Bank Use Only. By: Misc. Information: Scan:
Bank Use Only. VISA DEBIT SERNO: Click or tap here to enter serial no. CUSTOMER NUMBER: Click/tap here to enter no. CUSTOMER NUMBER Click/tap to select branch location BANK OFFICIAL SIGNATURE: BRANCH: Choose an item. Bank Use Only VISA DEBIT SERNO: CUSTOMER NO.: Click/tap here to enter serial no. Click/tap here to enter customer no. VISA DEBIT SERNO: Click or tap here to enter serial no. CUSTOMER NO.: Click/tap here to enter customer no. VISA DEBIT SERNO: Click or tap here to enter serial no. CUSTOMER NO.: Click/tap here to enter customer no. VISA DEBIT SERNO: Click or tap here to enter serial no. CUSTOMER NO.:
Bank Use Only. Borrowers acknowledge that any inspections, audits or evaluations performed by Bank of the collateral securing the Loan pursuant to this Agreement (a) are solely for Bank's use in evaluating and underwriting an existing or proposed transaction in Bank's capacity as an existing or proposed lender, and (b) shall not be relied upon by any person or entity, including, without limitation, any Borrower, other than Bank. Bank makes no express or implied representation or warranty of any kind with respect to such inspection, audit or evaluation of the collateral. Bank expressly disclaims any liability to any person or entity, including, without limitation, any Borrower, with respect to such inspections, audits or evaluations.
Bank Use Only. If the Account Holder Applicant is a Partnership, Limited Partnership (where the General Partner(s) is an/are individual(s)), Sole Trader, Trust (where the Trustees are individuals): The mandate on the Account is ‘any one to sign’ I confirm that all mandatory fields (i.e. ALL Sections EXCEPT Section C) have been completed I confirm that the Account Holder Applicant has received a copy of the Debit Card Terms and Conditions of Use I confirm that the Authorised User(s) name(s) and signature(s) detailed in Section B match the name(s) and signature(s) of the authorised signatories on the account mandate held I confirm that the Authorised User(s) has signed their name, in the space provided, in Section B I confirm that a minimum of two signatures has been provided in Section D, EXCEPT for Sole Trader Applicants, or, in the case of a Limited Partnership, if the General Partner is a sole individual If the Account Holder Applicant is a Company, Incorporated Society, Unincorporated Entity, Limited Partnership (where the only General Partner is a company), Trust (where the only Trustee is a company): The mandate on the Account is ‘any one to sign’ I confirm that all mandatory fields (i.e. ALL Sections) have been completed I confirm that the Account Holder Applicant has received a copy of the Debit Card Terms and Conditions of Use I confirm that the Authorised User(s) name(s) detailed in Section B match the name(s) of the Authorised User(s) named within the resolution in Section C on this application form I confirm that the Authorised User(s) name(s) and signature(s) detailed in Section B match the name(s) and signature(s) of the authorised signatories on the account mandate held I confirm that the Authorised User(s) has signed their name, in the space provided, in Section B I confirm that the individuals who signed the certification at (ii) in Section C match the signatories of the declaration at Section D Branch Staff Name Staff ID Signature Date Day Month / / Year
