Application No.

IN20230619003442 June 20, 2023 11 : 26 : 31

All-in-one application You’

re applying for

This application form will be digitally signed Smart Banking Savings Account
using Mobile OTP.

Basic Information

Are you a Standard Chartered employee? Yes / No

Full name Kari Bhavani

Also known as name

/ other name

Previous name

Title Mrs First name Kari

Middle name Last name Bhavani

Date of birth 06/03/1990 Gender Female

Mobile +91-8341885436 Work type Service - Private Sector (General)

Additional ID type ID No.

ID expiry date PAN BIKPG4518A

Aadhaar No. xxxxxxxx9644

Email bhavani.golusu0603@gmail.com

Residential Address

Address line1 1-659

Address line2 Kasinagaram

Address line3 Vajrapukotturu Mandalam

Address line4 Laxmidevipeta @ Nuvvalarevu Ka

City Srikakulam State Andhra Pradesh

Postal/Zip code 532222 Country INDIA

Permanent Address

Address line1 1-659

Address line2 Kasinagaram

Address line3 Vajrapukotturu Mandalam

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 Address line4 Laxmidevipeta @ Nuvvalarevu Ka

City Srikakulam State Andhra Pradesh

Postal/Zip code 532222 Country INDIA

Office Address

Address line1 NOVEL MSR TECH PARK 4TH FLOOR

Address line2 MARATHALLI VARTHUR MAIN ROAD

Address line3

Address line4

City BANGALORE State Karnataka

Postal/Zip code 560037 Country India

Mailing Address

Address line1 NOVEL MSR TECH PARK 4TH FLOOR

Address line2 MARATHALLI VARTHUR MAIN ROAD

Address line3

Address line4

City BANGALORE State Karnataka

Postal/Zip code 560037 Country India

Proof Of Address

Address proof PER

provided

FATCA

Are you a US citizen? Yes / No

Are you a US resident? Yes / No

Do you hold a U.S. Permanent Resident Card (Green Card)? Yes / No

Tax Residence Information

Are you a tax resident of India? Yes / No

Tax Identification Number BIKPG4518A

Are you a tax resident of any other country(ies)? Yes / No

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Additional Data

Nationality India

Occupation Computer Programmer/System Analyst/System Engineer

Maritial Status Married Country of birth India

Place of birth SRIKAKULAMI Country of residence India

Educational Post-graduate GST Registration

qualification No.

Are you registered No Do you have any

under GST special staus under
Regulations? GST?

Spouse's K Spouse's VENKATARAMANA

first name middle name

Spouse's MURTHY Mother's BRUNDAVATHI

last name first name

Mother's Mother's G
middle name last name

Maiden
name

Source of Fund for

offshore clients

Other Source of
fund

Employment Details

Company name Netobyte India Private Limited

Company type Private limited

Industry Information Technology Position / Designation ANALYST

Annual declared 780000

income

Investment Products & Services

Any other Product or

Service

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Savings Account - Smart Banking Savings Account

Purpose of opening Savings

savings account

Fund account choice Cheque No.

Cheque Date Bank name

Fund Account No. Fund amount

Email statement Yes Cheque book No

request
Debit card request No Debit card type

Debit card
embossed name

Insta Account No. 45611689430

Corporate Platinum Debit Card

Chargeable Free
Annual fee- INR 199 + applicable taxes

Cash Withdrawal fee from non SCB ATM’

s in India UNLIMITED transactions free
(INR 20 per transaction + applicable taxes over the specified limit)

Cash Withdrawal fee from non SCB ATM’

s outside India UNLIMNITED transactions free
(INR 140 per transaction + applicable taxes over the specified limit)

Do you wish to avail of the nomination facility? Yes / No

Nominee's residence address is the same as depositor’

s residence address Yes / No

Full name of the K VENKATARAMANA MURTHY

nominee

Date of birth 20/06/1983

Relationship with Spouse

depositor

Guardian's full name

Preference

How would you like Standard Chartered to contact you or send communication material regarding Email, SMS
our sales offers?

Home Branch

Branch

Terms & Conditions

Client Terms

I confirm that I have read and I agree to be bound by the client terms and I wish to submit my application

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 I undertake to provide any updated/amended document/s if requested by SCB or Regulator/s addressing difference in
my name (if any). If I fail to furnish document/s, SCB may take appropriate action in that regard.

