E-Banking Services Modification Form (Individual) : Customer Details

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e-Banking Services Modification Form (Individual)

Customer Details
Account Name Account Number

Mobile Number Email Address

User ID
(Internet Banking) Mobile Number

User ID Email Address


(Mobile App)
Please tick the service(s) you would want to modify
PIN RESET Deactivate De-register Enhance
SERVICE LIST /Block /Delete Re-activate
/REGENERATION Limit To
AMOUNT (GHS)

Transaction Password
Internet Banking
Login Password

Username:
Mobile APP
Login Password

POS
Mobile Banking (USSD)
ATM
eCommerce
ePay
GhQR Code
VISA
MASTERCARD
CARDS
UPI
READYCASH

Card No. Card No.


First six(6) digits
* * * * Last four(4) digits First six(6) digits
* * * * Last four(4) digits

Card No. New Account No.

First six(6) digits


* * * * Last four(4) digits
to be linked

Switch Account No.


linked
Declaration
I/We………………………………………………………………………………………………………………………………………….. hereby indemnify GCB Bank Limited (the Bank )
from any actions, proceedings, liabilities, claims, damages, costs, losses or expenses which may be taken or made against or incurred by
the Bank by reason for accepting my/our request to have Services linked to my/our account(s) amended including but not limited to
where my/our email or electronic instructions are incorrect, incomplete, forged, or intercepted.
To complete this modification please sign and bring to a branch location near you or email to [email protected].
If you have any queries please call 0800 422 422

FOR BANK USE ONLY


Authorised by
Branch Name

Verified by (Name) Date D D M M Y Y Y Y

Signature Customer ID

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