Service Request – Name / Signature / Mandate Details Update Form
Date: _____/________/_____________
Branch: _________________________
Present Account Details
Account Name:
Master Number:
 Update all my records with the bank with the details I am providing below
 ADD (to existing address)
 AMEND (replace with)
 DELETE (Remove)
Details Update
 Date of Birth: ______/________/_____________
 Account Name Change
First Name:
Middle Name:
Last Name:
 Signature Change
Primary a/c holder Signature
Secondary a/c holder Signature
 Mandate Change
 Signs Alone
 Either to Sign
 Both to Sign
Other ________________________
 Customer Identification Document Change / Update
ID Type:  Passport  Drivers’ License
 Voters’ ID
 Other______________________________
ID Number
Expiry Date
Account(s) to be updated
Please indicate account numbers
 For all my Accounts
Account Number:
Account Number:
Account Number:
A/c holder Signature 1
A/c holder Signature 2
For Joint accounts: if mandate is both to sign, both signatures are required
For Bank Use only
Relationship Number:
 Customer in Person
Receiving Branch: _____________________________________
Signature Verified by: ___________________________________
Supporting Documents checked by: ________________________
Approved By:_____________________________________________
Notes:



Legal documentation of the name change i.e. Marriage Certificate (civil) or Court Affidavit
Public Notification of change of name i.e. Newspaper publication
Valid Identification i.e. Drivers’ License, International Passport, National ID Card, etc