Back to Applications
LOST/STOLEN CARD REPORT
Attention:  Fill in all the information, print the form on your printer, and then fax it or mail to:
Kentland Bank
P.O. Box 145
Kentland, IN 47951
219-474-5155
Fax 219-474-5071		 Lake Village
P.O. Box 245
Lake Village, IN 46349
219-992-3313
Fax 219-992-2501		 Rensselaer
P.O. Box 164
Rensselaer, IN 47978
219-866-4142
Fax 219-866-4514		 Roselawn:
P.O. Box 304
Roselawn, IN 46372
219-345-4646
Fax 219-345-2038
Credit Card Information:
First Name  
Last Name  
Account Number  
Card Expiration Date  
Social Security #  
Street Address  
City,

State

 ,
 
Zip-Plus 4 -
 Daytime Phone Number  -
Date card was lost/stolen  
 
OUR PEOPLE CARE!  It's our policy . . . It's our promise.