VER10 16012019 DECLARATION ON SMART CARD LOSS OR THEFT

Podnositelj zahtjeva

Ver.1.0, 16.01.2019.

I hereby declare that a Smart card for the use of Internet Banking issued to:

Name of the Authorized Person

Has been lost stolen

Smart Card was issued for the following Business accounts:

Name and Company OIB:

Name and Company OIB:

Name and Company OIB:

Name and Company OIB:

Place and date:

_____________________________

Signature of the Authorized Person

_____________________________________________________________________________________________________

J&t banka d.d. – Declaration on Smart card loss or theft – January 2019