Collection details : Will be collected over the counter in person. * By an
Authorised Representative. * Please note that the authorised representative must
be ...
CHEQUE BOOK REQUEST Branch : _________________
Date : ________________
Please supply one Cheque Book containing _________________ leaves (10, 20, 50, 100) For Account No.
Collection details : Will be collected over the counter in person
* By an Authorised Representative * Please note that the authorised representative must be present at the Bank, at the time of collection of the Cheque Book, with a proof of identity, in original, and submit a letter of authority duly signed by the Account Holder. The Authority Letter must have attached a copy of the authorised representatives identification (citizenship, licence, passport etc.) and a specimen signature.
AC 025 0802
In case the Cheque Book is not collected within 2 months from the date of requisition. It will be destroyed automatically and the necessary charges will be recovered from the Account Holder.
______________________ Account Holder's Signature
BANK USE ONLY Account Holder's Signature(s) Verified by: ____________________________
