Block ATM / Debit Card - sample
Ramesh Kumar Sharma
Account no.: XXXXXX5678
Mobile: 98XXXXXX10
Date: 13/11/2026
To,
The Branch Manager, bank name, branch, city
Subject: URGENT - Request to block my lost / stolen RuPay debit card ending 4321 and to issue a new card
Dear Sir / Madam,
1. I, Ramesh Kumar Sharma, am the holder of account no. XXXXXX5678 with your branch. I am writing to inform you that my RuPay debit card ending with 4321, linked to the above account, was lost / stolen on 25 September 2026.
2. Request to block. I request you to block the card immediately and permanently, so that no transaction - at an ATM, a shop, online, contactless or through any wallet or UPI link - can be made with it. I have also blocked the card on the mobile banking app and called the customer care number. Please confirm the time at which the card was blocked.
3. Transactions. No unauthorised transaction has been noticed so far. The last transaction I remember is a cash withdrawal of Rs. 5,000 at an ATM on 24 September 2026. If any transaction is found to have been made after I lost the card, I request you to treat it as unauthorised, to investigate it and to reverse the amount as per the RBI's guidelines on the limited liability of customers in unauthorised transactions. I will not be responsible for any transaction made after the time of this intimation.
4. Police report. Lost report no. 187/2026 filed at the local police station on 26 September 2026. A copy of the report is attached. I will give any other document or statement that you need for the investigation.
5. Replacement card. Please issue me a new card against the same account, with a new PIN, and send it to my registered address by the bank's secure process, or tell me when I can collect it from the branch. I agree to pay the replacement fee as per the bank's schedule of charges.
6. Linked services. Please also stop any e-commerce, subscription or recurring mandates linked to this card, and tell me which of them have to be re-registered on the new card.
7. Request for acknowledgement. Please send me a written acknowledgement of this request with a complaint reference number, and send the status to my registered mobile number 98XXXXXX10.
8. Safety measures taken by me. I have changed the PIN of my other cards, the net banking password and the UPI PIN as a precaution, and I have not shared my PIN, OTP or CVV with anyone. If your inquiry needs it, I will give you the CCTV details, the SIM details and any other help that you may need.
Thanking you,
Yours faithfully,
Ramesh Kumar Sharma
Signature: ____________________ (as in the bank's records)
Mobile: 98XXXXXX10