26/12/2017 Sample Complaint Letter to Bank and Banking Ombudsman about a Failed ATM Withdrawal
To: The Branch Manager
[Name of the Bank will be printed already]
Name of the Branch:______________ [this should be the name of the Bank branch where
card holder account is maintained which is linked to the ATM card]
Name of the City: ________________
Customer Information:
Name: ____________________
Account No.:________________
Debit Card/ATM Card No.: ________________________________
ATM Information:
ATM ID/Location, if ID is available: __________________________
Name of the ATM Bank: _________________
Nature of the Complaint:
[Here, fill in the details of (a)]
(a) Complaint relating to Cash withdrawal:
Amount requested for withdrawal: Rs.________
Amount actually disbursed at ATM: Rs.________
Amount debited to the account: Rs.___________
Date of transaction: ________________
Time of transaction: ________________
(b) Card captured by ATM: _________________________
(c) Other Complaints: ______________________________
Signature of the Card holder [put your signature above these words]
Contact No: ________________________
Date: __________________
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