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ACKNOWLEDGEMENT OF PASSWORD RESETTING

PERSONAL & SOLE PROPRIETORSHIP USERS


The Manager - Electronic Banking
Sampath Bank

User Name

Account Number

Name

: ...............................................................................................................................................

Address

: ...............................................................................................................................................
...............................................................................................................................................

E-mail

: ...............................................................................................................................................

I confirmed having changed the Sampath Vishwa password for the above User Name.
Further I agree that this acknowledgement form an integral part of my original Sampath Vishwa terms, conditions &
indemnity.

Signature of User :

....................................................................... Date : ...........................................................

Instructions
Please complete the acknowledgment form and return to the Manager - Electronic Banking, Sampath Bank PLC, No. 110, Sir James Peiris
Mawatha, Colombo - 02, Sri Lanka.

FOR OFFICIAL USE ONLY

Signature verified by / Date

: ................................................................

User enabled by / Date

: ................................................................ Verified by / Date

: ................................................................

Sampath Bank PLC Company No. PQ144, Electronic Banking


No. 110 Sir James Peiris Mawatha, Colombo 02, Sri Lanka. Tel: +94-11-2305844/5 Fax: +94-11-2305481
Email: vishwa.mgr@sampath.lk Web: www.sampath.lk

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