CUSTOMER INFORMATION FORM

(For Resident & Non-Resident Individual)

in case of RKIT -
'Paste RKIT Sticker duly signed by the customer and date'
OR 'Existing Cust ID in case modification required

(Please fill the form in BLOCK LETTERS and SAME INK only. THIS IS A MACHINE READABLE FORM AND WILL PASS THROUGH A SCANNER) Tick boxes as applicable.
(Separate CIF to be filled for joint holder/s) *Mandatory Fields

CKYC Number: Existing CIF ID : Update Application Date 3 0 1 1 2 0 2 3

Bank Use *Capacity of Individual Auth. Signatory Guardian Beneficial Owner Case Type: R-Kit Non R-KIT
Only: Customer: Auth. Signatory & Beneficial Owner Other NA

1. *PERSONAL DETAIL

*Title Mr. Ms. Mrs. Mx. Dr. Others (Please Specify)

S A C H I N K U M A R
*Full Name
Same as ID proof

*Date of Birth 0 1 0 1 2 0 0 2 Minor Yes No

(Please Provide Guardian Details)

*Gender Male Female Transgender *Marital Status Married Unmarried Others

* Father/ S U R E S H C H A N D R A
Spouse Name (Prefix)

*Mother’s Name K A M L E S H D E V I
(Prefix)
*Nationality *Date of becoming NRI
I N D I A N
Country Name
*Religion Hindu Muslim Christian Sikh Zoroastrian Jain Buddhist Others
*Category SC ST OBC General Others
Applicants
Maiden Name (Prefix)

*Are you a Politically Exposed Person or related to one Yes No If PAN not available Father's/Spouse name is mandatory

2. *CUSTOMER PROFILER

ICIF/31052023/Ver
*Educational Qualification Illiterate Undergraduate Graduate Post Graduate Professional
*Employment Type Salaried Politician Self-employed Professional Housewife Retired Student
Diplomat Unemployed Farmer Infant

Employer Name NA If Director Yes No If Yes, Director ID number :

(For Salaried) Mandatory if Director

*Occupation Doctor CA/CS Lawyer Architect Engineer Consultant Agriculturist Others

*If Agriculturist Landless Laborer Below 2.5 Acres of Land 2.5 - 5 Acres of Land Above 5 Acres of Land
*Source of Income Salary Business Income Investment Income Agriculture Dependent Fees/Commission/Brokerage
Gross Annual Income <= 60 K 60K-1.2 Lakh 1.2 - 2 Lakh 2-3 Lakh 3-5 Lakh 5-10 Lakh 10-50 Lakh >50 Lakh-1Crore >1 Crore

*Type of Company/Firm Proprietorship Partnership LLP Private Ltd. Public Ltd Unlisted Public Ltd Public Sector Government
(For Salaried/Self-employed)
*Industry type
(For Salaried/Self- Manufacturing Construction NBFC Non Profit Organization Micro Enterprises Others
employed/Diplomat)

3. ADDRESS DETAILS
*CURRENT ADDRESS (For Bank Use:- Address Proof Submitted Officially Valid Document (OVD)/ Deemed OVD)

*Address Type: Permanent Overseas Others *DOCUMENTS GIVEN FOR CURRENT ADDRESS PROOF Mailing Address Yes No
*HouseNo.&Building Name/No v i l l a g e n a g a l a r u n d h
*Road/Street Name/No. . . . .

*Landmark . . . . *City N a r k h i D h o n k a l

*State U t t a r P r a d e s h *Country I n d i a *Pin Code 2 8 3 2 0 6

OTHER ADDRESS

*Address Type: Permanent Business Office Overseas Mailing Address Yes No

*HouseNo.&Building Name/No

*Road/Street Name/No.

*Landmark *City
*State *Country *Pin Code

2. FATCA / CRS Declaration

*RESIDENCE FOR TAX PURPOSE IN JURISDICTION(S) OUTSIDE INDIA Yes (If yes, mention the following details) No (If, no rest of the fields are not mandatory)

Tax Identification Number or equivalent TIN Description

Country of Tax Jurisdiction TIN Issue country
City of Birth Country of Birth

Page 1 of 4
 5. *ADDRESS IN THE JURISDICTION DETAILS WHERE APPLICANT IS RESIDENT OUTSIDE INDIA FOR TAX PURPOSES* (Applicable if Section 4 is
ticked Yes)

*Address Type: Residential Business

**Company Name
*House No. & Building Name/No
*Road/Street Name/No.

*Landmark *City
*State *Country *Pin Code

6. *CONTACT DETAILS

Office Country Code STD Code Tel. Residence Country Code STD Code Tel.

