Barcode Sticker

Miscellaneous Request (For Individuals / Sole Proprietor only)

Branch Name: Sol ID: Date of Request: D D M M Y Y Y Y

Customer Name: Mobile Number:

Customer ID: Account Number:

(Please tick the appropriate box)

Change of Mailing Address: (Valid Address proof to be attached)
Address 1

Address 2

Landmark City

State Country: Pin code:

Mobile No: Telephone No.:

Email ID
Change in Scheme code

From: To Approved by BH Signature of BH
(refer upgradation matrix)

Update my following details in your records:
(i) Telephone Number: Add: Delete:

(ii) Mobile Number: Add: Delete:

(iii) Email ID

(iv) Passport No Valid From D D M M Y Y Y Y To D D M M Y Y Y Y

(v) Residential Status From To

Linking of Aadhaar No. to my account (Declaration) (Aadhaar Copy to be enclosed)

I, the undersigned having Account Number…………………………………………………………………...,under
Client ID No………. ……………., with IDBI Bank Ltd., do hereby authorize IDBI Bank Ltd., to link the same to my Aadhaar Number (Photo copy of
the Aadhaar card duly self attested is enclosed) for electronic transfer of subsidies and also for using the Aadhaar number and bio-metric
information for providing the Aadhaar Authentication Service.

Branch transfer of accounts (SOL Change): From: Sol ID Branch Name To: Sol ID Branch Name

Account Number:

Updation of Date of Birth: D D M M Y Y Y Y (Proof to be enclosed)

Conversion of minor account to major account (AOF & ISA to be enclosed)
I hereby confirm that the balance in my Savings Bank / Term Deposit Account No. _______________________________ with your Branch at the close
of business on _________________ was Rs.________________(Rupees ________________________________________________________________________only).
My son/daughter _______________________________________was maintaining a minor a/c in your branch. On ______________ he/she became major.
So kindly convert the a/c to major in his name and the Mode of Operation of accounts will be:

Single
E/S
F/S
A/S
Joint
Others ________________ (Please specify).

Guardian Signature Minor Signature

Kindly Update/Delete/Change Nomination from my Account No.:

(DA1 / DA2 / DA3 to be enclosed)

Change of name (Proof to be enclosed)
Old Name:
New Name:

Change in Signature:

New Signature:
Old Signature:
(in Black Ink)

Addition / Deletion of joint holder in Account number

I would like to add/remove the name of ______________________________________________ in the above mentioned account number and the
Mode of Operation of account would be.
E/S
F/S
A/S
Joint
Others _____________(Please specify) (New AOF, ISA to be enclosed).

Merger of Customer ID
I/We, do maintain the following accounts with your branch(es) with different Customer IDs as detailed here in below.

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 Account Numbers under Customer ID 1 Account Numbers under Customer ID 2
SN Name of Account holder
Cust ID _______________________ Cust ID ____________________
1
2
3
4
5
6
You are requested to consolidate the customer IDs retaining the customer ID _______ for my future operations. I/We understand that all the
accounts will be here after maintained under the above mentioned customer ID.

Kindly update my KYC in the bank records (CIU form with proof to be enclosed)

Mandate holder addition
(Mandate holder form to be enclosed & KYC documents)

Sweep IN/OUT (only for RSWOM / RSOLD)

Kindly activate Sweep IN/OUT in my account number

Standing Instruction (only variable amount request to be submitted to RPU)

Kindly setup standing instruction detailed as below

From A/c: To A/c:

Amount: Frequency:

Execution Time: D D M M Y Y Y Y Start Date: D D M M Y Y Y Y End Date: D D M M Y Y Y Y

Please update my PAN Forward to CPU, Mumbai -

proof to be enclosed

Kindly Update my TDS Status Form Attached
15G
15H
Other (other than 15 G / 15 H)

Grouping of Accounts (Grouping annexure to be enclosed)

Internet/Mobile/Phone/Email/Debit card
Please activate the following service(s) on my accounts(s) with IDBI Bank:

(i) Receipt of Bank statement by email

(ii) Use of Internet banking for transacting bank

(iii) Use of Mobile/Phone banking

(iv) Issue of debit card Emboss Name: (25 Charters only)

I confirm having read and understood IDBI Bank term and conditions for all the services I have requested above. I accept and agree to be bound
by the said terms and conditions for the use of the above selected services. I/we have understood that the terms and condition may be revised by
bank from time to time.

Date: DD/MM/YYYY

Place: ________________ Customer Signature: ____________________________

(KYC Declaration to be signed by BH wherever ISA documents are enclosed along with the above request)
I hereby certify that all necessary KYC documents have been obtained / verified by me. I confirm that the documents are adequate to comply with
KYC requirement of the bank. Based on this the requested modifications/amendments be carried out. I hereby confirm that I have verified UN list of
terrorist groups & GOI advices & Bank’s guidelines & confirm the applicant/s are not included in caution advices / black list. I/we confirm that Online
PAN and Multiple Customer ID – MULCUS Verification has been done.

Name of the Branch Head / SOM:

EIN No.:

Signature:

Date & Stamp:

For Branch use For RPU use

SOM / ASOM RPU Official

Branch Head

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