Helb phone Number, Bank Account Changing Application Form

Helb phone Number, Bank Account Changing Application Form.

Do you need to change your Phone Number and Bank Account number? Well. Fill out this form and send it to Helb for immediate action.

STUDENT’S PERSONAL PAYMENT DETAILS UPDATE REQUEST FORM

FULL NAME
NATIONAL ID CARD NO.
INSTITUTION/SCHOOL
ADM/REG NO.
MOBILE PHONE NO.
EMAIL ADDRESS

MODE OF PAYMENT *Tick the preferred mode of Payment*			BANK	MOBILE PHONE

OLD MOBILE PAYMENT PHONE NO.
NEW MOBILE PAYMENT PHONE NO.

		BANK NAME	ACCOUNT NO.		BRANCH
OLD BANK ACCOUNT NO.
NEW BANK ACCOUNT NO.

Declaration: I declare that the NEW Payment details -Mobile Payment Phone or Bank Account Number provided above is mine and that I will be solely responsible for any risk associated with it. Signature: Date:
Attachments: *Tick if attached*	Copy of National ID Card
	Copy of ATM/Bank Card (Front side only)
	Other document(s)- Specify

FOR OFFICIAL [HELB] USE ONLY (BANK ACCOUNT/ MOBILE PAYMENT PHONE NO. RECEIVED/CONFIRMED BY)
Name
Signature
Date