Download - Appln Debitcard Rev
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8/11/2019 Appln Debitcard Rev
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APPLICATION FOR SYNDICATE BANK VISA/MAESTRO GLOBAL INSTANT/
PERSONALISED-CLASSIC/GOLD/PLATINUM/PHOTO DEBIT-cum-ATM CARD
The Head of the branch
Syndicate Bank..Branch.
1. Please issue me/us SYND!"T# B"N$ %S"/&"#ST'( )*(B"* NST"NT/ P#'S(N"*S#D+!*"SS! /)(*D/ P*"TN,&/PH(T( Debit+cum+"T& !ard a-ainst my SB / Staff (D "ccount Number
...ith you.
. Please issue us SYND!"T# B"N$ %S"/&"#ST'( )*(B"* NST"NT/P#'S(N"*S#D+
!*"SS!/ )(*D/ P*"TN,&/PH(T( Debit+cum+"T& !ard to the folloin- 0oint account holders in the
said account
a.
b.2. /3e undertake that /e shall be holly liable/res4onsible for all ty4es of transactions done on my/our
abo5e said account throu-h my/our card6s7 issued by the Bank to me/us. /3e ha5e read the rules and re-ulations
ith re-ard to issue of Syndicate Bank %S"/&aestro )lobal Debit+cum+"T& !ard and /e shall abide by thesame.
8. /3e hereby declare that the transactions under this/these Debit !ard6s7 shall be strictly in conformity iththe -uidelines under 9orei-n #:chan-e &ana-ement "ct 69#&"7 and is not desi-ned for the 4ur4ose of any
contra5ention or e5asion of the 4ro5isions of the 9#&" or any rule; re-ulation; notification; direction or ordermade there under from time to time.
ue 4ersonal identification6?7 nformation for authenticatin- the card holderc7 #+mail D .........
d7 Tele4hone No.
e) Mobil No!"M#$%#&o'( )o' SMS #l'&*+ .........
OR/3e declare that /3e do not ha5e/are illin- to share the &obile number ith the Bank.
Name (ccu4ation/Profession/desi-nation Si-nature",+
a.
b.
D#&......
",+n case of 0oint accounts; all the 0oint holders should si-n the a44lication form."+Please rite any uni>ue identification information; hich ill be useful to the Bank to identify you in case you
for-ot your "T& PN or to ser5ice any other s4ecific re>uests.
Fo' B#$01* u*
'e>uest acce4ted and Debit !ard issue a44ro5ed. 'ele5ant 9la- in the System has been set.
nstant Debit !ard No.@@@@@@@@@@@@@@@@@@@@@ issued / Data forarded to D!! on@@@@@@@@@@@@@@5ide
'ef No.@@@@@@@@@@@@@@@.
Si-nature of Branch Head