ATM OPERATION DEPARTMENT

Ref. No: OPRAF04

ATM ACCEPTANCE CERTIFICATE Rev. No: 02-2016

Date of Acceptance S.O. No. : -

CUSTOMER INFORMATIONS

Customer’s Name Region

Branch Location City

ATM UNIT INFORMATIONS

ATM Type / Model ATM Serial Number

Terminal ID Branch ID

AUC ENGINEER’S ATM CONFIGURATION CONFIRMATION

I have checked and reviewed the enclosed ATM Configuration Check List and found it complete and accurate.

EMPLOYEE’S NUMBER 4 0 0
Engineer’s Name & Signature

Supervisor’s Name & Signature

CUSTOMER’S ACCEPTANCE AND CONFIRMATION

I hereby receive and affix my signature to confirm and accept the above ATM Machine and its configuration with a
defined Group Password as the default password.

DATE
Authorized Customer’s Name & Signature

Note: The details of this Acceptance Certificate correspond to the attached ATM Configuration Checklist.

AUC is “Committed to meeting or exceeding customer expectations.”

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