APGVB

Customer Name *:

Account Number*:

(Customers are requested to enter correct Account number for faster resolution; Entry of incorrect account number may lead to rejection of complaint)

Contact No *:

(Customers are requested to enter Mobile number registered with the bank for faster resolution)

Email ID *:

Address for correspondence*:

Nature of the Complaint:

Please give brief details of your complaint*:

Note: Please do not enter 16 digit card number anywhere in the form. If require, please mention only the last four digits of the card