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Commercial Bank of Ceylon PLC
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USER INFORMATION FORM
*Mandatory
Full Name
NID/ Passport No.*
Email Address *
Mothers Name
Nationality
Mobile Phone No.*
User Level
Preferred User Name
Authorizer Maker & Authorizer
+
Account to be Linked Account to be Linked Display Full Display Full
1
2
3
4
5
6
7
8
9
10
Signature Group (e.g. A, B, C...)
Date of Birth
IN BLOCK LETTER
Inquiry Maker
List of Transaction to be Assigned
5. Intrabank Transfer 1. Own Account Transfer
10. Dome���������
4. Reque�������
7. Order Cheque Book
6. One to Many File Upload
11. Many to Many File Upload 3. ������������ quest
8. Bill Payment
9. Apply for Le�����攀 dit (LC)
12. Speci�����������
2. Group Payment
All Specify (if any) from the table below
User Signature
Date
Authorizer’s Signature with Name Stamp
Date
a. Separate Form to be completed for each user.
b. Every user has to be authorized by the authorized signatory of the company
Note:
This number will be registered for OTP and
SMS N�����
To receive OTP to this email, please accept
���������� d in “Annexure-2 ”
(DD MM YYYY) (DD MM YYYY)
(DD MM YYYY)
✓ ✓
Mr. Hasegawa Hiroshi Mr. Hasegawa Hiroshi Mr. Kogoro Osumi Mr. Kogoro Osumi
✓ ✓