316usman/test_1 huggingface dataset:
Antigua & Barbuda Social Security Board 
ELECTRONIC FUNDS TRANSFER (EFT) 
AUTHORIZATION FORM 
 Please complete and email this form to: remittance@socialsecurity.gov.ag after your EFT 
transaction.

EFT transaction information 
 Company Name:  
 Antigua Barbuda Social Security Board 
 BANKING DETAILS 
 Payee Name on Account:   Antigua Barbuda Social Security Board 
 Account Number:  
Name of Bank: 
Branch Location: 
Branch Code:   
Swift Code: 
Account Type:  
 100-000-67 
Caribbean Union Bank 
Friar’s Hill Road 
(070-28201) 
CUNBAGAG 
Cheque 
 Please complete the below form in details after your EFT payment.

Employer Name: _______________________________________________________________ 
 Registration No.: __________________________________ 
               (six (6) digit only) 
 Remittance Month: ________________________________ 
  (mm/yyyy) 
 EFT Transaction/Receipt No: ________________________ 
 EFT Transaction Amount: __________________________ 
 Remember to sign and date all R5As then email to remittance@socialsecurity.gov.ag 
 Having trouble?

Please contact us at 1 (268) 736-3000/1/2/3 or email us at customerserv@socialsecurity.gov.ag