REGISTRATION FORM FOR TWO– FACTOR AUTHENTICATION (2FA)
Please send the completed form to us at: csbonline@capitalsecuritybank.com Account Name / Account Number: Name (Mr/Mrs/Miss/Rev./Dr.): PASSPORT Number: Country of Issue: Residential address:
TWO-FACTOR AUTHENTICATION (2FA) REGISTRATION/ UPDATE: I/We request Capital Security Bank in addition to our CSB Online facility, register my mobile phone number in order to receive OTP*. Please update my mobile phone number in order to receive OTP*. Mobile Phone Number: *OTP – One time password
AUTHORISATION AND AGREEMENT: In consideration of Capital Security Bank ‘CSB’ agreeing to my/our request to extend the CSB Online facility, as selected in this Registration Form, I/We confirm that I/We have read and understood and that I/We agree to be bound by Capital Security Banks Terms and Conditions ‘Electronic Portal – Additional Terms’ (Located at http://www.capitalsecuritybank.com/terms-and-conditions/) and any amendment thereof as CSB may introduce from time to time in connection with the use of the said service(s), and to indemnify CSB from and against all claims, demands, losses, charges and expenses which the bank may sustain, incur and be liable for as a result of the CSB agreeing to my/ our said request. Signature of Account Holder: Date:
CAPITAL SECURITY BANK LIMITED 1