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	Western Union Payment Form
Make Money Transfer to : Beneficiary First Name Beneficiary Last Name City State Country Currency :  GUILIN :  SU :  SHENZHEN :  GUANGDONG :  CHINA :  USD Only *Please fill up test question and answer to ensure safety of your money transfer Please fill in the form below after you've made the transfer: Sender Details [ * ] Required fields. Login Email: * Order No: * MTCN No * Sender First Name (Surname-Family Name): * Please fill the detail exactly as what you have written on the Western Union Form Sender Last Name (Given Names): * Please fill the detail exactly as what you have written on the Western Union Form Sender Country: * Sent Amount (USD and Euro only): * Please fill the exact same amount as what you have written on the Western Union form If you have filled out a test question and answer for us in order to retrieve the money, please fill it in below, else please leave it blank Test Question: * Test Answer: *

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