ATM / DEBIT CARD APPLICATION FORM Thank you for applying for the State Bank ATM / Debit

Card. To help us process y our request quickly please fill this form as per the instructions overleaf if yo u have any questions, please check with your Branch Official. We are committed t o making your life simpler with the State Bank CARDs. Application No: New Name N ame as you would like it on the card (max. 25 Letters (including spaces) Renewal Replacement Address Town / City State Telephone Email My designated account/s on which I require CAR D services Account Type: Savings Pin Mobile Current Overdraft Date of Birth Male / / Female A/C No. TYPE OF ATM CARD APPLIED FOR: (Read Overleaf before selecting Card Type) ATM-cum-Debit Card Yuva Card International Debit Card SBI Gold International De bit Cards 1.VISA 2.MASTERCARD DECLARATION: I am aware of the Terms and Conditions governing the use of the ATM Card and agree to abide by them. The bank may call me at my residence / office in connection with my ATM transactions. Place: Date: / / FOR OFFICE USE New Renewal Replacement Date: / / Applicant's Signature ATM Branch Code CIF of Customer Issue Card Old ATM Card No. Ticket No. Old ATM card No. to be mentioned for a replacement or renewal of the card. Ticke t No. in case of Lost ATM card. YES NO _________________________ Branch Official's Signature & Branch Stamp

INSTRUCTIONS: Please fill the entire form in CAPITAL LETTERS only. Leave one box space between each word. Do not write outside the provided boxes. The address filled in the f orm must be same as the address in the Account. If different, first change the a ddress in your account and then apply for new card. Complete all sections. Sign the declaration. If joint A/c please fill separate application form for each A/c holder. Joint A/c to be either or survivor / anyone or survivor. ATM CARD TYPES : ATM-cum-Debit Card (Maestro): Usual type given to all account holders. Max. 40 ,000/- withdrawal at ATMs. Max. 50,000/- at Merchant Establishments. At all ATMs Displaying MasterCard, Maestro, Cirrus Logos. International Debit Card (Maestro ): Usual type given to all NRE account holders. Usable at all ATMs around the Gl obe. Max. 50,000/- withdrawal at ATMs. Max. 1, 00,000/- at Merchant Establishmen ts. At all ATMs Displaying MasterCard, Maestro Logos. SBI Gold International Deb it Card (Visa / MasterCard): Only for Customers who maintain their quarterly bal ance as 50,000/-. Max. 50,000/- withdrawal at ATMs. Max. 2, 00,000/- at Merchant Establishments. At all ATMs Displaying Visa / MasterCard Logo whichever applica ble. Can undertake transactions through internet for ticketing, e- commerce. Vis a Bill pay[For Visa Cards only], Mobile Top Up, Virtual cards solution for e-com merce and wide range of Discount on shopping, entertainment and leisure, and pur chase etc. Yuva Card (Visa): Only for Youngsters within the age group – 18-30 Years. Max. 5 0,000/- withdrawal at ATMs. Max. 2, 00,000/- at Merchant Establishments. At all ATMs Displaying Visa Logo. Can undertake transactions through internet for ticke ting, e- commerce. Visa Bill pay, Mobile Top Up, Virtual cards solution for e-co mmerce and wide range of Discount on shopping, entertainment and leisure, and pu rchase etc. on use of Yuva Cards. o For more details on the cards visit our website: http://sbi.co.in TERMS AND CONDITIONS Bank means State Bank of India Card(s) means SBI ATM / Debit Card issued to cust omer either in association with MasterCard / VISA. Cardholder means customer who has been issued ATM / Debit Card • • • • The card is the property of the Bank a nd shall be returned unconditionally and immediately to the Bank upon request by the Bank. The Bank reserves the right to cancel the card and stop its operation s unilaterally without assigning any reason. The Card is non-transferable. The C ard Holder is initially allotted a computer generated 4 digit PIN (Personal Iden tification Number) which will be in a secured and sealed PIN Mailer. It is manda tory for the card holder to carryout a successful transaction using the PIN at S BI in order to activate the card. Any financial loss due to misuse of Card will be to the Card Holder's account. Loss of card should be reported at Bank's all I ndia Helpline No.1800112211 and ticket no should be obtained in order to apply f or replacement card. And also notify the Branch from where he/she has obtained t he card in writing. Fresh card will be issued in replacement of lost/damaged car d at a charge of Rs.200/- plus taxes, if any, at present. The cardholder can req uest for regeneration of PIN in case he has lost / forgotten the same. The Bank provides the customer with a new PIN at a charge of Rs.55/- which will be debite d to the customer’s account. The Card holder wishing to close the designated acc ount or surrender the card facility will give the Bank 10 working days notice in writing and surrender the Card along with the notice. • • • • •

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