BOZ Vetting Request Form 2

SECURITY DEPARTMENT
(FINANCIAL AND PAYMENT SERVICES INDUSTRY EMPLOYEE LISTING) THE DIRECTOR - SECURITY BANK OF ZAMBIA P O BOX 30080 LUSAKA Re: VETTING DATA SUBMISSION FORM
PART A: (TO BE COMPLETED BY THE INSTITUTION UPDATING VETTING RECORD ON DISMISSALS/DISCHARGES)
The (FINANCIAL INSTITUTION OR PAYMENT SERVICE PROVIDER NAME) Wishes to advise that the under listed individual/s separated with the institution. The reasons for separation are as stated on the table below and to be used for purposes of vetting only. N o. Name /S Surname NRC Date of Birth Sex Last Job Title Employee’s Current Status Date Employed Date Dismissed/ Discharged Reason for Dismissal/Di scharge
SIGNATURE:.............................................................................................
NAME:......................................................................................................
TITLE:.......................................................................................................
DATE:.......................................................................................................
PREVIOUS EMPLOYERS (Apart from the institution submitting) a) ……………………………………………………………….......……….…………… b)…………………………………………….………….......…………………
PART B: (FOR USE BY THE BANK OF ZAMBIA SECURITY)
REMARKS AND RECOMMENDATIONS:…………………………………………………………………..........………................................…………………… ………………………………………………………………………………………........................................................................................................……… SIGNATURE:……………………………………..........................................……….. NAME:…………………….........................................…………..….….……………… TITLE:…………………………………..........................................….…….…………..
DATE:...................................................................................................
OFFICIAL STAMP
BANK OF ZAMBIA STAMP