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Customer Application Form BAG askaribank % Branch Name /rt¥$1 REQUEST FOR/2 ico» [7] sip Payment Release of rou ie é (Statement of Account / Betws FJ Bank certcate adh CUSTOMER INFORMATION / 264/~ TTT U1 Contact No. (Mobile) / (fir) Zein. an STOP PAYMENT OF CHEQUE(S) / 0.2 SUSIE [Account Closure / “ Account No. / 22+%¥il TTT) ‘Account Tile /t6261 Date /&.e change of Maling Address / Contact Number/ [_| Reactivation of Dormant / inactive Account 22 /Uutivis'_Failiid Lib atlas Bi Sawin Contact No. (OfffRes) (FA) Ze Reason /* Cheque No.7 From/= tole From fe tort ol From f= tolr Time of Instructions Received vi Arete [ fe Bank Ome) Wire | RELEASE OF STOP PAYMENT OF CHEQUE(s) / Jin (USIGL EI (for Bank Ofc) Reason / Cheque No./2G — From/< From /= From /— Time of instructions Recelved /SvL sete Fa) apiece ns Tex Banca) weno CORTES “tetany STATEMENT OF ACCOUNT / 2746) lie request for Bank statement) ofthe above sald accounts) maintained at ELS and! etinbt het. ‘Time of Instructions Marked (26.14 ‘Statement required from (Date) [DO] Tifa] Y to [ofc eee e : [[ Please deliver the statement to my / our following representative | 22% Jura te CONIC No. ues I I EA Ane BANK CERTIFICATE | 2-5, Please provide me/us following! yruM tine tb bicete Name /¢= Signature /° [| Balance Certificate 2s of / Baca Ti Lehi LOGIE [] withholding Tax deduction Certificate From /a%-3# A fhe Propriotorship Cerificate: Addressed to /ia¥ [Account Maintenance Certificate / He lease deliver the bank ceificate to my fllowing representative / EAM eben te See Name I(t onic No. /a¥geL1 TTT TT ] Signature 133 CHANGE OF MAILING ADDRESS I CONTACT NUMBER 1h 402 “81 /2,61 My / Our mailing address / contact number(s) has been changed as per the below mentioned details and I / We hereby authorize the Bank to update the same accordingly, for any future correspondence / contact: wheat Old Address /t!¢ EPI eater (Old Contact No (Mob) [ (Old Contact No (OfffRes) T Grd, New Address / = Guond New Contact No (Mob)| TM New Contact No (OftfRes)| (he) bur GAuneie dye Itis requested to reactivate my / our A/c No. etet ‘maintained at —_______, Braneh ethical PY Reason for Non-Operation. = > Pele + please attach copy of valid CNIC -f WSK EAT 11 We request you to close my / our account No| Reason for Closure of Account ALLELE Meh eli Sat Cheque Book Returned /e SSsAth fe Yesiut [_]No/ut? Reason if (No) (2) [ATM Card Surrendered (tf applicable) Card No. I Suite) even weber ves ]No/ce? — Reason it(Noy/ (22) 2» Locker and Key surrendered (if applicable) Yes / No lad? (Ce SiiJe KARI Bp oA [7 ts requested to transter the remaining © Bhradiiyren torccount no, [] E i wal Papsiites Orit by the terms & conditions contain 's account opening form related to the aforementioned banking tS and agree fo abide by them and such other rules as may be in force from time to time. IWe hereby authorize plicable charges as per prevailing SOC from my / our account. ve BLUE Hing Lie Abe Stem P iG he LRA AB gob Ae le ihe aoe Pb vite sel cr ySwn ter ‘Signature(s) of Appicant(s) ‘lorsed Signature 2 ‘Ruthorsed Signature 3 Facto Oa achigies igs ‘Through Mail | Post / i244 Representative / 1"Uis.4 Application Received Iuesetts [7] Signature Verifed By (si. Name it "Signature / > Approved by (MGR/MGR- OPS): Name /f?____________ Signature s*_____ Branch Stamp Fee aoe Ss | Sela eee Received at CPU on E-rSL AE whys Processed by isha Hne AZ Authorized by sts stg. (Name and Signature) (Name and Signature)
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