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To apply for Prime PMI @ 0% lnterest Purchase Plan, please fill up the following and send
it to prime Bank Limited, Card Division, 29 RajukAvenue, Motijheel, Dhaka-1000.

Cardholder's Name

PBL Credit Card Number:

Transaction Date:
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D D M M
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[T-I-t n-r-n Expiry Date:
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Approval Code:
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Purchase Amount: Tk. (ln words):
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Name of Merchant:
.(...... OutletLocation:

Cardholder's Mobile No:

Yes, I would like to purchase the product under,ihe prime pMi

PMllnstartmentPlanrenure:tr
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(as mentioned overleaf,) of this Form.

Signature of Cardholder
& Signature of the Merchant

Checked by:
Approved by:
For more informatlon, pleasd call our 24-hour contact centre-02-9553g32, 0i 75s556667
Prime Bank Limited, Card Division; 29 gajuk Avenue, Motijheel, Dhaka_1000.
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