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  • Visa Debit Card Application Form1468218519 PDF

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    9 views2 pages

    Visa Debit Card Application Form1468218519 PDF

    Uploaded by

    roshan jaiswal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 2
    VISA VISA DEBIT CARD APPLICATION FORM Branch Namo Dat areraraieaa a fife Name 7. ‘Addeoss S- Emairé-2, Telephone no./ Ser TI wobieno tee * [| TT LL LILI resldenceftrare [| F-LLLLLLL oncorerafaa[ | }{] | || | [) TOPE Ta aco e Type of Card Requested! rate ardah are NPR arch ata thers a4 Name to appear in the Card aréeraere a ate | | 111111 LLLLII ‘Account to operate VISA Debit Card fier fre ard wearer Tat Account maintained at branch/ eet @iat #11. Type of account/ararat Wa [_|Savings! tT [_JCureny a= [_Jothers Details of other accounts, ifthe service is intended for the other accounts as well 3 " mi ‘Account No. ‘Account Name: ‘Account No. ‘Account Name: ara ‘ara AT aaa erat a Branch where delivery is to be made (ifother than the branch applied) wre ere TH TT ATH ae AT CRY TT TE TAT a a ee fle idl Please issue a supplementary VISA Debit card with details as under evar fre freer meateé ee ar ware atieg ata 1 Name to appearin the Card LOLOL Leo andar gare wart Mobile no: Taree Residenceitrare [_[_]+ oftcerararar|_[_ | Relation to Principal Applicant rircwaiey ara Photo of Supplementary cardholder Re are fared wet (request you to handover th Card and PIN Maer issued In my name to Mes —— bearing the below mentoned signature solely at my own risk. In consideration of your handing over of Card and PIN mailer tothe aforesaid person, le hereby agree and undertake to indemnily ard keep indemnified MEGA Bank Nopal Limited and is slaifs against any loss and clams arising aut of such act, 3 ‘area are gi ard fer fret sealers weave Heat a ‘arg aecrcrem afefeaprar | metal arg x Feta afer weaves, wh eae A as aes eto ey are fice «away afi fr ah vaca adh A Oo A He Specimen Signature Terme FM DEE ccianl {have ead, understood and agree fo abide by the terms and conditions as slated in the back of his form, Sacre creat ord Seger dee ve, PR CATE ay Ae Principal Applicant erat ‘Supplementary Cardholder Tea) aca cee EE ‘Appication received on | I I-LIL-LILILI1 ‘Application checked by ere popcabiotoe []ves [No Recommended by — Verified and Approved by: Request forwarded to Card & Altemate Channel Department on: [_][_}-[ JL JIL IL] TERMS AND CONDITIONS wi a a-ear ‘The Cardis the property ofthe Bank at al times, 3m Ar Aura fafkee fre Be are cern ar ae etapa A oe et fafaee cravis ta wPrre a arent a The Cardis non-transferable. ed eu tes eenrare wh aa | ifthe information submited by Cardholder fs found to be false andor the Card has been misused, the Bank reserves the ight to seizecance the Card issued to any Cardholder. 1 areea Mer wea eran sper TT ey aruar ade Ger HT pa ard are eh aa are fara aa Apa Fafa TEA ‘The Bank shal debit the Accounts), designated by the Cardholder fr al transactions inated including cash withdrawals by using the Card. For this purpose, the Cardholder irevocably authorizes the Bank to debit his/her Nominated Accounts) withthe amount of transacton(s) effected through the use ofthe Gard, #1 salar ey pH Fear whey me area ah aT aT ard anfeacta ayaa aera wart wee The Bank shall debit the Nominated Accounts) for all fees and charges as determined by the Bank relating fo the Card and the services thereby provided, ord « ardare wart aie Gane were Haare ators amy eR cer cere aoe Tew mTE fee an ia In case of Joint Nominated Account(s), all the members shall be jointly and severally be responsible for all transactions performed on Card. eee HTT eT ATSART MAA AH TATA aT TH MI TAHT CTS OTT PTT GATT | The Bank reserves the right to terminate membership, withdraw the privleges attached tothe Card or not renew the expired Card at any time and to call upon the Cardholders to surrender the Card, 4 Pt rrr WzeraT Tet are yard afeear afeareeare feat od an renee ar afc rd x ard Rah parser ef arg area were ee atvare Seow fc eA 1 Use ofthe Card after notice of withdrawal ofthe privileges ofthe termination of the membership is fraudulent and may be subject to legal action by the Bank in accordance with the prevailing law. afauree afseret areata aaexat aia weet qe cs arden Seemed ac ra args aga Sea ach ree i eI Upon termination of membership or withdrawal of privileges ofthe Card for any reason whatsoever, the card shall be retumed tothe cconcomed branch within 7 days from the date of recsipt of natice. The Cardholder shal be labo for paymont of the bilsarsing out of use ofthe Card til Cards not surrendered tothe Bank. GS ea ATT TRA CAT a TST Tera RT afer ao Frorreeah at arg ence rer GB 1 ‘The Cardholder shall provide wien instructions to the Bank forthe cancellation Inon-renewal of the Card one month prior tothe expiry date spectied in the Card, aTEat area ars Per ar ca war sorst ard area amend arg ark rd 7 afrrer ser ater Pte fag | ‘The Card and PIN issied to the Cardholder are entirely atthe Cardholders risk and responsibil. The Card holder shall not disclose the PIN or permit possession of the Card to any other person. The Cardholder undertakes full responsibilty for any and all transactions made by the use ofthe Card whether or not made wit hishher knowledge or authony, @1é rear afl mua ard € afer aero eae cers, Ree se emererer aE area anf eaten eT | aE ee zt PT aT afrarg fit ann wt Gat a eatice vem wh aque fet Be 1 areas ae at aera we ed anger vane aA afer we artareat aftee ard area ‘The Cardholder agrees to inform Bank in wrting regarding oststolen, damage of Card and disclosure of PIN. The Cardholder will be hold fable for al the transactions received prior to this notification, ees =, fafa ar < aren nea fa ea Staerg fafa oom arrant fer ae eee Ho Tee | Ta eee arn Gat we atares aft aE ores A tae aah The Bank reserves the rights to limit daly transaction including cash withdrawal and purchase by the Cardholder and decide on denomination that would be dispensed from Bank's own ATM, a fie < ute ara] Afra artare far Fruit x Area avg Automated Tolar Machine erniz qs irra) are ara ae reat

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