23-40L

Digital Services Amendment Form

ID No.:
Full Name:
Date of Birth: Address:
Account Number:

SERVICE MOBILE OPTIONS [tick the applicable option (s)]

(where applicable) NUMBER(S) REGISTRATION DEREGISTRATION PIN RESET OTHER (where applicable)

ECOCASH
EWALLET

WHATSAPP

MYZB

I have read and understood the terms and conditions governing the application for and use of the above-mentioned digital service and will abide by
them. I confirm the details supplied above are complete and correct.

Signature: Date:

FOR OFFICIAL USE ONLY

Verified and processed by: Approved by:

Name: Name:
SERVICE CENTER
Date: Date: STAMP
Signature: Signature: