STATE BANK OF TRAVANCORE

(Associate of State Bank of India)

Head Office : Trivandrum

APPLICATION FORM FOR ACTIVATION OF MOBILE BANKING SERVICES Sl No. From Date : To The Chief/Branch Manager State Bank of Travancore Branch I/We wish to *register/de-register for Mobile Banking Services of SBT offered under State Bank FreedoM. I/We submit the information required for the purpose as under:(* Please choose the option) Name of the Customer : (Maximum 20 characters and leave a box blank after each name)

Mobile Banking User ID

Mobile Number

e-mail id

Primary A/c No. Other Account Numbers Add/ Delete

Single/#Joint A/cs Single/#Joint A/cs

(# Rights on the State Bank FreedoM Service will be same as that in your account at the Branch. Accounts which are operated by all or some of the account holders jointly are not eligible for Mobile Banking Services.)

I/We have read the terms and conditions prescribed by the Bank for offering Mobile Banking Services to its customers and unconditionally accept them. I/We am/are also aware that Bank is entitled to modify the terms and conditions without any notice and posting them on the Banks website would constitute appropriate notice. I agree that the transactions executed while using mobile banking services under my/our User ID and MPIN will be binding on me/all the joint account holders.

Date: FOR OFFICE USE ONLY

Customers Signature

Verified the details of the account holder from the record and found correct. Signature(s) of the applicant(s) verified with those on record with the Bank and found correct. The applicant is permitted to subscribe to Mobile Banking Services offered by the Bank.

Date:

Authorised Official

Details uploaded upon the Core System for enabling the account(s) for Mobile Banking Services requested by the customer. Date: Authorised Official