Helb form for changing student loan disbursement bank details

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: contactcentre@helb.co.ke

Facebook and Twitter: @HELBPage | USSD: *642# | Website: www.helb.co.ke

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