Updated on 01/01/2018

REQUEST FOR ISSUE OF REPLACEMENT CARD IN LIEU OF LOST / STOLEN

SYNDICATEBANK DEBIT CARD.

From- Date___________
____________________
____________________
____________________
____________________

Phone No.: _________________________

e-mail id: ___________________________

To,
The Branch Head
Syndicate Bank
______________________ Branch.

Dear Sir,

Ref: My Syndicate Bank Debit Card No. (16 digit) __________________________

Reg: Issue of Replacement Card in lieu of Lost/ Stolen Debit Card.

I wish to inform you that I have lost my above Debit Card on __________(Date) at ______________
(Place) and got the Card hot listed on ___________(Date) and at _________(Time) through your
branch/Help Line/Card Centre.

I request you to issue me a Replacement Debit Card in lieu of above lost / stolen Debit Card
immediately to enable me to continue availing Debit Card facility. I hereby authorise you to debit the
stipulated charges to my account no. ______________________ at your branch.

Further, I wish to inform you that [tick ( ) whichever is applicable) –

1. I have already lodged a Police Complaint / FIR and copy of the same is enclosed for your perusal
and records .
OR
2. I am yet to lodge the Police Complaint / FIR and I will submit you copy of Police Complaint / FIR
shortly.
OR
3. I do not intend to lodge a Police Complaint / FIR. I confirm that my Lost Card has not been
misused and all the transactions carried out through my Lost Card prior to Hot Listing &
debited to my account have been done by me only. I am aware that filing of police complaint is
necessary in case my Debit Card is misused.

Yours faithfully,

(Signature of the Cardholder)

Name: _________________