*Mobile *Country + 9 1 8 4 4 5 3 5 1 9 5 3
OTP will be sent to this mobile Code In-case Mobile number is not provided, you will not receive timely information on important notification and transaction alerts in your account from
number Bank

*Email ID s a c h i n n a y a k 9 @ g m a i l . c o m
Please consider opting for environmental friendly e-statements by furnishing your correct email ID

7. *KNOW YOUR CUSTOMER (KYC) DOCUMENTS

*Proof of Identity (Is your proof of address same as proof of identity? Yes No) *Proof of Current Addresss (^^If current address other than OVD)
Aadhaar UID Voter ID Driving Licence NREGA Job Card Utility bill Letter of allotment by SG/CGD
Passport (Mandatory for NR customers) Others Property/Municipal Tax receipt PPO's
Proof of Identity 1 Embassy letter Others
*Document ID. No.
*Document ID. No. 1 3 3 3 4 1 4 6 7 9 4 6
(Do not write Aadhaar No. here)
(Do not write Aadhaar No. here)
*Issuing Authority:
*Issuing Authority:
(If other than Indian Passport - fill PIO Declaration)
(If other than Indian Passport - fill PIO Declaration)
Place of Issue: Issue Date:
Place of Issue: Issue Date:
*Document Expiry Date
*Document Expiry (Applicable for Driving License & Passport
only) (Applicable for Driving License & Passport only)
Date
Note: ^^ Customer shall submit OVD with current address within a
Proof of Identity 2 period of three months of submitting the deemed OVD documents.
*Document ID. No.
(Do not write Aadhaar No. here)

ICIF/31052023/Ver
*Issuing Authority:
(If other than Indian Passport - fill PIO Declaration)
Place of Issue: Issue Date:
*Document Expiry (Applicable for Driving License & Passport
only)
Date

Visa type / Residence Permit (Not applicable for PIOs) Aadhaar No. (Only mention last 4 digits)

Temporary Long Term Work Student (Kindly select Aadhaar if it is provided as Proof of Address in the section above)
Visa type
Immigrant Dependent Others *Branch use section only (Mandatory if Aadhaar No. provided)
Residence Permit Yes No Aadhaar Ref Key 1 3 3 3 4 1 4 6 7 9 4 6
Visa type / Residence Permit Expiry Date Maker ID Maker Sign:
(In case of temporary visa, fill in Declaration) Checker ID Checker Sign:

Form 60 (Form 60 declaration to be filed by a person who does not have a Permanent Account Number and
*PAN Card K O I P K 9 8 5 7 P OR
makes payment in cash in respect of transaction specified in clauses (a) to (h) of rule 114B)

8. GUARDIAN DETAILS FOR MINOR (Mandatory Only If Applicant is Minor)

Name of Parent/Guardian Customer ID declare that

I am the minor's natural guardian or I am the lawful guardian appointed by the court order dated (copy enclosed).
Guardian’s Signature

