Add - on Card (s) Application Form Cum MID

Version 1.15

If you are an existing Cardmember, please tick whichever is applicable Appl. No.:
CUG Business Teacher's Business Snapdeal
Solitaire MoneyBack MoneyBack ALLMILES Doctor's Superia
Platinum Platinum HDFC Bank Card
Times Titanium Times Platinum Diners Club Diners Club Diners Club Infinia Regalia Regalia First
Card Card Rewardz Premium Black
JetPrivilege JetPrivilege JetPrivilege JetPrivilege
HDFC Bank HDFC Bank HDFC Bank HDFC Bank Business Regalia Doctor's Regalia
World Titanium Diners Club Platinum

Credit Card Number CUST ID

Name of the Primary Cardmember: First name Middle name Last name

Please leave one box space between names and surname

Primary Mobile No.

Add-on applicant not holding a HDFC Bank account & staying with Primary cardholder will be required to submit valid photo ID, Pan Card or Form 60 with Address proof.
If Add-on applicant does not hold HDFC Bank a/c and is a sibling of primary applicant then valid photo ID, Pan Card or Form 60 & Address proof will be required.
Please refer to the List of Acceptable valid photo ID & address proof for Add on in the next Page.

I hereby acknowledge the request made for Add-on Card and warrant that the above information is correct and hereby request and authorise that an Account be opened and Card(s) be
issued as indicated herein and renewed and replaced until I give notice to cease, and in connection herewith authorise the exchange and transfer of credit information from / with my Bank
or any other source. I understand that HDFC Bank Ltd., reserves the right decline the application without giving any reason whatsoever. The additional applicant (s) and I agree to be
bound by the terms and conditions of The Cardmember Agreement earlier executed by me. I declare and undertake that the Cards issued to me, if used overseas shall be utilised strictly in
accordance with the relevant exchange control regulations issued and as amended by the Reserve Bank of India (RBI) from time to time. In the event I exceed my entitlemants as per the
exchange control guidelines of RBI, I undertake to bring the same immediately to the notice of HDFC Bank Ltd., in writing. And in the event of any failure to comply with the prevailing
exchange control guidelines issued by RBI, I shall be liable for action under the Foreign Exchange Management Act, 1999 as amended, and be debarred from the Card facility. The
undersigned will be liable for all charges incurred with the Add-on Card(s) issued on the Account and each Add-on Applicant will be liable for all charges incurred with the Add-on Card
jointly and severally with the holder of the Primary Card.
Conditions Apply: Sub-limit on Add-on Card is per statement cycle. Sub-limit will hold good only for ATM and POS transactions but the same will not apply for online transactions.
For detailed terms & conditions visit www.hdfcbank.com.

Primary Cardmember’s Signature ........................................................................................................................ Date : ............................................................

By Signing here, I certify that I have read and agree to all applicable Terms & Conditions.
 List of acceptable Photo ID for Add on Card holder. (Expired ID proof will not be consider as valid proof)
ANY ONE OF THE BELOW
1. PAN Card
2. Passport
3. DL / LL (DL from Uttar Pradesh alone can be accepted without Signature)
4. Voters ID
5. Ration Card (In Customer Name)
6. Company/Institution photo ID card
7. Student ID card
8. Club membership card (which carries customer photo)
9. OBC Photo Card
10. Insurance / Mediclaim Photo Card
11. Passbook with Photo
12. Railway station pass ID - Government recognised
13. Senior citizen ID - wherever applicable
14. Government organisation ID card with signature and photo.

List of acceptable Address Proof for Add on Card holder.

ANY ONE OF THE BELOW
1. Passport
2. Driving licence(Customer having Driving License Issued from Uttar Pradesh can be accepted with out the Signature on the
same.)
3. Telephone bill - MTNL / BSNL & all WLL lines' bills can be accepted
4. Electricity bill - Ebil and Physical Bill
5. Bank account statement - Bank statement or Pass book can be accepted - In both the address should be mentioned
6. Ration card
7. Voters ID (if it has address)
8. Letter from the society (only Registered societies) - on the letterhead which carries the society's Registration No. The letter
should carry the applicant's name & full address as well as the signatories full name, designation (Secretary, President) and
address.
9. Monthly outgoings bill from Registered Housing society - on the letterhead which carries the society's Registration No.
(Maintenance charges receipt issued by the society NOT acceptable)
10. Registration documents/Ownership proof copy
11. Senior citizens card from Indian Railways/Indian Airlines (if it has address)
12. Mobile post paid bill
13. Letter from any recognized public authority (In original)
14. Company ID card (For CAT AB companies only)
15. LIC Premium receipt
16. Address confirmation by the corporate on company letter head as valid address proof (For CAT AB companies only)
17. Gas Bill
18. Water Bill
19. Society Maintenance Bill
20. Property Tax Receipt

Name of TSE : ________________________________________________________ Team Supervisor’s Code : _______________________________________________

TSE Code : __________________________________________________________ Signature of Team Supervisor : ___________________________________________

Name of Doc-Ex : _____________________________________________________ PB/RM (Mandatory Field) :

Doc-Ex Code : ________________________________________________________ BRANCH CODE :

Channel : ____________________________________________________________ BDR Code / LC Code :__________________________________________________

Source Code / Activity : _________________________________________________ City : _______________________________________________________________

Sep’16