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This document is a declaration form for HDFC Bank that includes sections for confirming date of birth, opting for a direct debit facility, and acknowledging signature authenticity. The declarant must provide their personal details, choose a direct debit option, and confirm their signature. It requires signatures and names for validation and accountability.

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bittuds009
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59 views2 pages

Download

This document is a declaration form for HDFC Bank that includes sections for confirming date of birth, opting for a direct debit facility, and acknowledging signature authenticity. The declarant must provide their personal details, choose a direct debit option, and confirm their signature. It requires signatures and names for validation and accountability.

Uploaded by

bittuds009
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

DOB, DIRECT DEBIT & SIGNATURE DECLARATION

The Manager,
HDFC Bank Cards Division,
PO Box No. 8654, No. 94,
SP Estate Bus Stand, Wavin
Main Road, Mogappair West,
Chennai 600058

Please quote your 16 digit application reference number………………………………………………

DATE OF BIRTH DECLARATION

I, Mr/Mrs…………………………………………… ………………………………………………confirm
that my DOB is ………………………………(dd/mm/yyyy) and I have enclosed a valid DOB proof
to support this declaration.

(Signature of declarant) __________________

(Name of the declarant) __________________

DIRECT DEBIT

This is to confirm that I, Mr/ Mrs_______________________________ am maintaining an


account with HDFC Bank bearing account
number……………………………………………………and would wish to avail the Direct Debt
facility with the following option

o 100% of Outstanding Due

o Minimum Amount Due (MAD).

If above option is not clearly chosen, the MAD option will be setup by default

(Signature of declarant) __________________

(Name of the declarant) __________________

SIGNATURE MISMATCH

My signature as per Bank records is


I, Mr/Ms/Mrs____________________________________confirm that the above signature is
mine for which I accept full responsibility and agree not to make any claim against HDFC Bank in
respect thereto.

(Signature of declarant) …………………………………….


(Name of the declarant) …………………………………….

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