@SBI Customer Request Form Dater: ‘1st Applicant's Name": i 2nd Applicant's Name": ‘Account number: Mobile Number: (Fields marked" are mandatory) “Kindly fill only those boxes where information isto be added or updated. On s acknowledgement* (Kindly tick the boxes against the request opted for) ADD/UPDATE PERSONAL DETAILS (17 1. Update KYC 1D Type:LJ PAN [_] Aadhar [“]Oriving License_]Passport (voter DC] NREGA Card Document number. (Attach selhattested copy of document for verification with original) Place of Issue Issue Date Vali tit date 2. Address Changal_I Permanent [_] Correspondence [_]Both (Please leave space between two, ‘words/digits) submission of form always ask for Address line 1: ‘Address ling 42.0 ‘Address Line 2 Address Line 20 ‘Address Line Address Line 3: Document Type: LIPAN [] Aadha® (Ipriving License] Passport(] Voter IDL] NREGA Card (Mandatory for Permanent Address Change) [[]3-Add FathernMother/Spouse name: [4+ Please Seed/update my Aachar Number inthe account number mentioned above for DBT purpose: — (strike out whichever is not applicable) 5: Please delete my Aadhar Data frm the account Number mentioned above, my Aadhar No CS: PAN: oP. emai [8 Change my Tie to: t i 1 ® Change ry Neimrs eg Gon Garete NOVction 7 Warage Certfeate to Be attached) [C1 10. Change mobile number to OTHER ACCOUNT/CIE MODIFICATION; 7f- Transler [Account [VEIF [th To Branch Name Branch Code: 412. Change mode of operation in above mentioned account to: Li'sett’ L] Either or Survivor LiFormier or Survivor [Vointly [7] As per mandate enclosed 1 1a, Request to activate my inoperative/Dormant account (number mentioned above): Reason for dormancy: 1 14.Convert my account from Minor to Major as | became Major on [0 15. Change Alc Type to: Salary Package Variant: Corporate/Defence/Others{__|Savings Bank to NRO [1 current Account Variant: Regular/Gold/DiamondiPlatinum | | ee 16. Change my signature in above mentioned account i OLD SIGNATURE NEW SIGNATURE © scanned with OKEN ScannerC17. twe request to close above account and pay the balance by: Cash Gredit 1 account no. FIXED DEPOSIT/PPF ACCOUNT RELATED SERVICES C0 18. Please change the tenure of my/our Fixed deposit AIC NO. mmm——rvmmm———— [Op Tar Resse Term Dapost aves Tor NC number; (7-20: Presse es0e TOSTITeTeST ceriicaTa Tor Recount Numbers: OTHER ACCOUNT RELATED SERVICES (121. Passbook required: Yes/No [I No, Request for statement of account through e-mall i [RE ReqUEST TO Tésue Duplicate Passbook for the Account Number: [1)23. Request to activate Phone Banking/Mobile Banking services in the above-mentioned acca 1.24, Standing Instruction: Please transfer Rs. ____.to RO/Loan/SB Account Number ram to unt. Starting trom date, Every altemate Dally/Monthly/End of Month [.25. Setup Auto-sweep facility - Saving Plus Threshold amount: Rs ay ‘Sweep time: Weekly/Monthly Under reverse sweep faciity the MOD (Mul-option deposi) tobe broken by: Last in First OuMF NOMINATION 1026. Nomination to be modified in my account mentioned above: New/Change/Delete DA? form to delete nomination and DA-3 form to change in Last out (Please fil and attach DA-1 form for new nomination, nomination) 2127. Nomination o be modified: [Add/Modt] in the scheme APYIPM.JJBYIPMSBY/PPF APY RELATED SERVICES 1 2a.Request to update the pension amount for APY from RS to 1900/2000/3000/4000/5000 1 hereby authorize the bank to debit my above mentioned bank account til the age of 60 for making payment Unger APY as applicable based on my age and the Pension Amounts elected by me. (CHEQUE RELATED SERVICES (21z.cheque book facility: Please provide cheque book facility in my account number mentioned above. [D30.New personalized cheque book request: Number of leaflets: 10/20/25/50/100 Name on cheque: oe Sea EEE AP ‘Address to be delivered to: PermanentiCorrespondence/New (C31. Request to stop (number of cheques) Cheque number listed below/attached Starting from ‘ending at. ‘or Cheque number: Cheque number: Cheque number: cheque number: Cheque numbe’ DEBIT CARD SERVICES D2, ATM card issuanco (Charges willbe deducted as applicable): NewReplaco Address to be devered to: PermanentGorrespondonco Name on card: © scanned with OKEN ScannerC 83. Block/ Unblock debit card number; INTERNET BANKING SERVICES 1 34. Activate Internet Banking in the above mentioned account. Kitnumber (for official use only): C1 35. Request to: Reactivate the usemame/Re-issue login password/Reset the INB profile password Date of Birth: C1 Wish to receive the Pre-Printed Kit (PPK) at address mentioned in my account 1 36. internet Banking rights modification : Full Transaction rights/Limited Transaction rights O37, Request to add beneticiary to INB: Reference Number, Beneficiary name: Beneficiary account No: | Beneficiary Bank/Branch: IFS Code: Limit (INR): Rs: PENSION SERVICES D2 38.1 wish to submit Lite Certilicate for PPO no; 2 for the Month, Year___ 1 39Please issue Pension Certiticate/Slip for PPO no: D0 40Please issue Form 16 for PPO no; ( 41.Pensioners Grievances (Pension not credited/Life Certificate not updated) ° LOCKER SERVICES i [B 42.Request for Allotment of Locker: (Size): Small/Medium/Large/Extra Large 1 43. Request to add Nomination o Locker number: 2 (Duly filled in nomination form's tobe attached) Ti 44,Request for Locker Conversion from Single to Joint: Locker No. Name of Joint Holder: ‘Account no. of Joint Holder: “ O45. Request for closure (Surrender) of Locker No: Bearing Key No: B46. Request for break open of Locker No: | have read, understood and agree to the Terms and Condltions of various products and services including SMS ‘alerts, Debit card and Intemet Banking. | accept and agree to be bounded by the Terms and Conditions as ‘Gisplayed on bank.sbi. | agree that the bank may debit service charges plus taxes to my account whenever ‘Spplicable. | wish (9 seed this account with NPC! mapper to enable me to recelve Direct Benefit Transfer (DBT) of nia (GO) tnt account. Fly Brus the number ef Roqucts submited coun and ontar numberof ike in the checkboxes) — ‘Second account holder's Signature of Branch | sna Ofisal win Sono. | ACKNOWLEDGEMENT. Customer Name: Date of Request Received: Employee Number: Name of Branch Official: Signature: Please note: Your request willbe processed within 2 working days. Delivery of kis/cheque book etc. f0 your address will ake between 7-15 working days (depending on delivery locaton) © scanned with OKEN Scanner