Transcription of National Treasury Z894 G.P.-S 81/329645 Pensions ...
1 Bar CodeZ894 ACB bank PARTICULARSP lease have this form completed by your bank as confirmation of your bank particulars. National TreasuryPensions AdministrationSEE INSTRUCTIONS OVERLEAFA) BENEFICIARY PARTICULARSDateC) PREVIOUS BANKING DETAILS OF ACCOUNT HOLDER (Complete only if banking details have changed)B) BANKING DETAILS OF ACCOUNT HOLDER (This section must be completed by the bank )D) DECLARATIONI CONFIRM THAT THE ABOVE DETAILS ARE CORRECT:To be completed by the beneficiary ( Pensioner/Member/Executor/Other)Thumb print of beneficiary (Compulsory)SignatureTel O D ECell O D EFax address 6. Account No. 5. Branch code 4. Branch name 3. Name of bank2. Type of accountChequeTransmissionSavings1. Account holder name8. Passport ID Middle names5. First name4. Surname1. Pension Date of birthC C Y Y M M D D3.
2 Title10. Branch email address C O D E9. Branch postal address 7. Branch tel O D E8. Branch fax O D E3. Branch code 4. Branch name 2. Name of bank1. Account holder nameSurname of bank OfficialInitialsSignature ofBank OfficialC O D E 5. Account No. 6. Type of 81/329645 Official DateStamp of BankC C Y Y M M D D39512(Compulsory)(Compulsory)