9. *DECLARATION
I/We, declare that the information furnished by me/us is true and correct. I / We, the undersigned have read and understood and agree to abide and be bound by all the
provision of the Terms & Conditions published on the bank’s website www.rblbank.com governing the opening of all my / our accounts, present and future with RBL Bank and
those relating to various service including but not limited to ATMs / Debit Card / Mobile Banking / Internet Banking / Phone Banking / Bill Payment Facility etc. I / We hereby
confirm having read, understood and accepted the terms and conditions of card usage and opt the above transactional options. I / We agree not to share the card number,
CVV, OTP, PIN, etc. to anybody including but not limited to Bank officials. I / We understand that the Bank may at its sole discretion discontinue any of the services
completely or partially without any notice to me / us. I agree that the Bank may debit my account for service charges as applicable from time to time. I / We agree that if the
premature withdrawal is permitted at my / our request, the payment of interest on the deposit may be allowed in accordance with the prevailing stipulations laid down by
the Bank / Reserve Bank of India from time to time. I / We authorized the Bank or its agents to make reference / enquires as may be necessary and to exchange / share /
part with any / all information with the Bank’s other branches / subsidiaries / affiliates, Credit Bureaus / Rating Agencies, Services Providers, banks / financial institution,
governmental / regulatory authorities, third parties for KYC information verification, credit risk analysis, or for other related purposes that the Bank may deem fit. I hereby
state that I have no objection in authenticating myself with Aadhaar based authentication system and consent to providing my Aadhaar number, Biometric and / or One
Time Pin (OTP) data (and / or any similar authentication mechanism) for Aadhaar based authentication. I consent to receiving information from Central KYC Registry through
SMS / Email on the above registered number / email address. I / we hereby consent to uploading the required information on CKYC Registry.
I/We hereby agree and undertake to send Instructions to RBL Bank by email from the email address registered with the bank. I/we hereby further agree and undertake to
exempt RBL Bank from any and all responsibility of such misuse and receipt of information through my registered email ID, and hold RBL Bank harmless for any costs or
losses that I/We may incur due to any errors, delays or problems in transmission or otherwise caused by using the Internet as a means of transmission. I/We understand that
the bank may attempt to authenticate all requests received on e-mail, prior to executing the transaction.
a. RBL Bank, would like to use your personal details in the application form from time to time to send you marketing information /contact you to inform about products,
services or promotional offers that are offered by RBL bank, on its own and in collaboration or through tie-ups with partners/ third parties. By giving your preference below
you either allow or disallow RBL Bank to contact you through SMS, phone calls and Emails :
Yes, Bank can contact me No, Bank may not contact me
b. I/We authorize the Bank to share, disclose, exchange, or use in any manner whatsoever, without any further specific consent or authorisation from me/us, the
information/data provided by/related to me/us to the Group companies/Associates/Subsidiaries/Affiliates/Joint Ventures of RBL Bank/ any person with whom the Bank has
entered/propose to enter into an arrangement for provision of ‘services/products’ for the purpose of marketing/offering/selling any product/services offered by Bank.
Yes No, I do not consent to share, disclose, exchange, or use my information/data .

Page 2 of 4
 9. *DECLARATION (Contd..)

I/We wish to update our existing CIF as per the details provided in this Customer Information Form.
NR Declarations (Tick as applicable)
PERSON OF INDIAN ORIGIN (PIO) DECLARATION (Status proof is mandatory)
I was citizen of India and held an Indian Passport in the past OR
I was a citizen of India by virtue of the Constitution of India or the Citizenship Act, 1955 (57 of 1955) OR
I belonged to a territory that became part of India after the 15th day of August 1947, OR
I/my father / mother/ grandfather / grandmother/ great grandfather/ great grandmothers is / was a
citizen of India by virtue of the Constitution of India or the Citizenship Act, 1955 (57 of 1955) OR belonged to a territory that became part of India
after the 15th day of August 1947 OR
My spouse held an Indian passport in the past OR
My spouse or my spouse’s father/ mother / grandfather / great grandfather/ grandmother / great grandmother is
/ was a citizen of India by virtue of the Constitution of India or the Citizenship Act, 1955 (57 of 1955) OR belonged to a territory that became part
of India after
the 15th day of August,1947
Note: PIO includes an ‘Overseas Citizen of India’ cardholder within the meaning of Section 7(A) of the Citizenship Act, 1955

Seafarers’ declaration
I hereby declare and confirm that I am a Non-Resident Indian and I am presently on contract with
company registered in (address of the principal). I confirm that I will inform the Bank in case I do not renew my
contract or choose to go on a new contract OR I am unable to proceed on a new contract or in any case in the event that my status of Non-
Resident Indian is altered. Accordingly, I will have the Non-Resident accounts in my name redesignated to Resident accounts.

Temporary Visa Declarations

I/We have submitted my/our temporary visas work/Residence dated expiring on . I/We hereby
agree to furnish the bank with copies of my/our regular visa/s immediately on issuance and confirm that I/We do not have any objections if the
bank freezes transactions in the account or closes the account if I/We do not submit copies of regular visas within 3 months form the date of
expiry of Visa.

