bank of baroda atm card application form

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Application form for BANK OF BARODA INTERNATIONAL DEBIT CARD I wish to apply for Bank of Baroda International Debit Card. My/Our Account Type Name of the Branch Account Number I have an ATM card no. leave blank if not applicable issued to me and linked to the account. My/Our Account Type Name of the Branch Account Number I have an ATM card no. leave blank if not applicable issued to me and linked to the account. I would like to link our savings account to the debit card also. I confirm that I...
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the Bank Of Baroda does not authorize us for the operation of the Bank Of Baroda ATM card without being accompanied by the person with the relevant authorisation, and we are not in possession of such authorisation. We therefore have decided to apply for a Bank of Baroda International Debit Card to be issued to each of the following persons only Name of Authorized User Name of Authorized Representative (if different) Name 2 Country of Signature (if different) Branch address(s) Please provide any evidence that the above persons are authorised to act on our behalf I have read and understood the Information above. BANK OF BARODA INTERNATIONAL DEBIT CARD Bank Of Baroda C/o KIMURA BANK Branch code No. 1058 1st Floor, No. 9, Shinjuku-ku, Shinjuku-shi, Tokyo JAPAN BARODA INTERNATIONAL DEBIT CARDS BANK OF BARODA INTERNATIONAL DEBIT CARD Branch code No. 1001 Bank Of Baroda 12A-1, Nakano, Nakano-ku, Tokyo, 108-0026 JAPAN DUAL ATM CARD BANK OF BARODA INTERNATIONAL DEBIT CARD Branch code No. 1001 The Bank Of Baroda Kasagawa Branch, Kasagawa-shi, Kitazawa-ku, Nagoya, Japan TELL JAPAN 1-7-1, No.2-15, J-1-3 Shibuya-ku, Tokyo, 150-0046 TELL VICTORIA 6-1-7, Shibuya-ku, Tokyo, 150-0071 TELL MEXICO 6-27-7, Edificio Alcalá-26, 6th Flr., Guadalajara, Jalisco, Mexico TELL PORTUGAL 2-2-7, Porto Seguro-10, 10, Rua Pinto-C.E.G., Porto-Seguro, Pombal, Portugal TELL U.K. 1-1, Paddington New Road, London, WC1E 6NS Please
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