CREDIT CARD APPLICATION FOR NRI ME ‘VERSION 15 fis T | rene] Jom TTT TTT fnveness| 1 [ feovoe] [TP | | loves] TTT) horcas COT eee TTF [Visa Rogatia [5 Wi ntnie etal Cars ‘Annu Foo. 2500s GST Poseato ‘Aerval Foe: Ri. 12.500 + GST Appicatio 1 International Enabled Chip + PIN Card: 100% auto debit mandatorily from NRE account only 1 ony Domestic Chip + PIN Card : 100% auto debit mandatory trom NRO Ae only The Mendy ‘Name.as you would prefer on the card Martal Status Shde Maviod tos Gonder. MF Date of Birth No, of Dependents Educational Qualification 1herboiw 10+ Zerbalow Giada —-Ptgacintoandabo Profesional Otho (aso enact) PAN No, Pessport No. Pace otisue ‘tor 10. Dring Lone to, Pave of eave Netonaty NR/P;O PLEASE TELL US WHERE YOU LIVE Residential Address: Flat 207 No. & Bulding Name Road Number / Road Name y/state PIN Lena *TeINo. IsitaPPNo? ve Ne Mobile No. Personal Et 10 Pate prodgoron-gononc Ema D for sccuty reasons a coder cor fomaten may be charod vido Ema ecmanent Address: Flat Dor No. & Bulding Name Road Numbor/ Road Namo cryistate PIN Landmark *TeINo. IsitaPPNo? Y= Mm Mobile No. Pease ie us the name fa elatve/tendn your ey who das not say wh you 8s ference, Name TeINo. Yurresience is Onned Ranta Company Provided ArcsstalFamiy PG Acconmeniton Ras curofos Period ateuentesidence Yous vote Yourvohicl ls Fourvnecer — Two-Whaoler Others Nena Veico-rato ocal Name). Ye oFPurcsase Yourvehiclo ls Frances Owned Company proved Poly Exaty Mont Corres by thauraoo Co) PLEASE TELL US YOUR OFFICE ADDRESS "Company Name Designation Department Company Address Fiat "Door No. & Building Name Road Numbor/ Road Name cyistate PIN Landark Enp Coe Company Code ‘Tet No, Extension No. Fax No, HA Contact No ‘Superisor Contact Time ot Contact ffeo E-mail 1O fa tr cen emeloyment yews Norns Please prov non ganar El D fr eucuty rotons a coda sortie iefoaten may be shad id Ema Teds aoymtbasres Yous neue ae emeljePLEASE TELL US YOUR OCCUPATION Occupation Salared — Sot-empioyed Ried Housewte Student stared, empoyed tn Private Lmtd Parieship Progrstostip Pubic United Puke Sootar Govemont Multinational Hedoed Ypectiausinybushess: —Aawisinartt Reseach Banking Consiucton/Real Estate Consumer Goods Eensinmonwveda ExporVimport —NBFC Hote estauant Infomation Techonology Pharmaceutcals Testes Transport TraveToursm — Telocom insurance Intemet senices aalEstate Cal CovtesBPO/TES/MadicalTransciptons France Others: I sremeleyes your fis Private United Parner Propitorship Heat empioyed you ara Broker Chartered Accountant’ Constant Doctor Enginact_FimsfErtertaeent Fnarcor Red Eatto Agent amor ImpaterEsparer Jouralst Landleid/Agrcututst Manufacturer Software Professional TiadovDisbuior Retuloe/Groows IMPORTANT FIELDS TO BE FILLED™ For HFC Bank Customers NNROINRE Account No, Customer 10 No. Account Type Curent Samat FD. Demet Account ay. Duration ofthe account held Yeas Months Loan Account / Agreement No. Loan Account en) CarLoan Personal Losn Coreumer Durable Lom Laan Agarst Snees Hush Loan HOEC) Other Bank Credit Card / Loan Detail Issuing Bank CreditiCharge Card / Loan AccoutNo, | Expiry Date | Member Since /Loan open date | Credit Limit / Loan Amount Income Details; 1. Gross Monthly Ineom@.en . ‘Spouse's Name. 2, Aattonal Manthly Incame(atacn documents ey ‘Spouse's Monthly Income (tach docu oes vn ‘Spouse's Company Name 3. Avarage Monthly Exponsos... 7 ‘Spouse's Ofice Te. No Extension No. ‘Yes - The details provided are corect tothe best of my knowledge”. 'No- dont want to provide any details. RELATIONSHIP - IMPORTANT* Do you have any relationship with any Director or Senior Officer of HDFC Bank: ves No me of Cicer Serir Oost Feleonchip wth he Dros Sesioe Oticer CARD DELIVERY & STATEMENTS rary Aopterts Saree Where would you lke your card and other correspondence to be sent? Office Residence ‘Your Crest care Monthly Statement wil be sent only by Email on the Mail ids mentioned in the application form DIRECT DEBIT OPTION | pecept the crect cel fac ard authorise HOFC Bank o det my Bark account, lorementoradin te Bank etal secon, Primary npr Sqranre ‘owares exalt cad payments as heated blow f HOFCBankaccountnumberalorementionadabeveintheBank Details section wile usedfordrectdebitlacity. 