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SERVICE REQUEST FORM
Date: D M M Y Y Y Please tick the appropriate boxes
For joint accounts, please use separate forms (if applicable)CUSTOMER DETAILS
To: ICICI Bank UK PLC, (Branch)
Customer Name
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To fill out a date in the format d d m, follow these steps:
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Write the day number (d) of the date using two digits. For example, if the day is 5th, write it as 05.
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Leave a space between the day number and the month number.
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Write the month number (m) of the date using two digits. For example, if the month is October, write it as 10.
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