Signature Card

Branch Base Number

_ _
Account Title Account Number

Authorized Signatories I.D. # & TYPE Mandate Info Specimen Signature

1

Special Instructions

For Bank Use Only

Date

Customer Services Staff Signature as Verified and Witnessed Manager’s Signature Date

IN/1/3/59 V1.0
 List of Authorized Persons(s) on a Power of Attorney Basis (Docs. on file)

Name of Attorney I.D. # & TYPE Mandate Info Specimen Signature Effective Expiry

A A

B B

For Bank Use Only Date Customer’s Signature

Customer Services Staff Signature as Verified and Witnessed Manager’s Signature Date

Signature Capture (Internal Use Only)

Capture Type Capture Processed Capture Authorized Datebase Verified

Signature Signature Signature

New Amended Date Date Date

IN/1/3/59 V1.0