www.bracbank.

com

CORPnet- USER REQUEST FORM

The Manager, Date:

BRAC Bank Limited

Dear Concerned:

Please make the appropriate changes in CORPnet as per below information:

Company Name*

Profile Name
Account Name Account Number
Company/Profile Account*

Request Type* Select Add More Account(s)

User Role* Approver Checker Maker

Full Name*
Designation*
E-Mail Address*
Mobile Number*

Payment Module Single File Mode Multi File Mode

Collection Module Own Account Third Party Account

Access to Service(s)* MFS Wallet Disbursement Module

Trade Module
Bill Payment Module
Payroll Module
Virtual Account Management
Pay Order Issuance

Positive Pay
Token Type Hardware Token Software Token No Token Required
Account Name Account Number
Charge Realization Account

I/We authorize the bank to deduct all charges relevant to the above request type of CORPnet from the Company’s BRAC
Bank Limited Account as mentioned above, whenever BRAC Bank Limited deems necessary.
I/We declare that the all information provided above is true and complete and also confirm that the authority given to
the user is lawful, and according to the company’s rules and regulations.

Authorized Signature(s)