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eStatement / Alert Notification Enrollment Form
All information is compulsory unless otherwise stated.
Personal
Amendment
Name
*
U
Daw
Account Name
*
Nationality
*
NRC No
*
N
E
P
T
Y
S
Passport No
Expiry Date
Village/Town Name, Apartment No, Building, Street
*
State/Region
*
Township
*
Phone No
*
Email
*
Service Type
*
eStatement
eAlert
SMS Alert
Payment Plan
*
Yearly
Quarterly
Monthly
Weekly
Daily
Subscription Period From
*
To
*
Account to receive eStatement/ Alert Notification
*
Note*** eStatement/Alert will be sent to above mentioned email and phone number.
Debit From Account No
*
