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Account Services Request Form

The document is an account services form from a customer of Eastern Bank Limited requesting several services: [1] The customer requests a duplicate statement of account for a specified period, [2] a bank certificate or balance confirmation certificate, and [3] an update of their contact information including address, phone number, and email. [3] The customer also requests updating the same contact information on their debit card(s) associated with the listed account number. The customer signature and bank information is at the bottom.

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Tasneef Chowdhury
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60 views1 page

Account Services Request Form

The document is an account services form from a customer of Eastern Bank Limited requesting several services: [1] The customer requests a duplicate statement of account for a specified period, [2] a bank certificate or balance confirmation certificate, and [3] an update of their contact information including address, phone number, and email. [3] The customer also requests updating the same contact information on their debit card(s) associated with the listed account number. The customer signature and bank information is at the bottom.

Uploaded by

Tasneef Chowdhury
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ACCOUNT SERVICES FORM

Branch Manager Date


Eastern Bank Limited Branch
Dear Sir,
Account No.

Account Title
Please arrange to:
Issue a duplicate statement of account for the period to
Issue a Bank Certificate / Balance Confirmation Certificate
Update my information as follows:
Present/ Mailing/ Permanent Address:
Phone:

Mobile: Email:

Please update the above Mobile No. and/or Email in the Debit Card(s) tagged with my/our above account.

Provide me with a copy of Cheque No. encashed through my

Account No.
Provide me the duplicate advice for the following entries :

Please cancel Standing Order for (Currency & Amount)

Due on (Date) Favoring

Any other request may be stated herein:

Customer Signature (All to sign if Join Signature Account) S. V. (full Signature)

BANK USE ONLY

Received By Date & Time

Charge Deducted Tk.

Action Taken By Authorized By

Delivered To Date & Time

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