it appears to be an application form for reporting a lost ATM card to a police station. It is not an official form, but it can be used as a template to fill out when reporting a lost ATM card. The form includes space for the following information: Applicant's name Applicant's address Applicant's phone number Date of application Name of bank Account number Card number Description of the card (e.g., color, design) Date the card was lost Circumstances of the loss (e.g., lost, stolen) There is also space for a police officer to take additional notes. It is important to note that reporting a lost ATM card to the police is not always necessary. If you think your card may have been stolen, you should report it to the police immediately. However, if you simply lost your card, you may be able to get a new one from your bank without filing a police report. Here are some steps to take if you lose your ATM card: Contact your bank immediately to report the card lost or stolen. The bank will cancel your old card and issue you a new one. If you think your card may have been stolen, you should also file a police report.