Application for ATM Setup Customer Info New     Change     Add     Delete Customer Name: Address: Telem           Telcell Utility Account #: Telephone #: Account #: Currency: Identification #: Utility Company: Prepared By: Address: Reference Checked By: Date: Activation of this request is subject to the final approval of the aforementioned Utility Company and The Windward Islands Bank. I hereby confirm receipt of the General Conditions, which governs this service provided by the Windward Islands Bank Ltd. Discontinuation of this Transfer can only be done in writing. Signed on , philipsburg, Sint Maarten N.A. Customer Utility Company W.I.B.