CORPORATION BANK Form No:

Corporate Office : Mangalore Date :

CorpNet - INTERNET BANKING
Registration Form [For Individuals/Sole Proprietorship ]
(This application should not be used for joint accounts having joint operation clause)


Name of Account Holder

























































































































































































































City































PIN CODE/ZIP No.















A
D
D
R
E
S
S

COUNTRY





























E-MAIL



















I/We request you to register my/our application for CorpNet Banking facility and link the accounts as mentioned below,
maintained at the branches of your Bank.


Branch Name

Account Type &No.
(e.g.,SB/01/12345)

Mode of Operation

Name/s of co Account Holders

1





o Self o Any one of us




2





o Self o Any one of us




3





o Self o Any one of us






1
st
Choice

2
nd
Choice3
rd
Choice

User ID preference





























































(Please specify 3 choices, minimum 6 letters & or numbers and maximum 16 letters & or numbers. Use only small letters)
Every time screen view is required for the last ............. days (maximum 15 days)
Kindly approve the following beneficiaries for effecting Funds Transfer under CorpNet Banking/ Corp E cheque facility:
(This portion need not be filled up if you do not wish to transfer money to other persons accounts through CorpNet)


1. Beneficiary Name



Beneficiary Account Type & Number



Beneficiary Bank Name



Beneficiary Bank Branch



City



PIN CODE

















Beneficiary code (for easy identification) if required please furnish

















2. Beneficiary Name



Beneficiary Account Type & Number



Beneficiary Bank Name



Beneficiary Bank Branch



City



PIN CODE

















Beneficiary code (for easy identification) if required please furnish

















3. Beneficiary Name



Beneficiary Account Type & Number



Beneficiary Bank Name



Beneficiary Bank Branch



City



PIN CODE

















Beneficiary code (for easy identification) if required please furnish

















4. Beneficiary Name



Beneficiary Account Type & Number



Beneficiary Bank Name



Beneficiary Bank Branch



City



PIN CODE

















Beneficiary code (for easy identification) if required please furnish
















I/We have read and agree to be bound by the terms and conditions governing CorpNet Banking facility. Further,
(Tick whichever is applicable)

I/We hereby irrevocably authorise the above-mentioned User, being one of the joint holders, to access and operate the accounts cited above through CorpNet
Banking facility. We further agree that all the transactions executed by the said User through the CorpNet Banking facility will be binding on us.
I/We authorise you to debit our Account No. ...................at............................ branch towards any charges for providing service under CorpNet Banking facility.
The Password Mailer for CorpNet Banking facility will be collected by me/us in person from the ............................................Branch.
The password mailer for CorpNet facility may please be mailed to my/our address provided above at my/our risk and responsibility.(Applicable only in the case of NRI
clients).
Name Signature

-------------------------------------- ---------------------------------------
--------------------------------------- ---------------------------------------
--------------------------------------- ---------------------------------------
[Name/ s & Signature of all the account holders]

Guidelines/Instructions For Filling-Up The Application Form

1. Branch-1 denotes the branch at which your main account is maintained and where you submit the application form for verification. The details of accounts in other branches
which you would link to CorpNet shall be given against branch 2, branch 3, etc.
2. User ID : The applicant shall indicate 3 identification names, called as User ID, in order of preference(give most preferred as first). The bank shall select/allot any one of
these User-IDs subject to availability or suitably modify/ add to the characters to ensure security and uniqueness. The User ID will be of minimum 6 characters but will not
exceed 16 characters. The characters shall be alphabets & or numbers only. All the characters shall be of the lower case (small letters).
3. Approved beneficiaries: Transfer of money from your account through CorpNet is possible only to individuals/ organisations you list out in the application form. Kindly provide
details of the individual or organisation to which you want to transfer money through Internet from your account with us.
4. Beneficiary code: Any identification you give to make out a particular transaction to the said beneficiary from the statement. (Eg. The code could be school fee if the
beneficiary is your chi lds school for paying his tuition fees)
5. E-Cheque: If the beneficiary is maintaining account with some other bank, then you can use the e-cheque facility (managed by R.B.I) within Internet banking (CorpNet) to
transfer money to such customers.
6. Declaration: In case of joint accounts the declaration has to be signed by all the account holders.
7. Delivery: For NRIs the user name and password shall be sent by mail/courier on request. The user ID will be activated only after receiving duly signed letter of
acknowledgement for receipt of password mailer from the customer
* For Funds transfers, per day and per transaction limits will be fixed by the bank

from time to time


For office use only

Certified That









Branch
Name

Address of
the party is

Account
Number is

Mode of
Operation

CorpNet facility

Reason for rejection

Name & Sign code
No. of official

Signature with
Branch seal



o correct
o Incorrect

o correct
o Incorrect

o correct
o Incorrect

o recommended
o rejected











o correct
o Incorrect

o correct
o Incorrect

o recommended
o rejected











o correct
o Incorrect

o correct
o Incorrect

o recommended
o rejected







AT WEB CENTRE

Registration Form No. _ _ _ _ _ _ _ Serial No. ____ /200_
Received from the Base Branch (Name)


Date Signature of Authorised Officer Seal of Web Centre

----------------------------------------------------------------- Cut Here --------------------------------------------------------------------

At Base Branch - Acknowledgement to User

Regi s t r at i o n Fo r m No . _ _ _ _ _ _ _



Dat e Signature of Authorised Officer Branch Seal
This Acknowledgement does not imply the acceptance of the application for CorpNet Banking facility.