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

000/. Complete all Merchant Establishments. ATM CARD TYPES : ATM-cum-Debit Card (Maestro): Usual type given to all account holders. Max.withdrawal at ATMs.1800112211 and ticket no should be obtained in order to apply for repla cement card.INSTRUCTIONS: Please fill the entire form in CAPITAL LETTERS only. and pur chase etc.000/. if 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. SBI Gold International Deb it Card (Visa / MasterCard): Only for Customers who maintain their quarterly bal ance as 50. Sign the Merchant Establishmen ts. The address filled in the f orm must be same as the address in the Account.commerce. 50.000/. Cardholder means customer who has been issued ATM / Debit Card • • • • The card is the property of the Bank and shall be returned unconditionally and immediately to the Bank upon request by the Ban k. Fresh card will be issued in replacement of lost/damaged card at a c harge of Rs. Vis a Bill pay[For Visa Cards only]. Mobile Top Up. The Card holder wishing to close the designated account or su rrender the card facility will give the Bank 10 working days notice in writing a nd surrender the Card along with the notice. Cirrus Logos. Yuva Card (Visa): Only for Youngsters within the age group – 18-30 Years. Loss of card should be reported at Bank's all India Hel pline No. The Card Hold er is initially allotted a computer generated 4 digit PIN (Personal Identificati on Number) which will be in a secured and sealed PIN Mailer.000/. first change the a ddress in your account and then apply for new card. o For more details on the cards visit our website: http://sbi. International Debit Card (Maestro ): Usual type given to all NRE account holders. Max.55/. If joint A/c please fill separate application form for each A/c holder. Mobile Top Up.000/-. Leave one box space between each word. Merchant Establishments. 00. At all ATMs Displaying MasterCard. 40 .200/.which will be debited to the customer’s account. at present. At all ATMs Displaying Visa / MasterCard Logo whichever applica ble.000/.plus taxes. and purc hase etc.withdrawal at ATMs. 50. Maestro Logos. At all ATMs Displaying MasterCard. Maestro. 50. The Bank reserves the right to cancel the card and stop its operations unilat erally without assigning any reason. 00. 2.commerce. Can undertake transactions through internet for ticketi ng.000/. The cardholder can request for regeneration of PIN in case he has lost / forgotten the same. Virtual cards solution for e-comm erce and wide range of Discount on shopping. Max. 000/. entertainment and leisure. Merchant Establishments. If different. The Card is non-transferable. Max. 00. entertainment and leisure. Max. on use of Yuva Cards.withdrawal at ATMs. Usable at all ATMs around the Gl obe. Max. And also notify the Branch from where he/she has obtained the card in writing. Can undertake transactions through internet for ticketing. Joint A/c to be either or survivor / anyone or survivor.withdrawal at ATMs. Virtual cards solution for e-com merce and wide range of Discount on shopping. Do not write outside the provided boxes. Any financial loss due to misuse of Card will be to th e Card Holder's account. e.000/.co. 1. 50. At all AT Ms Displaying Visa Logo. 2. The Bank provides the customer with a new PIN at a charge of Rs. Visa Bill pay. It is mandatory for the card holder to carryout a successful transaction using the PIN at SBI in or der to activate the card. • • • • • . Max.

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