Application for Holiday Package Enrollment Fee / Lost ... - Seylan Bank

SEYLAN “THILINA SAYURA” PRELIMINARY APPLICATIONPLEASE FAX TO NO. 0094112421597 OF SEYLAN BANK SRI LANKATO BE FOLLOWED BY THE ORIGINAL APPLICATIONBRANCHACCOUNT NO.OVERSEAS ADDRESSTELEPHONE NUMBERFAX NUMBER__________________________________________________________________________________CATEGORY OF CLAIM1) SURGERY 2) EDUCATIONAL MERITS 3) WINNING AN INTERNATIONALEVENT SPORTS /ARTS/DRAMA/MUSIC4) MARRIAGE 5) COMPLETION /PURCHASE 6) EMERGENCY AIRFAREOF A HOUSE7) DEATH OF A FAMILY MEMBER 8) CHILD BIRTH9) HOLIDAY PACKAGE 10) ENROLLMENT FEE11) LOST BAGGAGE COVER 12) FOREIGN EMPLOYMENT BUREAUREGISTRATION CHARGES________________________________________________________________________________________________DETAILS OF CLAIM___________________________________________________________________________________DETAILS OF CONTACT PERSON IN SRI LANKA FOR DETAILS / SUPPORTING DOCUMENTS ETCNAME …………………………………..RELATIONSHIP ………………….TEL NO……………………ADDRESS………………………………………………………………………………………………………SIGNATURE ………………………………………………………

SEYLAN BANKTHILINA SAYURA APPLICATION FOR HOLIDAY PACKAGE/ ENROLLMENT FEE/LOST BAGGAGE/ FOREIGN EMPLOYMENT BUREAU REGISTRATION FEEAnnexure VIIIBranchDateName of Account Holder / Patient (Mr. / Ms / Dr. / Rev ) :Address :Account No:Passport No.Category of claim (Please Tick)Holiday Package Enrollment fee Lost BaggageEnrollment feeSLBFE Registration FeeDocumentation RequiredLost BaggageLetter issued by the school confirming child’s selectionDocumentation RequiredDocument issued by the Air Line indicating the value should be produced.FEBSL Registration FeeDocumentation RequiredRegistration fee payment voucherI have fulfilled the eligibility criteria under the Thilina Sayura Scheme and wish to submit my applicationunder the above category.I confirm that this is only application that I have submitted under this category............................................. ............................Signature of Account HolderDate