I wish to apply for this product with your bank. I understand that there a mismatch (if applicable) in my name as it appears
on my Aadhaar and PAN/Other ID Proof (as applicable). I hereby declare that my name as per Aadhaar and/or PAN/Other
ID (as applicable) belongs to one and the same person.

This space is intentionally left blank.

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Declaration

By accepting /submitting this electronic application form you:

Current Account / Savings Account / Term Deposit Declaration:

1. represent and warrant that all information (including any documents) you have given to us in connection with the application is correct, complete and not
misleading (If this is not the case you may be personally liable). You agree to notify us within 30 calendar days if any information given by you changes are is
incorrect or misleading
2. authorize us to verify any of the information you have given to us or your credit standing from anyone we may consider appropriate (such as an authority or
credit information company) including authenticating any credit card details you give us by conducting test authorisations with the issuer of that credit card;
3. acknowledge that the acceptance of the application is at our sole discretion and acknowledge that we may decline your application. If this happens, no
contractual relationship will arise between us, and we reserve the right to retain the documents you submitted to us with your application;
4. confirm that no insolvency / bankruptcy proceedings have been initiated against you nor have you ever been adjudicated insolvent;
5. consent to each of Standard Chartered Group and its subsidiaries and affiliates (including each branch or representative office) its officers, employees,
agents and advisers disclosing / sharing information relating to you (including personal details, details of the accounts, products, defaults, payment history,
transactions or any security interest) to:
a) our head office and any other member of the Standard Chartered Group in any jurisdiction (“
permitted parties”
);
b) professional advisers, service providers or independent contractors to, or agents of, the permitted parties, such as debt collection agencies, data
processing firms Including forth is application) and correspondents who are under a duty of confidentiality (whether located inside or outside of India) to
the permitted parties;
c) any actual or potential participant or sub-participant in relation to any of our obligations under our banking agreement between us, or assignee, novatee
or transferee (or any officer, employee, agent or adviser of any of them);
d) any credit information company, rating agency, business alliance partner, insurer or insurance broker of, or direct or indirect provider of credit protection
to, or any permitted parties
e) any court, tribunal, regulator or any other authority (including an authority investigating an offence) with jurisdiction over the permitted parties;
f) a merchant, card issuer or a member of a card association (for instance, Visa or Master Card) where the disclosure is in connection with use of a card;
g) any dealer of a foreign exchange, authorized person or any security provider;
h) anyone we consider necessary in order to provide you with services in connection with an account;
i) domestic or overseas regulators or tax authorities where necessary to establish your tax liabilities in any jurisdiction pursuant to orders, agreements with
regulators or authorities or otherwise
6. authorize us to provide monthly details of credit facilities we have given to you to credit information companies (“ CIC” ). Such details include the amount of
monies you owe us (even if you dispute the amount owed or have entered in to agreement with us to settle the amount owed) and your repayment history. We
will also get details of credit facilities given to you by other financial institutions from the CIC. We will use such information to determine whether we will give
you additional credit facility. If you have regularized an account with us, we will update the CIC. If you apply for a credit facility from us we will guide you to get a
copy of your credit information report from the CIC and such report will only show your credit position as provided by the CIC.
7. agree that you will inform us when there is any change in your address, occupation, employer or the status of your residency in India. If we ask, you will also
give us the documents to prove such a change;
8. confirm that you have, read, agreed to and understood our Client Terms, applicable documents referred to in Part A of our Client Terms, loan agreements
forming our banking agreement which are available as part of the electronic application journey as PDF at any of our branches or on our website at
www.standardchartered.co.in and you agree to be bound by them. You acknowledge that you are bound by any variation we make to these documents, in
accordance with our banking agreement. In particular, you understand that by entering in to our banking agreement you give indemnities, authorisations,
consents and waivers and agree to limitations on our liability;
9. declare that all foreign exchange transactions entrusted to us from time to time do not involve and are not designed for the purpose of any contravention or
evasion of the provisions of the Foreign Exchange ManagementAct,1999oranyrule, regulation, notification, direction or order made under that Act. You also
agree to give us any information or document as will satisfy us about the purpose of a transaction. You also understand that if you do not fully comply with any
requirement, we can refuse to undertake a transaction and may report the matter to RBI. Relying up on this declaration, we may not insist on your giving
specific further declarations for future foreign exchange transactions;
10. if you are applying for any Insurance product, you agree to be bound by the terms& conditions applicable for that product which are made available to you
separately and that we may receive a fee from the insurers in connection with the corresponding products;
11. as NRI/PIO you also undertake to adhere to all the requirements of Foreign Exchange Management Act1999
12. consent to submit further documents as maybe required by us from time to time to comply with the Know Your Customers (KYC) required by the RBI and the
bank;
13. agree that Supplementary Card holder(s) will not be eligible for the Priority Pass Program and complementary insurance cover under the Visa Infinite Credit
Card;
14. confirm that all dues in respect of the Standard Chartered Bank Credit Card utilised for services availed of and goods purchased from eligible Service
Establishments by the supplementary card holder will be payable by you and you guarantee the payments towards the same in your capacity as the principal
card holder;
15. undertake to advise Standard Chartered Bank immediately in the event of the supplementary card holder ceasing to qualify under the terms for holding a
supplementary card;
16. authorize the bank to verify information contained in the application form from any third party as per the bank's requirement;
17. confirm that the contact preference as chosen by you in this application will be effective 60 days from the date of account opening / change request and will
supersede any contact preference already registered with us for any product;
18. the Borrower shall forthwith inform the Bank of any un-hedged foreign currency exposure on a quarterly basis.

