Transcript Request now

Reference letter
request form
1. Details of organisation
1a Name of organisation
1b Street
1c Number (and suffix)
1d Zip code
1eCity
1f Country
1g Name of contact
1i Telephone number
1h
Male Female
1j IBAN of corporate account
(Go to Mijn ING and/or your
statement)
2. Details of recipient ING will send two copies of the reference letter, one to you and one to the person stated below.
2a Who is to receive the reference
letter?
business associate or applicant
other
Name of company
2b Name of contact
2c
Male Female
2d Street
2e Number (and suffix)
2f Zip Code
2gCity
3. Signature and authorisation
I hereby declare that I am a representative who is authorised to sign this request form.
I authorise ING to debit the one-off costs of preparing the reference letter from the corporate account stated at 1j.
3a Name of representative
3bDate
3cCity
3dSignature
4.Costs
There are costs associated with preparing a bank statement. These can be found at ing.nl/bankverklaring (Dutch only).
The costs of the bank statement will be debited from the corporate account stated at 1j after you have received the bank statement.
266406 1016
Please send this form in an unstamped envelope to ING, Antwoordnummer 40620, 8900 TA Leeuwarden.
ING Bank N.V., statutair gevestigd te Amsterdam, handelsregister nr. 33031431, Amsterdam.