Date: _____________

In d e m n i t y F o rm f o r M e e za n In t e rn e t B a n kin g

Account Title: ___________________________________________________________________________________________________________

Relationship Number: _____________________________________ New NIC: _____________________________________________

Account Number: _________________________________________ Branch Name: _______________________________

By signing below you confirm the acceptance of the terms and conditions provided at the Meezan
Internet Banking site.

Applicant Signature:

1: __________________________ 2: __________________________

3: __________________________ 4: __________________________

Indemnity must be signed (jointly) by all signatories even if the account is operated singly.

For Branch Use Only: Indemnity Received on: ____________

V e rific atio n o f In d e m n ity b y : V e ri f ic atio n o f C u sto m e r S ig n by :

C S O: _____________ M a n ag e r O P S: ___________

Date: ______________ Date: ____________

E-Form# ______________