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19. Here by authorise to share details of your transactions including the default of payments that may occur to any card issuers in India, the Reserve Bank of India,
to any authorised dealer of Foreign Exchange or merchants as we deem fit and proper without obtaining any further oral or written consent from you;
20. authorize us to recover any tax, penalty and levies from you that may be levied or demanded from the Bank due to non-generation of TDS certificate on
account if PAN not provided by you. The demand would be recoverable by way of direct debit to the account or any other mode, immediately on demand
from the Bank;
21. represent that if you are applying to open an account for a minor, you declare that you hold all and any monies in the account (including all principal payments
into the account, all interest and income earned from the date the account was opened) intrust, for the benefit of the minor absolutely and you will refrain from
doing any act or thing which will construct, negate or diminish the effect of this declaration of trust;
22. for persons of indian origin not residing in India; understand that the account / deposit will be opened on the basis of statements made by you;
23. confirm that your residential status as per Indian Income Tax Act 1962, is Resident Indian and you agree and undertake to inform us in writing of any change in
residential status;
24. undertake to strictly operate and use the account / deposit and the said banking facilities in accordance with the Exchange Control Regulations as laid down
by Reserve Bank of India (RBI) or any other authority from time to time; Printed July182018 Page 5
25. understand and agree that the deposits and their payments are governed by the law in effect from time to time in India and the deposit will be payable only at
the Branch in India where the deposit is placed. We shall have the sole discretion to allow the withdrawal of the deposit at any other Branch in India. We shall
not be liable to pay the proceeds of the deposit at any Branch or Office (including the Head Office) outside India. In the event of any failure on our part to
comply with all or any of the guidelines / rules / law laid down by RBI, the Bank, Government of India or any other duly constituted regulatory body or authority,
we agree to forfeit all our rights to the account / deposit and the said banking facilities and further agree to be debarred from holding /operating and using the
account / deposit and / or the said banking facilities. In the event of any default or breach committed by you of any of the aforesaid provisions, guidelines,
rules, indemnity, terms and conditions or any law of statute, you shall indemnify us of any loss or damage that maybe caused to it. We may adopt such action,
as it deems fit on the happening of such event;
26. understand that on subscribing to Internet Banking and / or Short Messaging Services (SMS) Banking services you will be getting alphanumeric SMS
messages related to these services, which may include Internet Banking activation code and / or SMS Banking PIN, on you mobile number/s provided to us.
You authorize us to send you all SMS messages, including activation code / PIN, related to these services on my / our mobile number/s. You agree that the
risk of non-receipt and / or disclosure of all such SMS messages shall be fully borne by you. You also confirm and agree that we shall not be held responsible
in any way for any losses that may be suffered by you as a result of disclosure of the SMS messages to an unauthorized third party;
27. As per the Income Tax department, Circular No.3/2011 dated 13th may2011, Bank will not be able to generate the TDS certificate for your account (held with
Standard Chartered bank, India) from the Tax Information Network in case your PAN is not updated with the bank Premature withdrawal of Term deposits
shall be subjected to a penalty of 1% on the interest rate payable for the tenure the deposit has been held with the bank. In the event of death of the depositor,
premature termination of Term Deposit will be allowed subject to completion of documentary formalities as required. Such premature withdrawal would not
attract any penal charge. In case of a premature partial break of Term Deposit/s, the deposit will be broken for the exact amount required, in multiples of INR 1.
The remaining / residual balance in Term Deposit will not continue to earn interest as per the initial contracted rate of interest but shall be revised to a new