100% paymant mandatory mado Wrough AutoPay mode from HOFC Bank NFE/ NFO account only ADDITIONAL CARD DETAILS Tle MM Myr ‘Add-on Cart seri Rin Orne Date fh serials Mr AFEIX (nxt te Aap. etre nin Aadens ina! [Erettnyaime | YOUF atthe same residential address as provided in this application form. 1 as primary card nokter take the ful responsibilty of te Add-on, including all PHO” {raeachons / nape ac payment ead toe halon. procs hed pon fhe Adon mete as and wher raquete ty te Gan ‘son epsiatwihat HOPG Banc ret tig we Pay ors wil ba gare emt ai proto, PAN Cars Cay hans pot. end ‘spice does otrels HOF Bark ands bingo pray apleant val pot DP Cx apy & Aes prowl be regres ‘Aston applicant's HOFC Bank ae No. ‘Adé-on applicant's Customer ID Pinoy Aostert Sesto Oo. ‘ADD ON SUB-LIMIT OPTION’: Please Indicate the Sub-Limit to be set on the Add-on Card pr Statement Cyclo 25% of Credit Limt 50% of ed Lit 100% of CredtLimt Fs. 1000-8 5000s 10000), I neltnor option is chosen leary, 100% willbe set as detautAck-on LimitDECLARATION {hereby apply for HOFC Bank nternational/Domestic Crecit Care(S) and declare thatthe information included inthis applications tue and correct and that lam @ Non Resident nian working/staying abroad and that | am eligible to apply for an international enablediaisebled card. | accept that HOFC Bank is eniled ints absolute cisretio to accept or reject this application. Its my responsibilty to obtain the terms and conditions applying tothe HOFC Bank intornational/Domestic Crit Card(s) separately and read the same. Iwillbe bound by the terme an conditions 8s may be In free from {ime to time and receiptuse ofthe card shallbe deemed tobe acceptance of those terms and conditions. | authorize HDFC Bank andiorits associates {0 veifyany information or otherwise at my offcoiresidonce orto contael melmy employer/tankerfcrecit bureau/RBI or any ther Source to obtain oF provide any information that may be requted for confirming membership requrernents oF maintaining my accountin good credit standing. Wwe hareby Authorize HDFC Bank to block migrate my our issued credit card ifresident status changes to resident indian in future and We confirm to Clear the dues if any. agree tobe charged my card fein my firstsialement. In case Ihave applied Adé-on card(s) (available for residenlnon resident Indian parenspouse/brothersistr/chidove 18 years lage at special rae) | vl be bed for such and Add on cardin the nomal monthy statement | the pximary applicant willbe habe for alcharges incurred with the Add-on cares] issued on the account and each Add-on applicant willbe liable fr all charges incurred withthe Ad-on-cars oily and severally with the holder ofthe primary card, The facily of Add-on card(s) being special facility ata concessional feeirate, continuation ofthe Add-on carcmember will be ceperdent onthe continuation of my membership. We understand thatthe Usage of the HDFC Bank International / Domestic Credit Card(s) shall be strictly in accordance with exchange control regulations, applicable laws or regulations of the Regulatory authorities as applicable from time to time, which !We undertake as mylourresponsibilities tokeep myselfour self-updated and alse that the card willnot be used for prohibited transactions including but not limited to Forex trading, lottery, betting, gambling, dating and In the event of any failure to do'so, iNWe will be lable for action under the Foreign Exchango Management Act 1988 orits statutory modifications or re-enhancement or any other applicable law thereof. Iconfim that have no insolvency proceedings pendings against me nor have i ever been adjudicated insolvent. | agree that my signature on the charge slip will amount to an Unconditional