Request Form For Issue of Duplicate card,Re-Pin,Activation of cards

Company Name(s): 

SYNDICATEBANK GLOBAL DEBIT CARD REQUEST FOR ISSUE OF ADD-ON CARD/ DUPLICATE CARD / RE-PIN, LINKING OF ADDITIONAL ACCOUNT/S OR ACTIVATION OF CARD
From- Date _____________ ____________________ ____________________ ____________________ Phone No.: _________________________ e-mail id: ___________________________ To, The Branch Head SyndicateBank ______________________ Branch. Dear Sir, Ref: My Debit Card No. ________________________ linked to A/c no. ______________________ I request for the following activities relating to my captioned Debit Card [tick () whichever is applicable) -
1. I am enclosing my existing Debit Card, which has been damaged. Please issue me the Duplicate Card. I hereby authorise you to debit the relevant charges to my account linked to the Debit Card.
2. My existing Debit Card has been retained in ATM of ___________________________ (Bank) at ________________________ / picked up by _________________________________(Merchant Establishment) at ____________________________. Please issue me the Duplicate Card. I hereby authorise you to debit the relevant charges to my account linked to the Debit Card.
3. The Debit Card has been issued for the first named person of the Joint Account. Please issue Add-On Card/s for the Joint Account holder/s as per following details-
Name of the Joint Account holder
Customer ID
Name of the Joint Account holder
4. I have forgotten the PIN allotted to me for captioned Debit Card. Please issue me a fresh PIN to enable me to operate the Debit Card. I hereby authorise you to debit the relevant charges to my account linked to the Debit Card.
5. My Debit Card is presently linked to account no. __________________________. I request you to link my account no. _________________________ & ____________________________ to above Debit Card.
6. Due to use of incorrect PIN, my Debit Card is not working. Please activate the same.
Thanking you. Yours faithfully, (Signature of the Cardholder) Name: _________________