CONSENT FORM

FINANCIAL ACCOUNT NUMBER CHANGE or NOMINATION

Programme Name

Date

Cooperating Partner

Name

HH ID

WFP, Bangladesh

From

Name

: Beneficiary

To

Beneficiary’s Current

account details:

Name of the Bank/ Mobile

money account:

Corresponding NID with the

financial account:

Accountholder’s name

Beneficiary’s Proposed

Financial account details:

Name of the Bank/ Mobile

money account:

Corresponding NID with the

financial account:

Accountholder’s name and

relationship with the

beneficiary

Justification for changing or nominating the proposed accountholder:

Signature of Beneficiary

Prepared and checked by Reviewed by – CP

Approved By- WFP

– CP