10. *CUSTOMER SIGNATURE

(Please do not sign this form if it is BLANK. Please ensure all relevant sections and columns are completely filled to your satisfaction and only then
sign the form)

ICIF/31052023/Ver
Signature

Name SACHIN KUMAR

Date 3 0 1 1 2 0 2 3 Place Narkhi Dhonkal

11. ARE YOU INTERESTED IN THE FOLLOWING PRODUCTS

Personal Loan Credit Card Home Loan Auto Loan

12. * FOR OFFICE USE ONLY

Account type Normal Simplified (for low risk customer) Small Walk-in customer: Yes No
Face to Face Customers: I have visited Mr. / Ms. at his/her current address. I
hereby confirm the identity and address. The form has been filled and signed in my presence. The original documents have been verified by me.
(Not applicable for Salary Accounts Opened at Corporate location).
For Non-Face to Face Customers: I confirm that we have obtained ID and address documents as per the KYC policy from the customer and have
spoken to.
the customer on CKYC Digilocker Receipt of physical third-party certified copies

*Branch Code Branch Name

Emp. ID: Lat: Long:
Signature of Bank Official & stamp
Emp Name:
Emp Designation:

*Staff Indicator - Employee ID: *Constitution: PIO Individual Pensioner (Other than RBL) RBL Staff (Ex/Existing) NRI Foreign National
Customer
Individual HNI Foreign students Person of Indian Origin/OCI Foreign national
(for RBL Bank emp. Only) Type:
Special Blind Illiterate Incapacitated PEP Relative to PEP
Category: Differently Abled Persons (DAP) Not Applicable

*LC Code: (Sourcing Code) *Primary Relationship Manager ID: *Business Segment:
*LG Code: (Lead Generator) Secondary Relationship Manager ID: Customer Segment:

Weaker Section (Only for Assets): *BSR Type of Organization:

4th Line Embossing: For approved cases only

MIS Code 1: MIS Code 2: MIS Code 3: MIS Code 4: MIS Code 5:

*Emp. ID:
Checked by - Signature of Bank official *Emp Name:
*Emp Designation:

Page 3 of 4
 ICIF/31052023/Ver
Page Intentionally Left Blank

Page 4 of 4
 ACCOUNT OPENING FORM
(For Resident Individual)

BARCODE
(Please fill the form in BLOCK LETTERS and SAME INK only. THIS IS A MACHINE READABLE FORM AND WILL PASS THROUGH A SCANNER) Tick boxes as applicable.
(Separate CIF to be filled for joint holder/s) *Mandatory Fields

Open my/our Account in Branch Name Application Date 3 0 1 1 2 0 2 3 Branch Code:

Savings Account 3 0 Current Account 4 0

Prefix Preferred/R-KIT Account Number Prefix Preferred/R-KIT Account Number

1. *APPLICANT(S) FULL NAME (Fill separate CIF form for each Account Holder)

Title Mr. Ms. Mrs. Mx. Dr. Others (Please Specify)

S A C H I N K U M A R
1st Applicant Cust ID No. (If existing)

2nd Applicant Cust ID No. (If existing)

3rd Applicant Cust ID No. (If existing)

2. *NATURE OF ACCOUNT(S) to be opened

Saving / Salary SBDG1 Current

Fixed Deposit (FD) Futuristic RD
Recurring Deposit (RD) Smart Deposit (SD)
*AMB ₹ *Average Monthly Balance - for Savings & Current Account

3. *MODE OF OPERATION

Singly Either or Survivor Former or Survivor Anyone or Survivor Joint Others

(No transaction rights to survivor)

Note: If Non Resident individual is joint holder, relevant declaration to be submitted.

RIAOF/31052023/Ver1
4. WHAT WOULD YOU NEED TO MAKE YOUR BANKING EASIER

Note: i. No cheque book or debit card will be issued to survivor under Former or Survivor mode of operation. ii. No Net Banking and
Cheque Book Yes No Debit Card will be issued in Joint Operation accounts. iii. You may obtain your personalized passbook from the branch after the account
activation. iv. No Cheque book will be issued if the account is opened with Thumb Impression.

