भारतीय स्टेट बँक

STATE BANK OF INDIA

Umapur Branch (06164)
Customer Request Form

1st Applicant's Name*: ___________________________________________________________

2nd Applicant's Name*: _________________________________________________________________
Account number: _____________________________Mobile Number: ____________________________
(Fields marked* are mandatory)
*Kindly fill only those boxes where information is to be added or updated. On submission of form always ask for
acknowledgement*
(Kindly tick the boxes against the request opted for)
SN Tick Type of Service Request Service Details
1. Update E-Mail ID
2. Update/Change Mobile Number
3. Activate/Deactivate SMS facility for above acc
4 Cheque book facility: Please provide cheque book 10/20/25/50/100
facility in my account number mentioned above.
5. New personalized cheque book request: Number
of leaflets:
6 ATM card issuance (Charges will be deducted as New/Replace
applicable)
7 Request to Issue Duplicate Passbook for the
Account Number
8 Request to issue statement of account (Charges _______________to_____________
will be deducted as applicable) Period
9 Request to stop (number of cheques) Cheque ______________to_______________
number listed above/attached
10 I/we request to close above account and pay the
balance by: Cash/ Credit to account no.
11 Convert my account from Minor to Major as I
became Major on
12 Delete my UID/Adhar from account UID No:
13 Delete my PAN from account PAN No.
14 Transfer My CIF/Account to above Branch Br. Code & Name
15 Request to activate my inoperative/Dormant
account
16 Setup Auto-sweep facility - Saving Plus Threshold Limit________ ___Monthly/Weekly
17 Under reverse sweep facility the MOD (Multi-option Last in First Out/First in Last out
deposit) to be broken by:
18 Internet Banking rights modification Full Transaction rights/Limited Transaction rights
19
I have read, understood and agree to the Terms and Conditions of various products and services including SMS alerts, Debit card
and Internet Banking. I accept and agree to be bounded by the Terms and Conditions as displayed on bank.sbi. I agree that the
bank may debit service charges plus taxes to my account whenever applicable. I wish to seed this account with NPCI mapper to
enable me to receive Direct Benefit Transfer (DBT) including LPG Subsidy from Govt of India (GOI) in this account.
Kindly provide the number of Requests submitted (count and enter number of ticks in the checkboxes)*

Signature Signature
___________________________________________________________________________________________
ACKNOWLEDGEMENT
Date of Request Received: ______________ Customer Name: ________________________________________
Employee Number: ________________Name of Branch Official: __________________Signature: ___________

Please note: Your request will be processed within 2 working days. Delivery of kits/cheque book etc. to your address
will take between 7-15 working days (depending on delivery location)