interest rate applicable for residual balance. Th e "interest rate" applicable shall be as per the deposit effective date. The revised rate shall be applicable on
remaining / residual balance for the entire term of deposit and not from the date of partial premature break. In such a case, no new Term Deposit shall be
created. Hence deposit effective date and maturity shall remain and same will not change at the time of premature partial break. The bank reserves right not
to allow premature partial break in certain term deposit booked under preferential rates. For such Term Deposits entire amount shall have to be prematurely
broken.
28. In case of traditional / Simple Term deposits, interest will be credited to the account at the end of the quarter. In case Re-Investment Term Deposits, Interest
will be capitalized with principal at the end of the quarter. Term deposits for the period less than 90 days are offered as Traditional / Simple Term deposits
only. In case of term deposits accounts held jointly with "Either or Survivor" or "Former or Survivor" mandate, in the event of death of any joint holder,
premature termination of term deposits will be allowed as per the mandate signed by all the joint holders to this effect and provided by the bank.
29. At the time of deposit opening /during the tenure of the deposit client can give a separate premature withdrawal mandate at the branch. In case premature
termination of the deposit mandate is not given, then all the depositors will need to provide an instruction signed by them to prematurely terminate the TD
30. If premature penalty rate falls below the applicable interest rate for reduced tenure then penalty rate will also be reduced to the extent of applicable interest
rate. By signing this electronic application form with a signature in electronic form:
31. As per extant regulatory guidelines, Resident Indians are not permitted to make remittances in the nature of margins or margin calls to overseas
exchanges/overseas counterparty. If any “ Overseas Forex Trading” transaction will be observed on your account, we would be constrained to close all your
accounts and report the same to the regulator. Hence, you are requested to refrain from doing such transactions on your Debit Card/accounts.
32. We advise you that the Savings Bank account (SB A/c) cannot be opened for business purposes as per RBI directives and hence SB a/c should be used to
route transactions of only non-business/ non-commercial nature. In the event of occurrence of such transactions or any other such transactions that may be
construed as dubious or undesirable, the Bank reserves the right to unilaterally freeze operations in such accounts.
33. ‘
Tax Collection at Source (TCS) will be applicable as per the provision of section 206C of the Income tax Act, 1961 on foreign remittance made under the
Liberalized Remittance Scheme (LRS) of the Reserve Bank of India (RBI) using UPI as a payment mode’
34. Confirm to use the debit card strictly in accordance with the Foreign Exchange Management Act, 1999, and any rules/regulations thereunder (hereinafter
referred to as ‘
FEMA’ ). In the event you fail to comply with the same, you will be liable jointly and severally for action under FEMA and may be debarred from
holding the debit card issued by us, either at our instance or at the instance of Reserve Bank of India (RBI). You shall jointly and severally indemnify and hold
Standard Chartered Bank harmless from and against any/ all consequences arising from you not complying with the provisions of FEMA. You shall intimate
us in case of change of your residency status under FEMA. You shall surrender the debit card before proceeding overseas on permanent employment
and/or emigrating and/or changing nationality.
35. Understand that for a resident customer, usage of debit card towards drawing cash or making payment to a merchant establishment overseas and / or online
usage on websites of overseas merchant is only for permissible current account transactions and is subject to limit as prescribed under Liberalised
Remittance Scheme (LRS) as applicable from time to time.
36. Understand not to use the debit card to effect payment/s for any illegal purchases, i.e. purchases of items/ services which are not permitted under the extant
laws, rules and regulations (including FEMA).
37. Understand that PAN is mandatory to enable international transactions on your debit card since LRS can be undertaken only with a valid PAN, in the absence
of a valid PAN being updated with Standard Chartered Bank, international transactions on your debit card will be disabled until updation of correct PAN.

