*For Bank Use Only

CUSTOMER ID

UCO BANK ....................(ಯುಕೋ ಬ್ಯ ಾಂಕ್ ......................) Download UCO

(A Govt Of India UnderTaking) ( ) Mbanking Plus Date(ದಿನಾಂಕ್)

ACCOUNT NUMBER (ಖಾತೆ ಸಂಖ್ಯಯ )

NAME OF CUSTOMER (ಹೆಸರು)
MOBILE NUMBER(ಮೊಬೈಲ್ ನಂಬರ್)
Please tick the appropriate box(ಸೂಕ್ತ ವಾದ ಪೆಟ್ಟಿ ಗೆಯನ್ನು ಟ್ಟಕ್ ಮಾಡಿ)
1. CONTACT DETAILS ADD/UPDATE
Mobile No Email ID

2. ACCOUNT RELATED REQUEST

Inoperative Account , I have not operated my account for the past……..months/years, please activate my account
Minor to major Kindly change my account status from minor to major
Signature & photo Updation Kindly Update my Signature And Photograph(3 Copies Of Latest Phtograph Required)
Name / Address Modifications Kindly Change/Update my details as per my.............................................................
(Attach Proof Of Address/ Name As Applicable)
Issue duplicate Passbook / Issue A/C statement from to

3. ATM/DEBIT CARD RELATED Personalised ATM card

Issue / Reissue Reason for reissue Damaged Lost Upgradation
Old Card Number

Block ATM Card Reason Damaged Lost Stolen ATM Card Minor To Major

*For Office Use Only Entered By

New Card Ref Num

Verified

4. CHEQUE BOOK REQUEST

Please issue the cheque book of ……………leaves. Personalised cheque book

5. LINKING OF DOCUMENTS TO MY ACCOUNT

(Attach Self Attested Copy Of The Document)
AADHAR CARD/UID PAN CARD
ಆ ಪಾನ್ ಕಾರ್ಡ್
6. OTHER SERVICES
Link LPG Id To Receive Gas Subsidy Kindly Link my LPG ID..........................................................................
of................................OMC to my UCO Bank Account For receiving subsidy.
Transfer of Account Kindly Transfer My Account To........................................................... Branch

Any Others (Please Specify) :........................................................................................................................................

Sir, I request you to comply with my above request & debit the charges (if any) For Bank Use Only
from my account (ಸರ್, ನನು ಮೇಲಿನ ವಿನಂತಿಯನ್ನು ಅನ್ನಸರಿಸಲು ಮತ್ತತ
ನನು ಖಾತೆಯಾಂದ ಶುಲ್ಕ ಗಳನ್ನು ಡೆಬಿಟ್ ಮಾಡಲು ನನ್ನ ನಿಮಮ ನ್ನು
ವಿನಂತಿಸುತೆತ ೋನೆ)
Signature verified

Signature Of customer(ಸಹಿ)……………....……………......
Officer
Address (ವಿಳಾಸ)……………………………………………....

mk UCO Bank Kdk