Account Reactivation Form access Branch Date Name Account No LLtEtt ttt it ttt nares Email Telephone Why was the account domant (Tick as applicable) [1 telcation Service not Satisfactory thers (Specify), 1 titoaton Customer Deceased Reasons) for Reactivation New Deposit Tick as appropriate) 1 cheque If “Cheque’, specify bank's name cash Fund Transfer Amount Customers Signature & Date For Access Bank's Use Only in the following information below Date Account Name Account No. Date of Last Transaction Balance on Account No. ‘Ate all account document complete? Yes Tick new documents collected On Passport Photograoh International Passport New Mandate Card Driver's Licence Referees TelMobile Approval Relationship Mangers Signature & Date Operations Head's Signature & Date