Debit Card (Not applicable for FD/RD/SD/Jointly operated account)

Card
1st Appl.: Yes No Classic/Titanium Platinum Insignia Crest Signature+ Enterprise Pinnacle Others
Variant:
Card
2nd Appl.: Yes No Classic/Titanium Platinum Insignia Crest Signature+ Enterprise Pinnacle Others
Variant:
Card
3rd Appl.: Yes No Classic/Titanium Platinum Insignia Crest Signature+ Enterprise Pinnacle Others
Variant:

For R-Kits Issued only

Daily Default Daily Default POS & #Daily Contactless
Enable Transaction Type Domestic International Card Variant
ATM Limit Online/CNP Limit Transactions Limit
ATM Enabled Yes No Platinum/Crest ₹1 Lakh ₹2 Lakh ₹5,000/-
Point of Sale (POS) Enabled Yes No Classic ₹50,000/- ₹1 Lakh ₹5,000/-
Online/CNP^ Yes No Yes No Business Card ₹1 Lakh ₹2 Lakh ₹5,000/-
#Contactless Transactions Yes No Yes No Rupay Card ₹50,000/- ₹30,000/- ₹5,000/-

Notes: i. Only EMV Card will be issued. ii. ATM and POS transactions within India are enabled by I/We have been informed of the charges of the card selected
default. For any other categories of transaction, respective settings will be in accordance with the and I / we hereby consent to debiting of these charges from
selection made by you in this form. iii. Only domestic cards are provided to customers who have
the linked account.
submitted Form 60 & NRO accounts. iv. In case you are mapped to a particular segment / type of
account, debit card for the respective segment / type of account will be issued. v. The default
limits (listed above) are applicable for both domestic & international transactions. These limits
will be activated as per your selection. You can also enable/disable/modify the transaction
rights/limits post issuance of the Debit Card through Internet banking / Mobile banking /IVR /
Branch. vi. In case of Non R-Kit, your Debit Card is / will be, dispatched to you in an ‘Inactive’
status. To activate the Debit Card, you must first generate your PIN. Signature of Applicant 1
(Only in case R-kit is issued)
^CNP - Card Not Present transactions (Online E-Commerce, IVR, On-call/Phone Orders,
transactions etc.)
For contactless debit cards only
†International debit cards only

SMS Alert You will be registered for e-mail/SMS alerts as selected: Credit/Debit transactions greater than r 5000 for current account and r
EMAIL Alert 2000 for savings account. For applicable charges, visit your nearest branch or www.rblbank.com. You will receive default
mandatory alerts from RBL Bank.

5. *MODE OF FUNDING

Initial Amount ₹ In Words

Cash^
Cheque No.@ Date Drawn on Bank Branch
Debit my RBL Bank Account Number
^If the Initial amount of account opening is in cash then customer should visit the branch in person and obtain official receipt.
@Cheque should be crossed A/c payee and drawn payable to 'RBL Bank Ltd. A/c. < Applicant's Name>'
Page 1 of 4
 6. DEPOSIT DETAILS

I/We wish to book a Callable FD Non - Callable FD (Declaration in prescribed format is mandatory.)
Amount ₹ Value Date (In case of RD, value date will be SI date)
Amount in Words
Cash^
Cheque No.@ Date Drawn on Bank Branch
Debit my RBL Bank Account Number
^If the Initial amount of account opening is in cash then customer should visit the branch in person and obtain official receipt.
@Cheque should be crossed A/c payee and drawn payable to 'RBL Bank Ltd. A/c. < Applicant's Name>'
Tenure Months Days Rate of Interest : . % p.a.
Interest Payout Interest Pay out Frequency Calendar days
Monthly Quarterly Yearly At Maturity
Frequency
Renew Principal & Interest Renew Principal & Repay Interest Deposit Anniversary
Maturity Instructions
Do not Renew Sweep-In Instruction: Sweep-In Facility Yes No
Interest/Maturity Savings /Current
DD/PO OR
payment to
Account Number
I am the minor's natural guardian or
Account Number IFSC code

