Professional Documents
Culture Documents
Registration form for 2-Factor Authentication* (Netsecure) for Corporate Internet Banking
Corporate Name: __________________________________________________________
Corporate ID
: ___________________________
Please provide the below mentioned details for all the corporate internet banking users
User ID
Sl.No.
Mobile Number
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
10
+ 9 1
Email ID
If there are more IDs to be added to the list, please fill in the form available in Annexure A
*2-Factor Authentication It is an additional security provided for online transactions. It will be mandatory to have 2-Factor
authentication to do financial transactions through Axis internet banking from 15th January, 2012..
I/We hereby request AXIS Bank Limited ("Bank") to activate the 2-Factor authentication offered by the Bank to carry out
transactions using Corproate iConnect in my/our account stated above to the stated Mobile Number of Authorized official.
I/We certify that the details furnished in this Application are correct and I/we give my/our consent to receive such information
on the said Mobile numbers of the authorized user. I/We shall advise the Bank immediately in case of any change in the above
details including the addition and deletion of user and the information given in the Application form. I/We agree to provide any
further information required and demanded by the Bank, from time-to-time, for providing this 2FA facility.
_____________________
______________________
_____________________
Signature of Authorised Person 3
For 2,3 and 4 Organization seal along with the signature of the authorized person is must
Annexure A
User ID
Sl.No.
Mobile Number
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
+ 9 1
10
+ 9 1
11
+ 9 1
12
+ 9 1
13
+ 9 1
14
+ 9 1
15
+ 9 1
16
+ 9 1
17
+ 9 1
18
+ 9 1
19
+ 9 1
20
+ 9 1
21
+ 9 1
22
+ 9 1
23
+ 9 1
24
+ 9 1
25
+ 9 1
___________________
______________________
Email ID
_____________________
Signature of Authorised Person 3
For 2, 3 and 4 Organization seal along with the signature of the authorized person is must