undertaking by me to pay HOFC Bank the amount staled therein and agree that a copy of my periadee statement of accounts willbe a Conclusive evidence of my lability forthe charges stated therein. My lablty under the charge slip signed by me shallnt withstand any dispute | may have with respect othe qualtylquanity of goods purchased or quay ofservices obtained. | wll ot held the bank responsible if any oulettranchisee relusesto accept the card HOFG Bank can siscose, from ime to me, eny infomation relating o my Credit Gard), including any cefaultin payments toany ether cardisuer,creditbureau, nancial institution, any parent/subsidiary, Afilate, Co-prand partner and associate of HOFC Bank, andto third partes engages by HOFC Bank. for purpose such as marketing of services, proper operation of Crecit Card accounts and others administrative Services. The bank wll be entitled to cancel my card(s t any time without assigning any reasons. | understand Goods & Services Tax applicable from ‘ime to mime wil bo levies on fees, interestand ether charges, as por government guidelines. | understand that Goods & Sorvces Tax isnot applicable on my regular purchases. | am aware thatthe bank reserves right not fo reiutn the supporting financial documents given by me along with the application | have received and read the detailed terms and conditons and agree io abide by them, once | am alloted the Credit Card | hereby confirm that have also read and understood the contents ofthe Schedule of Charges and disclosure details, and agree tobe levied various charges mentioned therein as anc when appicable to me. Creit limit on any card account may be reviewed as per the bank policy spected from time to ime. The bank reserves the right to decrease andier unconditionally cancel the limit assigned tothe card and intmale the card member about the seme. | also Understand and agree tothe fat thatthe bank is authorized to ehange any of all ofthe terms and conditions of the schedule of charges with due intimation te the customer. Any change in termes & conditions will be communicated through the Bank’s website and by other acceptable modes of Communiction. | authorize the bank to record specific conversations between me/my representative and the Bank's representative, In case of Qrevance-related conversations or payment-recovery-elated conversations or any ther conversation that the Bank may deem fi, at its own Giscretion. lagree to abide by any Terms and condiions as may be adided/amended by the Bank from time to time with due intimation to the customer. regarding this ere card any other facity/ van product that avail through his creditcard of any other edit card that I may bo issuod bythe Bankin the future. agree to receive my card statements through E-mail on the E-mail IDs mentioned inthe application form. | arm aware thal my new creditcard would be automatically registered for Net Banking incase | am already a HDFC Sank Nel Banking customer. We confirm tat We do not have any existing customer ID OR customer ID apert from ihe on mentioned above, andincase found otherwise, Gank reserves the right io consolidate the customer IDs under @ single customer ID as it may decide, without any prior notice to metus. We authorize HOF Bank Limited. To make any enguites regarding my application. We hereby autnonze & give consent tothe bank to disclose, without netic to meius, information funished by meus in application form(s)/telated documents executed in relation to the facilities availed from the Bank, to the Banks other branches/subsidiaries/aiates, credit bureaustating agencies, sevice providers, deem ft. MWe wave he privilege & privacy of contract. Do not sign this form if its Blank, please ensure al relevant sectors and columns are completely filled to your satisfaction and then only sign the form. We haroby declare that tho details furnishod above are true and correct to the bast of mylour knowledge and boliof and lMWe undertakes to