THE HELB STUDENT’S PERSONAL BANK DETAILS CHANGE REQUEST FORM
Do you wish to change the bank account through which Helb Loan Disbursement is to be made? Well. Fill in the form below. You can also download it here.
Last Name | First Name | Middle Name |
National ID Card No. | Admission No. | University |
Mobile No. | Email Address | |
Old Bank Account No. | Branch | Bank |
Reason for Account Change | Tick where applicable | |
Dormant | ||
Frozen | ||
Parent’s/Guardian’s | ||
Not Activated | ||
Other [Tick and explain] | ||
New Bank Account No. | Branch | Bank |
Declaration: | I declare that the NEW Bank Account Number provided above is mine and that I will be solely responsible for any risk associated with it. | |
Signature of student | ||
Date | ||
Attachments: | ||
Mandatory Attachment | Copy of National ID Card | |
Copy of ATM or Bank Card | ||
FOR OFFICIAL [HELB] USE ONLY | ||
Received by: Name & Signature | ||
Date | ||
Account changed by: Name & Signature | ||
Date |
Click here to download a pdf copy of this form.
HELB Contact Centre Tel: +254 711 052 000 | Email: [email protected]
Facebook and Twitter: @HELBPage | USSD: *642# | Website: www.helb.co.ke
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