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[null,"新臺幣金額"]
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[null,"取款日期"]
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[null,null,"☐","傳真指示扣帳 (請勾選。僅限與本行簽訂電話傳真交易授權書者適用)"]
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[null,null,null,null,null,null,null,null,"ACCOUNT NO.",null,null,null,null,null,null,0,0,1,null,null,null,null,null,null,null,null,null,null,null,null,"以本日匯率兌換外幣"]
[null,null,null,"    憑本條與存摺支領",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"交易性質:"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"存入帳號:"]
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[null,null,null,"存   戶   簽   章     SIGNATURE"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"陸、柒、捌、玖、拾、"]
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[null,"電\n腦\n印\n証\n欄"]
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[null,null,"交　　易　　金　　額",null,null,null,null,null,null,null,null,"最 高 可 提 款 額",null,null,null,null,null,null,null,"有　　效　　餘　　額",null,null,null,null,null,null,"可　抵　用　限　額",null,null,null,null,"起算日",null,null,"注"]
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[null,null,"相對\n科目","支票(當座)、活期(普通)、存放同業存款(金資口)",null,null,null,null,null,null,null,null,null,null,null,null,"手續費收入-金資口",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"核 章"]
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[null,null,"(G7044) Electronic Application",null,null,null,null,null,null,null,null,20220401]
[null,null,"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。"]