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					                                                                Proprietorship & Corporate Account Holders



APPLICATION FORM FOR UBONLINE INTERNET BANKING SERVICE



Customer Number :



1. Company Information

Company Name :

Key Contact Person :

Telephone No. :

E-mail :


2. We hereby authorize the bank to give access to following users

1)                                                       11)
2)                                                       12)
3)                                                       13)
4)                                                       14)
5)                                                       15)
6)                                                       16)
7)                                                       17)
8)                                                       18)
9)                                                       19)
10)                                                      20)


Note

     Please complete the Multiple User Application for each user.

     Any service other than Balance Inquiry should be requested with a Board Resolution to that effect
We hereby confirm that the information given is true and correct and we agree to abide by the terms and conditions
for UBOnline Banking Service.




          _________________                                   _________________                                   _________________

          Authorized Signature                                Authorized Signature                                Authorized Signature

Date:   _________________                                     _________________                                   _________________


Note:

UserID & Random Password - The User ID & Random password will be sent to the e-mail address given on the
application.

----------------------------------------------------------------- For bank use only --------------------------------------------------------------
Verified the signatures and other details furnished in the application/mandate. The applicant is eligible for UBOnline registration.


Date:     _________________              CSC:       _________________              CSC Manager:         ___________________


Approved

Date: _______________                               Head of Operations: _______________


Number of Users



    User ID                    Verified                 Mailing Date                                       Remarks

				
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posted:8/23/2011
language:English
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