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PsbOnline R I

This document contains an application form for availing internet banking services from a bank. It requests information such as the customer's name, account details, contact and demographic information. It includes declarations by the customer that they have read and agree to the terms and conditions of using the internet banking services. For non-resident customers, it includes an additional declaration that they will abide by foreign exchange regulations. The form is to be signed by the customer and verified by the bank branch manager to approve the customer's registration for internet banking facilities.

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180 views2 pages

PsbOnline R I

This document contains an application form for availing internet banking services from a bank. It requests information such as the customer's name, account details, contact and demographic information. It includes declarations by the customer that they have read and agree to the terms and conditions of using the internet banking services. For non-resident customers, it includes an additional declaration that they will abide by foreign exchange regulations. The form is to be signed by the customer and verified by the bank branch manager to approve the customer's registration for internet banking facilities.

Uploaded by

goyalpuneet007
Copyright
© Attribution Non-Commercial (BY-NC)
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
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( Form No.

RI )

APPLICATION FOR AVAILING INTERNET BANKING SERVICES


( For Retail Customers Only)
BRANCH NAME BRANCH CODE

CUSTOMER INFORMATION
PRIMARY ACCOUNT NO. A/C CONSTITUTION
Individual Joint Proprietorship

CUSTOMER-ID
(As in Primary A/c)

FIRST NAME MOTHERS MAIDEN NAME DATE OF BIRTH GENDER ADDRESS D D Male M M Y Y Y

Single MIDDLE NAME

MODE OF OPERATIONS EOS FOS All Jointly LAST NAME PAN

PLACE OF BIRTH MARTIAL STATUS PHONE MOBILE Married Unmarried Divorcee

Female

CITY STATE PASSPORT NO. PIN ISSUE DATE

FAX E-MAIL ISSUING AUTHORITY EXPIRY DATE

1. If you do not know your customer-ID, contact your Branch. Branch will help you in filling your customer-ID. 2. Passport related information is mandatory for Non-Resident Customers. 3. Mobile Number is mandatory for availing Internet Banking Services. The above mobile number will be Registered for SMS Alerts/SMS Banking facilities . 4. Linked Account Transfer Facility will be provided at Banks discretion subject to Terms and Conditions/restrictions for allowing this functionality.

GENERAL INFORMATION
Resident Indian Non-Resident Indian Foreigner STATUS OF APPLICANT Business Professional Service Others OCCUPATION General Staff Ex-Staff Senior Citizen TYPE OF CUSTOMER Up to 2 Lacs Between 2 Lacs & 5 Lacs Between 5 Lacs & 10 Lacs 10 Lacs & above ANNUAL INCOME I hereby undertake that the information submitted above is correct. I have read the Terms and Conditions applicable for availing Internet Banking Services, as displayed on the banks website http://www.psbindia.com and agree to abide by the same. Date : Place: Signatures of the Applicant

DECLARATION
I am aware that the usage of PsbOnline Internet Banking service is governed by the terms and conditions, which are displayed on the website www.psbindia.com maintained by the bank. I have read the terms and conditions applicable to the bank accounts as displayed on the bank's website and I agree to abide by the same. I do not use Cyber Cafes to access the PsbOnline Internet Banking Service. I accept that I would be deemed to be aware of the contents of the Terms and Conditions and that all my rights and liabilities would be governed by the said Terms and Conditions by my act of accessing on www.psbindia.com. Any changes made by the Bank in respect of Terms and Conditions which are on website are acceptable to me and I shall abide by the same and the bank need not give me a separate notice in this regard, l also agree that this application shall be treated as an authenticated request for generating User ID and Passwords/PIN for my use. The User ID and Password/PIN mailers can be mailed to my address provided in the application at my risk and responsibility. Further I declare that I have the knowledge in the use of Internet. I declare that all the particulars and information given in this form are true, correct, complete and up-to-date in all respects and I have not withheld any information. I further understand that I am applying for availing Fund Transfer Facility through PsbOnline Internet Banking. I hereby undertake that I will be responsible for keying in the correct account number(s) for the Fund Transfer. In no case, Punjab & Sind Bank will be held liable for any erroneous transaction(s) arising out of or relating to my User-ID, entering wrong Account Number(s) or for such other errors resulted from operations of the account(s) by me wrongly and loss thereby. Date : Place : Signatures of the Applicant

NRI-DECLARATION
I hereby declare that I am non resident Indian of Indian Nationality/Origin. I/We agree that the facility of PsbOnline shall be available only in specified type of accounts as notified by Bank as eligible for Internet Banking Facility from time to time. I/We do hereby undertake that I/We shall not make available to any person resident in India, Foreign currency again reimbursement in rupees or in any other manner in India. I/We further undertake that debits to the accounts for purpose of investment in India and credits representing sale proceeds of investments are covered either by general or special permission of Reserve Bank of India. I / We further undertake and declare that any request made by me /us through PsbOnline Internet Banking facility for transfer of fund shall be for the approved bonafide transactions of domestic nature only and in any event such request will not be in contravention to the various Regulations framed under Foreign Exchange Management Act 1999, Foreign Exchange Management [Deposit] Regulations, 2000 and other rules and regulations laid down by Reserve Bank of India including Exchange Control Regulations. I/We do hereby indemnify and forever indemnified the Bank and its successors and assign from and against any and all claims, actions, penalties that may be made, suffered or incurred by the Bank by reason of non compliance of any of the Terms and Conditions mentioned therein.

Date Place

: :
Signatures of the Applicant.

FOR BRANCH USE


I have verified the application form, signatures and mandates for accounts and confirm that applicant is Sole/ Primary holder in all the accounts under Primary Customer-ID. In case of joint account(s), Letter of Consent has been taken from all joint account holders and attached herewith. Signatures of First Customer and holders have been duly verified with Banks Record. The above Application has been entered in PsbOnline Application Receipt Register .I have verified and hereby confirm that KYC Norms are fulfilled completely for the account(s) mentioned in the application form. I hereby recommend for Registration of the customer for PsbOnline Facilities.

ENTRY NO. NAME PF CODE BR.CODE DATE

ENTRY DATE:

Stamp and Signatures of the Branch Relationship Manager

General Instructions:a. Entry No. and Entry Date of Branch PsbOnline Application Receipt Register must be filled. b. Branches to verify the particulars with data on record in Core Banking. c. Mobile Number is mandatory for availing Internet Banking Services. The mobile number will be registered for SMS Alerts/SMS Banking facilities .

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