yeu a eG Oe eno aor @ IDBI BANK Branch Name: Sol ID: pate of Request: [|] [1] ‘Customer Io: Credit Card Number: customer Name: Meimessms. [TTT TT TT TT?TTETiTtTrTttTtTt tit tt ttt tt Existing Mobile Exiting Email: 1L Update the following details in Bank records: Existing Name: MriMrs.Ms. MriMrs.Ms. svocode: [TTT TIT TTTTT ITT) New Mobile Number: New Communication Adéress*: | Lined: : [otic address Line : [lResidence address Landmarks city: Pneote TTT 2 State: Country: E 2. Change in Card Typel Card Limit/ Other Request Kindly change my existing card ype as per details provided below. New Card [_] Aspre Pistnum Creat card. [] Royale Signature Crest Card [_] Winings RuPay Select Cre Card euphoria Wore Travel credit Card [)kinay eniance my Credit Card Limit or[__] Maximum credit card Lit. (Please atach Latest 3 months Salary Slip and Bank Statemont/Latest2 years IT Return with computation of Income! One Month Salary or Pension Slip, 1 he salary or pension Is gating credited In IDBI Bank Account subject to consistency in monthly credits and atest CIBIL report. Kindly reduce my Credit Card Limit to or[_]inimum Credit Card Limi. Billing Gyte: Kindly change my existing biting date to [_]7* [_]2u* [Joo [Jar ‘Account details for refund of excess credit: Name acoountno[ TT TT TTT ET TT 1 ttf J secon Bank Name Updation of GSTIN No. Credit Card Reissuance: Reason for Relssuance:[_]Card Lost[|Card Stolen []Card Damaged [Fraudulent Transaction on Card []Card Expited Enhancement of creditcard limit (For secured card(s) only) iW, would ke to enhance the creit card limit o ‘% of my total fixed deposit amount linked to myfour credit card te woul tke to provide the below mentioned Fixed Deposits or enhancement credit ion my Cred Card iWe auter2e DBI Bankto marklen onthe ene arcu ofthe below mentored Fixed Depost(s)ncudnginerest earned unl erminaton ofthe Credit Cardiac Reduction of rel card init (Fr secured cae) on We, would ike ta reduce the creditcard limit to[__[__]96 of my toa fixed deposit amount inked to myfour credit card [1 petinking oF Fixed Deposit (Fr secured cara) oni) We, woul theo getnk ne below mentoned Fixed Deposit (6) marked ten aganstmylou Credit Car(s) We understand thatthe celtimit would be eised as pee Banks produetgudenes Fixed Deposit Details (For secured card(s)) ‘Sr.No. | _ Fixed Deposit Number Fixed Deposit Amount () _| Maturity Date 1 2 8 CLTETT TTT Tt tt tt | CEE ttt | SEE ett tt ‘Total Fixed Deposit Amount (2) Card Activation: Kindly activate transactions for [_] Domestic [] international [_]-commerce []Pos L]NFc L]at™ [L) oupticate statement: From 1) IE) COT) ° oO SS) Coo) LEE IDBI Bank Limited, Regd. Office: IDB! Tower, WTC Complex, Cuffe Parade, Mumbai - 400 005. Toll Free Numbers: 180-425-7600, Non-Toll Free Number: 022 - 4042 6013 fisit us: www.idbibank.in 9 E7|@)\e2 GB | CIN-L65190MH2004Gor148838Fixed Deposit Swap Request (For secured card(s) only) We would lke to swap mylour existing Fixed Deposits with the New Fixed Deposits as mentioned below. We understand thatthe creditmit of would be revised as per Bank's product guidelines ‘Sr.No, | _ Existing Fixed Deposit Number (To be De linked) Fixed Deposit Amount @) Maturity Date 1 Total Fixed Deposit Amount (%) ‘Sr.No, | _ New Fixed Deposit Number (To be Linked) Fixed Deposit Amount @) Maturity Date Total Fixed Deposit Amount @) 3. Auto-Debit Facility [[knly set up auto-debi (standing nsuuctor) as per deta provided below Vator 1b Bank Li. ode by (Sav e800) ELD TTP TTT oad tt an, tewards[—] Total Amount Du [_] Minimum Amount Bue Ky cancel my ensing Ato-Debi Fac. 4. Credit Card Cancellation [_]yes [_]No We, would like to close the credit card along with the add-on credit card (if any). Request you to release the fixed deposit(s) marked lien against the credit card (For secured card(s) only). We understand that all the standing instructions linked to the credit card will be cancelled. ‘The charges / outstanding (it any) may be recovered from my (SBA/CA/OD) account no, In the event, if there is insulficient funds in the account, Bank may liquidate the Fixed Deposit) (o recover the charges Joutstandings (For secured card(s) only). The Bank shall not be responsible for any foreseeable loss ofinterest thereof. +2999 plus GST shall be charged for credit cards closed before 2 year of issuance (For secured card(s) only). Signature of the Card Holder Signature of Fixed Deposit holder 1 ‘Signature of Fixed Deposit holder 2 5, For Office Use Applicable in case of enhancement of creditcard limit (For secured card) erly) ‘hereby declare that the folowing have been checked by me. 1. Allthe FDs ae eligible frissue of Secured card as per Bank’sextant guidelines 2. Allthe Fs are setto Auto Renewalmode. 3. Therepaymentalcof the xed depost(s) has been kept blankin nacle 4. Allthe FOs have been tagged to IMPCC label code. 5. Allthe Confirmation of Deposi(s) (COD) duly discharged by the Fixed Deposit holders) by signing on Revenue Stamp onthe reverse of the COD has been keptin the branch safe custody. 6, lunderstand that on cenewal ofthe Fixed Deposits) markedlien against the Imperium Secured Credit Card(), the COD (confirmation of deposi are tobe keptin the branch safe custody and shallnot be 'spatchedto the Fixed Depasit account holde(3). Recommended Credit Limit (96) [Max.859% (credit limit upto €10Lac)& Min.50¥ (credit mit not less than 217000) of FD Amount) 7 Updation of new communiZalorraddress! mobile number! e-malidis also updated in face ‘Branch Head For CPU Use! Yes/No 1 FD(s) detals and Address have been verified with Finacle 2, FD(s) have been Lien marked through ALM with CCARD as reason code, Verified By (CPU) IDB! Bank Limited Credit Card Miscellaneous Request Form - Acknowledgement Slip sol Date of Request Customer ID Credit Card Number ‘Customer Name: Mr/Mrs./Ms. Name of Bank Officer: MMs Ms. We acknowledge the receipt of Miscellaneous Request Form. Authorised Signatory (Seal and Signature) 1Da166_MSCFORW,23112022