To,
The Branch Manager,
____________ (Name of the Bank),
____________ (Branch Address)

Date: __/__/____ (DD/MM/YYYY)

Subject- Information about loss of passbook bearing account number ____________ (account number).

Respected sir/madam,

I, ____________(Name) having a ____________ (Saving/Type of Account) account in your branch bearing account number ____________ (Account number). This is to bring to your kind notice that I have lost my bank passbook. I am heavily reliant on passbook for keeping track of my transactions.

I would like you to take note of this loss of mine and issue me a new one as soon as possible.

Kind regards,
_________ (Name),
_________ (Address),
_________ (Registered Contact Number)

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