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Duplicate ATM/Debit PIN online application

I would like to request BNB to issue me a duplicate ATM/Debit PIN against my following details:
Enter code in CAPITAL letters:
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Where do you want the PIN to be delivered?
Mobile Number:
Name:
A copy of this form will be send to you
Account Type:
Account Number:
E-Mail:
ID Number/ Passport Number/ Resident permit:
Authorization
I hereby declare that the information given above is true and correct and would like to request the Bank to update my above details in your system. I authorize BNB & its representative to call or SMS me with reference to my application.
Your Relationship Bank
HOTLINE NO: 144     
BNB Signature tune
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