ACCOUNT MANAGEMENT FORM

Account Owner's Name: Date of Birth (DD/MM/YYYY):

Jhannel Dagunan Tupan 01/12/1995
Please choose a request below and fill out the details

Change Maya-Registered Mobile Number Reason for Changing:

Lost Phone/SIM
Maya-Registered Mobile Number: Stolen Phone/SIM
Disconnected/Defective SIM
New Mobile Number: Changing Mobile Number
Others, pls specify ____________________

Reactivate Account Reason for Reactivation:

Dormant Account*
Maya-Registered Mobile Number: Lost Phone/SIM
Stolen Phone/SIM

*For dormant accounts, please make sure you have cashed in at least P200.00 to your Maya account
*For lost or stolen phone/SIM, please make sure you have regained access to your Maya account

Fix a Duplicate Account

Account(s) to be Cancelled: 09550490777Account to be Retained:09394674770

Reason for Having More Than 1 Account I forgot my old user number
Transfer of Balance Reason for Transfer

Source Maya Wallet Number: 09550490777 Voluntarily Closed Account

/ Duplicate Account
Deceased Account Holder
Target Account Holder's Name: Jhannel Tupan

Target Maya Wallet Number: 09394674770

Amount to be Transferred:
100

JHANNEL TUPAN June 15, 2023

Account Owner's Signature Over Printed Name Date Signed