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HDFC Add on Card Application

HDFC Add on Card Application

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Published by chinnubkk

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Categories:Types, Brochures
Published by: chinnubkk on Aug 05, 2010
Copyright:Attribution Non-commercial

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11/17/2012

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Add - on Card (s) Application Form Cum MID
 Version 1.5 for web
Appl. No.:
Titanium CardPlatinum Plus CardVisa Signature CardWorld MasterCardilver Card
Silver Card
Gold CardBusiness Gold Card
 Name of the Primary Cardmember:
First nameMiddle name
 Please leave one box space between names and surname
Last name
If you are an existing Cardmember, please tick whichever is applicable
I hereby acknowledge the request made for Add-on Card and warrant that the above information is correct and hereby request and authorise that an Account be opened and Card(s) be issued asindicated herein and renewed and replaced until I give notice to cease, and in connection herewith authorise the exchange and transfer of credit information from / with my Bank or any other source. Iunderstand that HDFC Bank Ltd., reserves the right decline the application without giving any reason whatsoever. The additional applicant (s) and I agree to be bound by the terms and conditions of The Cardmember Agreement earlier executed by me.I declare and undertake that the Cards issued to me, if used overseas shall be utilised strictly in accordance with the relevant exchange control regulations issued and as amended by the Reserve Bank of India (RBI) from time to time. In the event I exceed my entitlemants as per the exchange control guidelines of RBI, I undertake to bring the same immediately to the notice of HDFC Bank Ltd., inwriting. And in the event of any failure to comply with the prevailing exchange control guidelines issued by RBI, I shall be liable for action under the Foreign Exchange Management Act, 1999 asamended, and be debarred from the Card facility.The undersigned will be liable for all charges incurred with the Add-on Card(s) issued on the Account and each Add-on Applicant will be liable for all charges incurred with the Add-on Card jointly andseverally with the holder of the Primary Card.
 Add on applicant who do not hold HDFC Bank account, please submit valid Photo ID proof. Add on applicant without HDFC Bank A/c & not staying with Primary cardholder needs to submit his/her Address proof.Please refer to the List of Acceptable valid photo id & address proof for Add on in the next Page.
My City Benefit Program - Applicable only to Primary Card Holder (My City Benefit is applicable only to Silver, Value Plus & Gold Card Holder)
Please mail the form with documents (If any)To,HDFC Bank Cards Division,P.O Box No. 8654,Thiruvanmiyur P.O.,Chennai – 600 041.
Petrol Rs. 99 (OTF*)Utilities Rs. 99 (OTF*)Petrol & Utilities Rs. 198 (OTF*)
*(OTF - One Time Fee)
My City Benefit Program
By Signing here, I certify that I have read and agree to all applicable Terms & Conditions.Primary Cardmember’s Signature ........................................................................................................................Date : ............................................................
Credit Card Number 
Add-on Card
Regular - (Life Time Free)
B
B
Relationship:SpouseParentBrother (over 18 years)Sister (over 18 years)Son
/
Daughter (over 18 years)
ADD-ON SUB-LIMIT OPTION: The limit to be set on the Add-on Card of the Applicant per statement cycle is as indicated below:I confirm that the add-on applicant who is my ________________________________________ ( relationship with Add-on) is staying with me . Yes / No
25% of Credit Limit 50% of Credit Limit 100% of Credit Limit Rs.1000 Rs.5000 Rs.10000
If neither option is chosen clearly, 100% will be set as default Add-on limit.
HDFC Bank A/c No.Date of BirthSexMF
DDMMYY19
 Name to be embossedon the Card
 Please restrict to 30 characters including Spaces
TitleMrMsMrsD
 Please tick as applicable
Add-onApplicant
Add-on Card
Regular - (Life Time Free)
A
A
Relationship:SpouseParentBrother (over 18 years)Sister (over 18 years)Son
/
Daughter (over 18 years)
ADD-ON SUB-LIMIT OPTION: The limit to be set on the Add-on Card of the Applicant per statement cycle is as indicated below:I confirm that the add-on applicant who is my ________________________________________ ( relationship with Add-on) is staying with me . Yes / No
25% of Credit Limit 50% of Credit Limit 100% of Credit Limit Rs.1000 Rs.5000 Rs.10000
If neither option is chosen clearly, 100% will be set as default Add-on limit.
* Mandatory for Add on customer who have a HDFC Bank account.* Mandatory for Add on customer who have a HDFC Bank account.
HDFC Bank A/c No.Date of BirthSexMF
DDMMYY19
 Name to be embossedon the Card
 Please restrict to 30 characters including Spaces
TitleMrMsMrsD
 Please tick as applicable
Add-onApplicant

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