.
核 章 Seal is omitted when sending through Mizuho Global e-Banking 實行日
主管	經辦

(C3063) Electronic Application / Mizuho Global e-Banking Applicable 20141020

Note: 使用此申請書時，本人/本公司同意不更動除填記欄位以外之申請書內容及文字，若更動該申請書內容或文字而造成 貴行損失時願負一切責任。