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AIBL Card Service Request Form

The document is a service request form for AIBL Card Division, allowing customers to request various services such as card activation, limit enhancements, and address changes. It includes fields for personal information, card details, and specific service requests, along with instructions for required attachments. The form also contains sections for signatures and internal use by the Card Division.

Uploaded by

Tahmid Tasnim
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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262 views1 page

AIBL Card Service Request Form

The document is a service request form for AIBL Card Division, allowing customers to request various services such as card activation, limit enhancements, and address changes. It includes fields for personal information, card details, and specific service requests, along with instructions for required attachments. The form also contains sections for signatures and internal use by the Card Division.

Uploaded by

Tahmid Tasnim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Card Division

36, Dilkusha C/A (18th floor)


Dhaka- 1000
24×7 Contact Center: 16434
Service Request Form Email: cd@aibl.com.bd

Branch: Date: ___/___/_______

Name: _______________________________
Mobile: _______________________________
E-mail ID: _______________________________

AIBL Card Number


Please DO NOT write the full card number

A/C Number (if any)

 Card Activation/Re-Activation/Renewal
 Contact Number Change: Old Number……………………..……………….…………New Number……………………..…………..……………………….
 Change E-Mail Address: Old E-Mail…………………………………………………….........New E-Mail.….……………………………………………………
 Change/Correction of A/C Number, From:………………………………………………………..To:………………………………………………………………
 Update Correspondence Address
Existing Address New Address

 Debit Card Daily Withdrawal Limit Enhancement: maximum BDT 2,00,000/Day


(Please attach Manager/Operation Manager’s recommendation)
 Credit Card Limit Enhancement From ………………………………..………………………….To…………………………………….……………………………
(Please attach: (1) Salary Certificate (2) Bank Statement (3) E-TIN/TIN Certificate (4) CIB & Undertaking form)

 Product Group Upgrade/Downgrade to: SILVER GOLD PLATINUM


 Redefine Supplementary limit to: 25% (Default) 50% 100%
 Fees/Charges Waiver: Amount:…………..……… (Reason:……………………………………………..…………………………………………………………..)
 REPLACE CARD
o Replaced with MC-Instant Card (New Card Number ………………………………………………………………………..…………………………………………)
o Replace with MC-Debit Card
o Wrongly Embossed. Correct Embossing Name: …………………………………………………………………………………………………………………………...
o Others(Please Specify:.…………………………………………………………………………………………………………………………………………………………………

 PIN Re-Issue
 Dispute Claim: (Request for Refund of BDT/USD ____________ in word ………………………………………………………………………………)
o Terminal: ATM POS E-Com
o Issuer Bank: …………………………………………………………………… Location: …………………………………………………………………………
o Txn Date: ______/______/__________ Time: _____|_____ AM/PM
o Txn amount attempted: BDT/USD ___________ in word ………………………………………………………………………………
o Amount Received/Dispensed: BDT/USD ___________ in word ………………………………………………………………………………
 Credit Card Standing Instruction (Auto Debit) Enrollment/Cancellation
Minimum Full Outstanding: Debit AIBL A/C no………………………………………………………. _____________________

 Closing Request : Close Debit/Credit Card along with supplementary card (if any). Signature as per ABABIL

o Reason(s):……………………………………………………………………………………………………………………………………………………………………………………
 Include Balance with Transaction Notification SMS
 Others (Please Specify):…………………………………………………………………………………………………………………………………………………………..

___________________ ____________________________________
Card Holder’s Signature Authorized Signature & Seal (with A.S. no.)

For Card Division Use Only

Executed by:…………………………………………………………………………………………………………………………….. Date:………………………………………………..

Notes: Fees & Charges will be deducted as per instruction circulars(where applicable)

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