DORMANT ACCOUNT REACTIVATION FORM

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Date (ZvwiL): D D M M Y Y Y Y

Branch Manager (kvLv e¨e¯’vcK)

City Bank PLC. (wmwU e¨vsK পিএলপি)
Branch (kvLv):

Dear Sir/Madam (wcÖq g‡nv`q)

Kindly make arrangement to reactive the following account, which is currently in a dormant status. The reason
for non-operation of the account was due to (wb‡¤§ ewY©Z wnmvewU eZ©gv‡b ‡jb‡`bnxb/Wig¨v›U Ae¯’vq Av‡Q| wnmvewU cybtivq mPj
Kivi wbwg‡Ë cÖ‡qvRbxq e¨e¯’v MÖnY Kivi Rb¨ Aby‡iva KiwQ| wnmvewU †jb‡`bnxb _vKvi Kvib):

“Reason for non-operation”

Account Number (wnmve bs):

Account Title

(wnmv‡ei bvg):

Customer Mobile Number:

MÖvn‡Ki ‡gvevBj bv¤^vi

I/we have authorized the above instructions and agreed to the relevant Terms, Conditions and Clauses of City Bank PLC.
(Avwg/Avgiv Dc‡i ewY©Z wb‡`©kvejx Aby‡gv`b w`w”Q Ges wmwU e¨vsK পিএলপি Gi mswkøó kZv©w` I kZv©ejx cwicvj‡b m¤§Z AvwQ|)

“Space for Confirmation of Customer(s) Physical

Presence with Bank official sign & seal”

______________________ Signature Signature ________________________

Signature of 1st Applicant Verified By Verified By Signature of Joint Applicant
(cª_g Av‡e`bKvixi ¯^vv¶i) (hyM¥ Av‡e`bKvixi ¯^vv¶i)

FOR BANK USE ONLY Customer ID: C B

CHECK POINTS
We the undersigned confirm that all the related document(s) are in order as per CBL Ops Manual/SOP/related circulars and all
necessary approval(s) are taken.

Initiated By CS Official/CFP Recommended by BOM/Designate Approved by BM/Designate Official

(with seal & sign) Official (with seal & sign) (with seal & sign)