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    PUBALI BANK Card Customer Service Form

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    অনন্ত জীবন
    The bottom section is for bank use only, for processing and checking the customer's instructions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    PUBALI BANK Card Customer Service Form

    Uploaded by

    অনন্ত জীবন
    145 views1 page
    The bottom section is for bank use only, for processing and checking the customer's instructions.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    The bottom section is for bank use only, for processing and checking the customer's instructions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    145 views1 page

    PUBALI BANK Card Customer Service Form

    Uploaded by

    অনন্ত জীবন
    The bottom section is for bank use only, for processing and checking the customer's instructions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    A-A Bhaban (2nd floor)

    Card Division 23 Motijheel C/A, Dhaka-1000


    Tel: 880 2 9512035
    Call Center: 16253, +8809612316253
    card@pubalibankbd.com

    CARD CUSTOMER SERVICE FORM / KvW© Kv÷gvi mvwf©m dig


    Card No.
    KvW© bs    
    Cardholder’s Name ________________________________________________________________________________________________________________________________
    KvW© †nvìv‡ii bvg
    Card Type
     Debit Card / ‡WweU KvW©  Credit Card / ‡µwWU KvW©
    Kv‡W©i aib
    Please update the personal details of my above mentioned Card/ Dc‡i D‡jø¨wLZ Avgvi Kv÷gvi KvW© Gi Avc‡WU Kivi Rb¨ Aby‡iva Kiv n‡jv:
     Name
    bvg 
     Date of Birth Photo ID ( NID/Passport)
    Rb¥ ZvwiL  d‡Uv AvBwW (GbAvBwW/cvm‡cvU©) 

     Father’s / Mother’s/ Spouse’s Name ____________________________________________________________________________________________________________________


    evev/gv/¯^vgx/¯¿x bvg
     New Address _____________________________________________________________________________________________________________________________________
    bZzb wVKvbv
     New Mobile/Tel ___________________________________________________ Previous Mobile/Tel ___________________________________________________
    bZzb ‡gvevBj/ †Uwj‡dvb cyivZb ‡gvevBj/ †Uwj‡dvb
     New/Updated Email Address _________________________________________________________________________________________________________________________
    bZzb/ Avc‡WU B‡gBj
     Any other modification _______________________________________________________________________________________________________________________________
    Ab¨vb¨ cwieZ©b
    I would like to request for the following
    Avwg wb‡¤œv³ wel‡qi Rb¨ Aby‡iva Rvbvw”Q
     Please activate my ecommerce transactions  Local/¯’vbxq  International/AvšÍR©vwZK
    AbyMÖn c~e©K Avgvi B-Kgvm© †jb‡`b Pvjy Kiæb
     Please Activate/Pvjy  Deactivate/eÜ Temporary Deactivate/mvgwqK eÜ my card
    AbyMÖn c~e©K Avgvi KvW© Pvjy/eÜ/mvgwqK eÜ Kiyb
     Please Activate Deactivate my card for international transactions
    AbyMÖn c~e©K Avgvi Kv‡W© AvšÍ©RvwZK †jb‡`b Pvjy/eÜ Kiyb
     Lien A/C change : A/C no
    wj‡qb GKvD›U cwieZ©b: GKvD›U bv¤^vi
       Lien amount (as per sanction letter) _________________________
    wj‡q‡bi cwigvY (†jv‡bi Aby‡gv`b cÎ Abyhvqx)
     ATM  POS  Transactions Limit Enhancement : Expected Limit ________________________________________ Nos. of transactions _______________________________
    __
    GwUGg wcIGm †jb‡`‡bi wjwgU ewa©ZKib: cÖ‡qvRbxq wjwgU cÖ‡qvRbxq ‡jb‡`b msL¨v
     Please replace my new account : Present A/C ____________________________________________ Previous A/C __________________________________________
    AbyMÖn c~e©K Avgvi bZzb GKvD›U cwieZ©b Kiæb: eZ©gvb GKvD›U Av‡Mi GKvD›U
     Please replace my Card for the following reason / wb‡¤œv³ Kvi‡Y AbyMÖn K‡i Avgvi KvW© cwieZ©b Kiyb:
     Card Broken / Damaged  Card Lost / Stolen  Wrong Photo /Name  Any Other Reason _______
    _____________________
    KvW© fv½v / bó nIqv KvW© nviv‡bv / Pzwi nIqv fzj Qwe /bvg Ab¨ †Kvb KviY
     Please replace my pin / AbyMÖn K‡i Avgvi wcb cwieZ©b Kiæb:
     PIN Forgotten / wcb fz‡j hvIqv  Any Other Reason / Ab¨ †Kvb KviY __________________________________________________________________________________

     Standing Instruction Setup / ÷¨vwÛs Bb÷ªvKkb †mUAvc  Minimum Amount Due (5%) / b~¨bZg e‡Kqv  Full Outstanding / cy‡iv e‡Kqv ___________________________ %
     Please debit my A/C no. ___________________________________________________ for Credit Card payment through standing Instruction.
    AbyMÖn K‡i Avgvi GKvD›U bs ‡WweU K‡i ÷¨vwÛs Bb÷ªvKk‡bi gva¨‡g †µwWU Kv‡W©i e‡Kqv / wej cwi‡kva Kiyb
    By signing, I agree to the relevant terms & conditions of the item mentioned above /Avwg wb¤œ-¯^v¶wiZ Dc‡iv³ welq mswkøó kZ©vejx‡Z mg¥Z

    Thanking You / ab¨ev`v‡šÍ

    _____________________________________ _________________________________
    Signature of Cardholder / KvW© †nvìv‡ii ¯^v¶i Date / ZvwiL  Branch Seal & Sign / kvLv mxj I ¯^v¶i

    For Bank Use Only / e¨vs‡Ki e¨venv‡ii Rb¨ cÖ‡hvR¨

    Instruction Processed by / whwb wb‡`©kbvejx cÖ‡mm Ki‡jb __________________________________________ Sign & Date / ¯^v¶i I ZvwiL _____________________________

    Instruction Checked by / whwb wb‡`©kbvejx ‡PK Ki‡jb __________________________________________ Sign & Date / ¯^v¶i I ZvwiL _____________________________

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