t MEGHNA BANK LTD

MEGHNA BA]IK 1IMITEIT e&

Bank Copy

To apply for SmartPay, Please provide the following information.

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Cardholder Name:
T
Credit Card No
Contact Number: II Merchant Name:
Merchant Outlet Address:
P rrchase lnstallment Plan (Months)
Transaction Date Item Details
Amr runt (BDT) (Circle your preferred tenure)
re ffi 3 Months 6 Months 9 Months

tIE 12 Months 18 Months 24 Months

ffi Yes, lwouldliketopurchasetheproductunderMGBL SmartPayprogram. lunderstandandagreetothetermsandconditions(asmentionedoverleaf) ofthisprogram.

Date & Signature of Cardholder Seal & Signature of Merchant

For more information please call MGBL call Center on : +88O1777797777
Fl & ADC, Reta i I Ba nking Division, Noor Hold ng (Leve!3) 33,Gu lshan South CiA,
i Gu lshan Avenue, Circle-1 Gulshan, Dha ka- 1 2 1 2
For EMI confirmation please call: +8801777797777 Email: cardsinfo6meghnabank.com.bd
Bank Use Only
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