inform you of any changes therein immediately. Incase any ofthe above information is found to be false or misleading or misrepresenting, We amfare aware that iWe may held liable for it. MyiOur Personal KYC details may be shared with Central KYC Registry. We hereby consent to receive information from central KYC registry through SMS E-mail on the above Reistered number /emailaddress. We hereby acknowledge, agree and confirm thatthe creditcard issued by HOFC Bank shall be blocked for usage tillthis application and relevanteredit ard documents including but not limited to my/our KYC doctiments are duly submitted to HOF Bank in original within timelines specified by HDFC Bankin this regard and in compliance of HDFC Banks internal guidelines. Final Submission Date: / hereby declare that the dale mentioned ‘below is the date on which the completed application form and all required documents have been submitted to the executive. MITC: I confirm that have received the MITC (Most Important Terms & Conaitions) and have read all the details in it. am aware that the MITC is also available for reference in the bank's website wwvihdfcbank.com | agree to participate in any oral of the Card Upgrade programmes or Limit nchancement programmes that the Bank may conduct on my Card account rom time as partof periodic portfolio reviews. |/ Wel iconsent/_|do not consent to recive information / services nahiesaeniimsadieaneata for marketing purposes through telephone / mobile / sms f e-mail / ase: pias bythe bank andallits agents. Primary Applcant’ Signatura Acknowledgement of Credit Card application 0 Visa Regalia Card 11Visa Infinia Metal Card sau F250 «6S Are ‘nn Fee Ri. 12.500 + GST Apleabe We acknowiedge te receist of your apalcaton fora ered card fom HOFC Bank, Incase of any queries App. No yeu may contact our Customer Serves cal centers or mail usa cistomerservce.cards@acicbank com Signature of DSA/ HAL Rep Date : ® HEL /DSA Name Mobile No of HBL. /DSACREDIT CARD APPLICATION (FOR NRI/ PIO) FD LIENTO BE FILLED BY CUSTOMER CUSTOMER LETTER FOR MARKING LIEN (TO BE SIGNED BY ALL JOINT ACCOUNT HOLDERS) Dear Sir/Madam, With reference to the application for a HDFC Bank Credit Card to be issued to (Card holder), 1 / We hereby authorize HDFC Bank Limited (‘the Bank") to mark a lien to the extent of Bs. (amount in figures) Rupees (amount words) on the FD account number. including renewals thereof, as.a security for the credit card being issued. We also confirm that the above FD is currently tree from lien and itis not linked to any sweep in/ super saver account. We agree that the Bank at its sole discretion is fully authorised to liquidate the FD without any cause or notice to me/us and appropriate the proceeds towards the outstanding on the credit card. In such event IW expressly agree that the Bank shall not beresponsible for any loss arising due to pre-mature encashment of the FD. We shall not apply for premature withdrawal of the FD and authorise the bank to automatically rollover the FD for further similar periods on each maturity date as long as the cardis active /in use. We further agree to arrange for further FDs from time to time of requisite amounts as may be required by the Bank, with lien in favour of the Bank. (We agree that the Bank shalll be entitled to proceed against the card holder for the balance outstanding after adjusting the FD towards the dues. We acknowledge that the Bank's rights herein shall be in addition to all rights, powers and remedies available to the Bank by virtue of any other statute, rule or law including the Bank's right of general lien and setoff. Thanking you, (sete: Signs tobe sme ae hat vee fr barking taneactone) amet sree ortscrem to tA) For Office Use Only HORS ou porsoa Barer /Ratonsip Mange Branch Manager Contain Ses TES nvm saci at ‘stwerene remorse Prep erenons Hae eS Pree oe Shccyacre ores ect SRS cpeeagtueeente ia seneniinaustoman Spree emerteaie | meneame eer emretaeaeae aaa ial.