INTERNAL USE ONLY

CLOSING/FREEZING ACCOUNT FORM

I/We would like to close/freeze my/our account

on.................................................................................

1. ACCOUNT NUMBER:................................................................................................................
2. NAME OF ACCOUNT:................................................................................................................
3. TELEPHONE: MOBILE:.................................................OFFICE:.................................................
4. EMAIL........................................................................................................................................
5. ADDRESS:..................................................................................................................................

REASON FOR CLOSING/ FREEZING

..........................................................................................................................................................
..........................................................................................................................................................

Signature of Customer.....................................................................................................................

Date..................................................................................................................................................

FOR OFFICIAL USE ONLY

Signature Verified by.................................................................Date...........................................

Authorised Signatory:................................................................Date...........................................

Closing Balance:..........................................................................................................................

Less charges:.................................................................................................................................

Balance paid out:............................................................................................................................

Ecobank Zimbabwe Ltd

INTERNAL USE ONLY