In case you wish to credit the fixed deposit maturity proceeds to other bank, kindly provide us with a cancelled cheque of the beneficiary bank
For Premature withdrawal of joint FD booked through any channel and where mode of operation is 'Either or Survivor' or 'Former or Survivor', I/we
agree in the event of death of one of the depositors, the bank shall be discharged by paying the Fixed Deposit proceeds prematurely to the
survivor/s on request.
Callable deposits - Customers can perform partial / full premature withdrawal.
Non-Callable deposits - Customers cannot perform premature withdrawal
Note: i. In case if we do not receive specific instruction from you before maturity of the Fixed Deposit, we will renew the Fixed Deposit for the original term as of the Fixed
Deposit, at the applicable rate of interest prevailing on the day of maturity / renewal of Deposit. On full / partial pre-mature withdrawal of the FD, the interest will be paid at
the rate applicable for the period for which the FD has actually remained with the bank, subject to a penalty of 1%. ii. In case of insufficient balance, the linked Term Deposit
shall be broken prematurely on Last In First Out basis (in the order of set-up of Sweep in instructions) and the required amount shall be transferred to the Saving / Current
Account. This facility is allowed if First account holder is common in the Saving / Current Account and Fixed Deposit Account. In case of the Saving / Current Account enjoying
OD facility against FD, then Sweep-in facility will not be allowed. iii. On pre-mature withdrawal of the RD / SD, the interest will be calculated at rate applicable for the period
for which RD / SD has actually remained with the bank, subject to a penalty of 1%. Penalty for missing instalments will be 1% of instalment amount for each month
instalment is missed. This penalty will be deducted from maturity amount. Maturity Proceeds of RD/SD will be credited only to the account the monthly instalments are
debited from. iv. To avail senior citizen Rate of Interest, ensure Date of Birth is updated in Bank account. Special rates available for staff and senior citizens are not
applicable for NRE / NRO / FCNR / RFC deposits.

RIAOF/31052023/Ver1
7. GST DETAILS (GSTIN will be mapped only to the account which is getting opened through this form)

GSTIN

8. *NOMINATION FORM DA1

(A. Please choose one of the available option B. Appointee and account holder should not be same)
Nomination under Section 45ZA of the Banking Regulation Act 1949, and rule 2(1) of the Banking Companies (Nomination) Rules 1985 in respect
of bank deposits.
I/We require nomination facility
I/We do not require nomination facility. I/We understand & acknowledge the risk & consequences associated with nomination not given by me.
*I/We
whom in the event of my /our/minor’s death the amount of deposit in the account may be returned by RBL Bank Ltd
Nomination details to be displayed on statement / passbook: Yes No

Nature of Deposit Distinguishing No.

Additional details (If any)
Nominee Name
Nominee Address
Relationship with Depositor (If
*Date of Birth of Nominee
any)
**As the nominee is a minor on this date, I/We appoint to receive the
amount of the deposit in the account on behalf of the nominee in the event of my /our/minor’s death during the minority of nominee.
Relationship with the minor : Address : Same as primary applicant
Address if different from primary applicant :

*Signature of 1st Applicant *Signature of 2nd Applicant *Signature of 3rd Applicant

***Witness

Name Name

Signature*** Signature***
Address Address

Date Place Date Place

*** Witness(es) required only if the depositor is giving thumb impression and not signature. (Witness can be i. Both Bank officials, ii. Both third party or iii. 1 third party and
1 Bank official)
** If deposit is in made in the minor's name the nomination must be signed by a person lawfully entitled to act on behalf of minor

Page 2 of 4
 9. FOR CORPORATE SALARY ACCOUNTS (Mandatory in case of Corporate Salary Account)

Company Name Company Code

Employee Code Designation

Designated Officer's Name Date

Designated officer's Signagture Company Seal

9. FOR CORPORATE SALARY ACCOUNTS (Mandatory in case of Corporate Salary Account)

In case of individual current account separate declaration to be obtained

10 A. MANDATORY (in case of Individual Current Account)

*Source of Income Business Income Investment Income Agriculture Others

*Expected No. of Transactions Annually <250 250 - 500 500 - 1000 1000 - 2500 >2500

*Expected Transaction Amount - (in ₹)

*Cash Deposits - Annual (in ₹) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.
*Cash Deposits - Annual (in ₹) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.
FCY Inward - Annual (in USD) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.
FCY Outward - Annual (in USD) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.
*Domestic Inward (in r) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.
*Domestic Outward (in r) 0-5 Lakh 5-10 Lakh 10-25 Lakh 25-50 Lakh 50 Lakh-1 Cr. 1-5 Cr. 5-10 Cr >10 Cr.

