BVN Correction/Incident Form
Date: BVN:
Day Month Year
Surname: ____________________________ Other names: __________________________________________________________
First Middle
Account No: Phone no:
Gender Male Female Date of Birth:
Day Month Year
Email address: ______________________________________________________________________________________________
Please Tick option(s) to be corrected
Surname Name First Name Middle Name Date of Birth Gender Others
Please specify for others
I understand that I am obliged to reflect the changes made herein on my account(s) with other bank(s)
________________________________
Authorized signatory
FOR OFFICIAL USE:
Type of Discrepancy: Major Minor
Remarks:
Name of Operations Head: ____________________ Signature of Operations Head ____________________________