Declaration

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1. I wish to apply for this product with your bank. I understand that there is a mismatch (if applicable) in my name as it appears on my Aadhaar and PAN/Other ID
Proof (as applicable). I hereby declare that my name as per Aadhaar and/or PAN/Other ID (as applicable) belongs to one and the same person.
2. I undertake to provide any updated/amended document/s if requested by SCB or Regulator/s addressing difference in my name (if any). If I fail to furnish
document/s, SCB may take appropriate action in that regard.

By signing this electronic application form with a signature in electronic form:

you agree that this form, the terms and conditions it refers to, and any instructions given in here shall have the same validity, admissibility and enforceability as if signed
by you in physical form and you agree not to challenge the validity, admissibility or enforceability only on the basis they are in electronic form.
You agree that this electronically executed application form and the terms and conditions governing the product(s) and / or services you have applied for may be
sent to you by email and you agree that you will not dispute the validity, admissibility and enforceability of such terms and conditions only on the basis they are in
electronic form.

Non-Resident Indians/ Person of Indian Origin (PIO) Declaration:

For Non Resident Indians investing through Standard Chartered Bank, India - I/We have met / spoken to the Concerned relationship manager of Standard
Chartered Bank in India and conform that I/We will be executing Transactions - during the course of our stay in India and in due compliance with applicable local
laws and regulations and also I/We execute any transaction from our country of residence I/we confirm that the same would be in due compliance with the
applicable local laws and regulations in my country of residence.

Client Tax Declaration and Certification:

1. I acknowledge that the information I have given you/Standard Chartered Bank in connection with this application and any related reportable account(s) may
be provided, directly or indirectly, to any relevant tax authority, including the tax authorities of the country in which this account(s) is/are maintained and
exchanged with tax authorities of another country or countries in which I may be resident for tax purposes pursuant to bilateral or multilateral agreements
between governments to exchange financial account information.
2. I undertake to notify you/Standard Chartered Bank within 30 days of any change in circumstances which affects my tax residence status or where any
information contained herein to become incorrect.
3. I certify that I am the account holder of all of the account(s) to which this information relates and declare that all statements made in this declaration are, to the
best of my knowledge and belief, correct and complete.

Aadhaar Declaration

I, Kari Bhavani
want to open an account with Standard Chartered Bank, India (“ Bank”) and I have been informed by the Bank that (a) it is not mandatory for me to submit my
Aadhaar number; and (b) there are other alternate and viable means of identification. However, in spite of the availability of other alternate and viable means to
establish my identity, I hereby consent to and voluntarily submit my Aadhaar number in physical / digital form to the Bank to establish my identity or in such other
form as may be notified by the government, UIDAI or under any law, for the purpose of establishing an account-based relationship with the Bank in my name or as
an authorised signatory in a non-individual account.

Declaration applicable for customers authenticated using Aadhar e-KYC facility and with residential address in account opening form
different from address available in UIDAI’
s Aadhar database:

I, Kari Bhavani
hereby declare that the address provided by me in the residential address field in the digital account opening application form is my current residential address an
should be updated as such on my account. I acknowledge that the aforesaid address is different from the address available in UIDAI’ s Aadhar database.

Applicant

Full Name
Kari Bhavani

Date
20/06/2023

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Declaration applicable for Employee Banking Customer:

I, Kari Bhavani
confirm that I am currently employed with the company whose name is updated in this electronic application journey. I would request you to tag my account under
the banks employee banking corporate proposition. I am aware that on ceasing to be employed with the company whose name is updated in this electronic
application journey, I will cease to receive any of the benefits under the employee banking corporate proposition

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By performing mobile OTP check successfully, I/We accept and agree to the aforesaid terms, client terms,
product terms and most important document and this acceptance shall have the same validity, admissibility and
enforceability as if signed by you in physical form and you agree not to challenge the validity, admissibility and
enforceability of such terms and conditions only on the basis that they are in electronic form.

Applicant Name : Kari Bhavani

Date : 20/06/2023
Time :11:31:11 IST
Mobile Number:+91-8341885436

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