BVN Correction/Incident Form

Date: BVN:
Day Month Year

Surname: ____________________________ Other names: __________________________________________________________

First Middle

Account No: Phone no:

Gender Male Female Date of Birth:

Day Month Year

Email address: ______________________________________________________________________________________________

Please Tick option(s) to be corrected

Surname Name First Name Middle Name Date of Birth Gender Others

Please specify for others

I understand that I am obliged to reflect the changes made herein on my account(s) with other bank(s)

________________________________
Authorized signatory

FOR OFFICIAL USE:

Type of Discrepancy: Major Minor

Remarks:

Name of Operations Head: ____________________ Signature of Operations Head ____________________________