11. *DECLARATION
I/We declare, confirm, agree:
a. That all the particulars and information given in the Application Form are true, correct, complete and up to date in all respects and I/we have not with-held any
information.
b. That I/we have had no insolvency initiated against me/us nor have I/we ever been adjudicated insolvent.
c. Declaration under 'Foreign contribution (Regulation) Act, 2010 and foreign contribution (Regulation) Rules, 2011'
1. I/We confirm that as part of the regular operations, I/We do not receive any foreign contribution from abroad and if in future we will be receiving the same then we will
inform the bank in advance with sufficient notice.
OR

RIAOF/31052023/Ver1
2. I/We confirm that as a part of the regular operation, we receive foreign contribution from abroad. Separate approval from ministry of home affairs (MHA) has been
sought for crediting the foreign contribution with the FCRA account with Bank which has been opened specifically for such
FCRA credits and I/We confirm that in the account with RBL Bank, no foreign contributions will be credited. I/We also confirm that approval obtained for the FCRA
account specific as well as Bank and Branch specific.
d. I/We hereby agree and undertake to send Instructions to RBL Bank by email from the email address registered with the bank. I/we hereby further agree and undertake to
exempt RBL Bank from any and all responsibility of such misuse and receipt of information through my registered email ID, and hold RBL Bank harmless for any costs or
losses that I/We may incur due to any errors, delays or problems in transmission or otherwise caused by using the internet as a means of transmission. I/We understand
that the bank may attempt to authenticate all requests received on e-mail, prior to executing the transaction.
e. a. RBL Bank, would like to use your personal details in the application form from time to time to send you marketing information /contact you to inform about products,
services or promotional offers that are offered by RBL bank, on its own and in collaboration or through tie-ups with partners/ third parties. By giving your preference
below you either allow or disallow RBL Bank to contact you through SMS, phone calls and Emails :
Yes, Bank can contact me No, Bank may not contact me
b. I/We authorize the Bank to share, disclose, exchange, or use in any manner whatsoever, without any further specific consent or authorisation from me/us, the
information/data provided by/related to me/us to the Group companies/Associates/Subsidiaries/Affiliates/Joint Ventures of RBL Bank/ any person with whom the Bank
has entered/propose to enter into an arrangement for provision of ‘services/products’ for the purpose of marketing/offering/selling any product/services offered by
Bank
Yes No, I do not consent to share, disclose, exchange, or use my information/data.
There is no change in my KYC details updated under my Customer ID (Tick if applicable else submit a fresh CIF )

12. *CUSTOMER SIGNATURE

(Please do not sign this form if it is BLANK. Please ensure all relevant sections and columns are completely filled to your satisfaction and only then sign the form)

Name of 1st Applicant Name of 2nd Applicant Name of 3rd Applicant

13. ACKNOWLEDGEMENT

Received application for Savings Current Fixed Deposit Recurring Deposit Smart Deposit
Initial Payment Details
Initial Amount ₹ In Words Ref No
Please Quote your reference No. for any
communication
Cash ₹
Cheque No.@ Date Drawn on Bank Branch
Signature of Bank Official
Debit my RBL Bank Account Number Branch Code
Note: DD/PO/Cheque subject to clearance
Amount Tenure Interest Rate % p.a Date
Only for FD or RD - Monthly Installment

Dedicated team of phone Email us as: Website:

banking For Resident/Non Individual Customers: [email protected] www.rblbank.com
officers available 24X7 - For Non Resident Customers: [email protected]
Call us on:+91 22 61156300

SMS Banking: MoBank Login to Internet Banking: Debit Card:

Type HELP & send to Scan here to download the www.rblbank.com and enjoy Best in class features &
9223366333 latest version of RBL MoBank easy access to your account benefits choose the one
for all SMS Banking Enquiries 2.0 - mobile banking app that suits you the best

Page 3 of 4
 14. *OFFICE USE SECTION

SITE VERIFICATION
I confirm that I have visited the Current address of the customer and *Branch Code:
confirm that I have met Mr/ Mrs/Ms. Emp. Branch:
Lat: Mandatory for Individual Current
Account
I hereby confirm the following details: Long: Mandatory for Individual Current
Account
Identity Address Fill up the form & Signature in my presence Signature of Bank Official &
stamp Emp ID
Verification of copies with the original documents
Lat & Long Location Name of the Emp.:
Customer Business in line with the profile (Applicable for Emp. Designation:
Individual current account)
Note : Site Verification Not applicable for Salary Accounts Opened at
Corporate location.
*Funds Branch code *Value Date *Business Segment:
*Funds Parked at Account Customer Segment:
*URN/Transaction ID: (URN not applicable for R-Kit) Exports/Imports involved: Yes No

