ATM Card Form YOU CAN FILL YOUR BSIC BANK ATM APPLICATION FORM ONLINE BSIC ATM CARD REQUEST FORMACCOUNT NAME *ACCOUNT NUMBER * VALID INFORMATIONEMAIL ADDRESS DATE MOBILE NUMBER(S) OFFICIAL ADDRESS HOME ADDRESS CUSTOMER INSTRUCTION: Please deduct the card fee D350 plus the VAT of 15% charge from my accountNAME OF ACCOUNT HOLDER SIGNATURE File Upload FOR OFFICIAL USE ONLYDate and Signature Verified by Authorized by NB: A transaction made on any ATM in the Gambia will cost a fee of D15. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo. February 2023 M T W T F S S 12345 6789101112 13141516171819 20212223242526 2728 « Jun Lorem ipsum dolor sit amet, consectetur adipiscing elit. Saffic Jammeh Marketing Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.