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Seylan Easy Payment Plan

Seylan Credit Card Easy Payment Plan Conversion Request Form

Name of the Cardholder *

Last 4 Digits of the Card Number *

National Identity Card Number *

Mobile number *

Email Address *

Transaction Date *

Transaction Amount *

Merchant Name *

Preferred Payment Plan Option *

Preferred tenure

Flexi Plan T & C

Relax Plan T & C

I Agree for the above Terms & Conditions. *