Application Form For Services Of Internet Banking, Fax Banking, And Automated Message Notification (Page 3 of 3) in pdf

Application Form For Services Of Internet Banking, Fax Banking, And Automated Message Notification Page 3

New Delhi Branch

Automated Message Notification Services

Please specify the email address / IP address / URL below to receive monthly statements and transaction related notifications including, but not

limited to, debit/credit, remittance, term deposits, and loans through Automated Message Notification Services.

EMAIL ADDRESS / IP ADDRESS / URL

Encryption(V)

EMAIL ADDRESS / IP ADDRESS / URL

Encryption(V)

Note

：

WinZip application is needed If encryption is chosen.

Others

Debit Accounts for Fees and Expenses

Debit Account No.

I/We hereby authorize the Bank to debit or deduct the related fees and expenses in connection with Internet Banking, Fax Banking, and Automated

Message Notification services from the Debit Account(s) above without our written instruction or confirmation. The Bank’s record regarding the

balance of the Debit Account(s) above shall be final and conclusive without manifest error. If no Debit Account above is specified, fees and

expenses shall be deducted from the Debit Accounts for Internet Banking in the column in page 2.

Declaration of the Applicant:

The Applicant hereby declares that it/he/she has carefully read the Application Form, all the terms and conditions hereof, and the Agreement for

Services of Internet Banking, Fax Banking, and Automated Message Notification and fully understands the contents hereof and thereof and

agrees to comply with and be bound by the same, as may be amended and restated from time to time. The Applicant understands that the Bank

may reserve the right to approve or reject this Application Form and acknowledges that this Application Form will be executed in one counterpart

which will be kept by the Bank.

(applicable to an individual)

Applicant’s Name: ________________________

Customer ID:____________________________

_______________________________________

Signature(s):

Date :

(applicable to a company)

Applicant’s Name: ________________________

Customer ID: ________________________________

For Bank Use only

Approved By

Verified By

Processed By

-------------------------------------------------------------------------

Name of Authorized Signatory(ies)

Title:

Date:

The Bank will verify the signature with the specimen signature filed with the Bank.

In case of any doubt about the contents of this Application Form, the Bank may verify such contents with the contact person below.

Contact Person:

Phone:

E-mail:

Page 3 of 3

Application Form For Services Of Internet Banking, Fax Banking, And Automated Message Notification Page 3

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