* Primary RM Code Secondary RM code *LC Code *LG Code

*Risk Categorization L M H *BSR Type of Organization PEP CRPEP

Promo Code 1 Promo Code 2 Promo Code 3 Checked by: Name of official

MIS Code. 1 MIS Code. 2 MIS Code. 3

Emp ID
MIS Code. 4 MIS Code. 5 MIS Code. 6
Signature:

15. MOST IMPORTANT TERMS & CONDITIONS

Savings/Current Bank Account:
1. On activation of the A/c customer may request for free personalised passbook and / or cheque book by visiting nearest branch. Customers will receive monthly E-
Statements on registered Email ID. Physical statements are provided on customer’s specific request. Cash withdrawals from Savings Account (subject to applicable
limits) permitted using withdrawal slips accompanied by passbook and identification documents subject to applicable limits.
2. Savings account Interest is paid quarterly on daily closing balance at rates announced by the Bank from time to time. Any change in Savings Bank interest rates shall be
informed to the customers via SMS/Email/or any other mode as deemed fit by the Bank. For latest rate of interest please log on to www.rblbank.com
3. All physical deliverables will be sent to ‘Preferred Mailing Address’ and digital deliverables on current registered Email ID or Mobile No.
4. Bank provides Standing Instruction (‘SI’) facility for auto debit of accounts for payment to registered payees. Bank will not be held liable for failure to execute the SI for
shortage of funds or for delays caused by third parties involved in performance of SI.
5. Bank charges apply for below services at rates indicated in Schedule of Charges displayed on website and on Notice Board of Branches.
• Cash Deposits & withdrawals, Non-maintenance of minimum balance prescribed depending on category of accounts, SMS alerts, Remittances, A/c. closure charges etc.
6. Debit Card is/will be, dispatched in an ‘Inactive’ status. To activate, you must first generate your PIN. ATM and POS transactions within India are activated by default.
7. The transaction rights/limits of the Debit Card can be enabled/disabled/modified, through following options – Internet banking/Mobile banking/IVR/Branch.
8. Debit card Fee will be applicable as per schedule of charges on www.rblbank.com >> Service Charges & Fees
9. Accounts with no customer induced debit or credit transactions for continuous period of 24 months will be categorised as ‘Dormant Account’. No transactions will be
permitted till the customer activates the account by visiting the Bank’s Branch and submitting required documents.
10. Deposits in bank accounts are insured with DICGC up to amounts stipulated by regulations from time to time. For details on deposit insurance, please log onto
www.dicgc.org.in.
11. Bank has Grievance Redressal policy displayed under ‘Customer Services on Banks website www.rblbank.com for redressal of customer grievances. To register your
RIAOF/31052023/Ver1

grievance, please visit your nearest branch or log on to Customer Services on Banks website www.rblbank.com or call 91 22 61156300
Fixed Deposits
1. Interest at contracted rate is compounded quarterly. Year for the purpose of interest computation is taken as 365 days. On pre-mature closure of deposit, interest at the
applicable rate for the actual no. of days the deposit remained with the Bank or contracted rate whichever lower subject to pre-mature penalty if any will be paid to
customer. No interest payable if deposit remained with Bank for a duration less than minimum tenure.
2. E-Fixed Deposit advices will be sent to the current registered email ID.
3. Instructions for renewal, closure of deposits (fully or partial) may be given up to 2 days prior to maturity date. Upon auto renewal, the maturity value less TDS if any shall
be renewed from maturity date.
4. Form 15G/H submitted without PAN No. is invalid and will not be processed.
5. Interest paid will be subject to Tax Deduction at Source (TDS) at applicable rates. Applications without PAN No. will attract higher TDS as per Income Tax rules.
6. Upon pre-mature closure of deposit, excess interest paid will be recovered from the principal amount. Tax deducted at source and deposited with the government will not
be refunded. Customers can claim a refund from the Income Tax authorities.
For detailed terms and condition, please visit www.rblbank.com >> Others >> Most Important Terms and Condition

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