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New Debit Card Application Form

This document is an application for a debit card from Indian Overseas Bank. It requests basic applicant information like name, address, contact details, account details, date of birth, PAN/GIR number, and annual income. It also asks if the applicant wants a new card, replacement card, or upgrade. The applicant must declare that they understand all ATM, POS, and e-commerce transactions done with the card will be binding. The application is signed to agree to the bank's debit card terms and conditions, which are subject to change. For branch use, it records any charges collected, the application reference number, and notes that the debit card may be issued once approved.

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2K views1 page

New Debit Card Application Form

This document is an application for a debit card from Indian Overseas Bank. It requests basic applicant information like name, address, contact details, account details, date of birth, PAN/GIR number, and annual income. It also asks if the applicant wants a new card, replacement card, or upgrade. The applicant must declare that they understand all ATM, POS, and e-commerce transactions done with the card will be binding. The application is signed to agree to the bank's debit card terms and conditions, which are subject to change. For branch use, it records any charges collected, the application reference number, and notes that the debit card may be issued once approved.

Uploaded by

useful seconds
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
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INDIAN OVERSEAS BANK

APPLICATION FOR DEBIT CARD


Branch Name _____________________________Branch Code Customer ID_________________

*Applicant’s Name Mr./Ms.


Address/Telephone *Residence Office
Door No/ Street
*City/District/State
*Pin Code
*Mobile No:
Email ID:
*Account Details: SB CD CC *A/C No.

*Date of Birth: *PAN/GIR No.


*PASSPORT No:__________ *Annual Income: Rs._________ Nationality: _________________ NRI YES NO

*Card Requested for: New Replacement Upgrade Personalised Card Insta Card

If Replacement: Reasons Lost Damaged

**Important Notice: As per RBI guidelines, cards will be issued for Domestic ATM/POS usage only. At
the time of Card activation, ECOM, Contactless and International Operation can be enabled, based
on the specific request.

DOMESTIC INTERNATIONAL CONTACTLESS TRANSACTIONS YES NO

ATM ATM
OFFLINE WALLET FACILITY YES NO
POS POS
ECOM ECOM

*TYPES OF THE CARD


RUPAY VISA MASTER
Classic Classic Platinum
Platinum Gold Signature Classic /Gold
PMJDY/Mudra/Kisan SME

Declaration:
I/We declare that the above information is true and correct. I/We clearly understand that all operations effected
through this Debit Card at any of the ATMs/PoS/Ecom are binding on me/us. I/We have read the terms and conditions
governing the use of Debit Card Facility and agree to the terms/conditions and also agree to abide by any
amendments stipulated by the Bank from time to time.
*Signatures (in case of joint accounts operated by anyone or survivor, all account holders to sign the application)
No. Name Signature No. Name Signature

FOR BRANCH USE:


Charges, where applicable, recovered: Rs.__________Application Ref No.__________________
*Roll no. of the applicant, in case of staff: _____________Application Processed & Bonafides Verified.
Debit Card may be issued.
Card No:________________________________________
Date: ________ Entered By: ___________________Approved By:________________

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