HDFC Credit Card Application PDF

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HDFC Credit Card Application Sample Paper...

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CREDIT CARD BROCHURE CUM APPLICATION FORM VERSION 1.36 E

Source

Promo

Team/BR code

LG/DSE LC2 Code

LC1 Code

We Understand Your World

Ld No

EReference No:

19031115549

Token No APS Reference No

I wish to confirm that,I agree to pay the fee as per the Credit Card chosen/ticked by me from the below RENEWAL 1ST Year Fee Waiver Condition FEE

ANNUAL FEE

CREDIT CARD TYPE*

Renewal Fee(2nd year onwards)waiver condition AFFIX YOUR PHOTO

HDFC BANK REGALIA FIRST Online Application

INTERNATIONAL ENABLED

Primary Applicants signature

*

Online Application

HDFC Bank customers need to sign as per bank records

Title

First Name ANJALI

MS

Full Name

Middle Name

Last Name SHARMA

ANJALI SHARMA ANJALI SHARMA

Name preferred on the card

(Applicable for Business Credit Card only)

Business Name as desired on the card JetPrivilege Frequent Flyer Program Membership No. Marital Status

JP

Gender

(Applicable for existing JP FFP Members only if applying for JetPrivilege Co-Branded Credit card)

NO

FEMALE

Date of Birth

02/03/1994

No. of Dependents

Educational Qualification PAN No.

Primary UID.

HAWPS1026P

Voter ID.------------------------

Place of issue --------------------

Passport No. Place of issue---------------------

Driving Licence No.----------------------

Nationality

INDIAN

PLEASE TELL US WHERE YOU LIVE Residential Address: Flat / Door No. & Building Name

D 137

Road Number / Road Name

NEAR GEM NURSING HOME AMBABARI PIN 302039 JAIPUR

City/State

302023

PIN

Landmark *Tel No.

141-2296831

Personal E-mail ID

[email protected]

Is it a PP No.?

Yes

No

Mobile No.

9782168209

Please provide non-generic E-mail ID for security reasons as confidential / sensitive informaiton may be shared vide E-mail. Alternate/Permanent Address: D 137 NEAR GEM NURSING HOME AMBABARI PIN 302039

Flat / Door No. & Building Name Road Number / Road Name

302023

PIN

JAIPUR

City/State Landmark

-

*Tel No.

Is it a PP No.?

Yes

No

Mobile No.

9782168209

Please give us the name of a relative/friend in your city who does not stay with you as reference. Name

Tel No.

Your residence is

Period at current residence

FAMILY

Your vehicle is Your vehicle is

Vehicle-make (Model Name)-------------------Financed

Owned

Company Provided

Policy Expiry Month

Years

Months

Yr. of Purchase-------------------Covered by (Insurance Co.) ---------------------

PLEASE TELL US YOUR OCCUPATION HOUSEWIFE

Occupation If salaried, employed with If salaried, type of industry/business

OTHERS

If self-employed, your firm is If self-employed you are a Total years in employment/business

Years (if self-employed, mention total period in business) If self-employed, Capital Investment-----------

Annual Turnover.............. No. of Employees----------

PLEASE TELL US YOUR OFFICE ADDRESS *Company Name

Designation

Company Address : Flat / Door No. & Building Name Road Number / Road Name City/State Landmark Company Code

Department

D 137 NEAR GEM NURSING HOME AMBABARI 302039 PIN

JAIPUR

302039

Emp Code -

*Tel No.

Extension No.

HR Contact No.

0

Fax No. Time of Contact Period at the current employment

Supervisor Contact

Office E-mail ID

Years

Months

Please provide non-generic E-mail ID for security reasons as confidential /sensitive informaiton may be shared vide E-mail. Are you an HDFC Bank / ADFC Employee NO

(If Yes – Salary A/C No.

Empl ID

/ Grade/Band:

IMPORTANT FIELDS TO BE FILLED* Other Banks

For HDFC Bank Customers Account No. 50100060267164 Primary UCIC.

57216237

Account Type

SAVINGS

Name of your Bank Branch Name Demat Account(if any)----------Years

Duration of the account held Loan Account / Agreement No. Loan Account (if any) Car Loan Other Bank Credit Card / Loan Details Issuing Bank

Months

Account Type

Current

No. of years a/c held Personal Loan Consumer Durable Loan Loan Against Shares

Credit/Charge Card / Loan Accout No.

Expiry Date

Income Details: 25000 1. Gross Monthly Income---------------------------------------------------------2. Additional Monthly Income (attach documents if any)-----------------------------3. Average Monthly Expenses.---------------------------------------------------------*

Account No. Savings Years

Months

Housing Loan(HDFC)

Member Since / Loan open date Credit Limit / Loan Amount

Spouse's Name---------------------------------------------------------------Spouse's Monthly Income (attach documents)-------------------------------Spouse's Company Name------------------------------------------------------

Spouse's Office Tel No-------------------- Extension No--------------------Yes-The details provided are correct best of my knowledge *. No-I don't want to provide any details*.

Online Application

HDFC Bank customers need to sign as per bank records

RELATIONSHIP -IMPORTANT* Do you have any relationship with any Director or Senior Officer of HDFC Bank : Name of Director/Senior Officer

NO Relationship with the Director/Senior

STATEMENT Where would you like your card statements and other correspondence to be sent?

Residence

DIRECT DEBIT OPTION I accept the direct debit facility and authorise HDFC Bank to debit my Bank account, aforementioned in the Bank Details section, towards credit card payments as indicated below

NOT APPLIED Primary Applicants signature * Online Application

Date--------

HDFC Bank account number aforementioned above in the Bank Details section will be used for direct debit facility. If neither option clearly chosen /the MAD option will be set by default..

ADDITIONAL CARD DETAILS Title

Mr

Ms

Mrs

Dr

Name to be embossed on the Add-on Card : Date of Birth

Sex DD

MM

M

F

AFFIX YOUR PHOTO

YYYY

I confirm that the add-on applicant is my---------------------- (relationship with Add-on) and is [

]Staying/ [

] not staying with me

at the same residential address as provided in this application form. I as primary card holder take the full responsibility of the add-on card, including all transactions/ usage and payments related to the add-on card. I will produce the ID proof of the add-on card member, as and when requested by the Bank.

Online Application

If add on applicant does not hold HDFC Bank a/c then valid Photo ID proof and Address Proof needs to be submitted. Add-on applicant's HDFC Bank a/c No. Add-on applicant's Customer ID Primary Applicants signature * Online Application

Date--------------ADD ON SUB-LIMIT OPTION : Please indicate the Sub-Limit to be set on the Add-on Card per Statement Cycle

HDFC Bank customers need to sign as per bank records

25% of Credit Limit

50% of Credit Limit

100% of Credit Limit

Rs.1000

If neither option is chosen clearly, 100% will be set as default add-on Limit.

Rs.5000

Rs.10000

D E C L A R AT I O N I hereby apply for HDFC Bank International Credit Card(s) and declare that the information included in this form is true and correct and that I am a Resident Indian/foreign national working in India and that I am eligible to apply for an internationally valid card. I accept that HDFC Bank is entitled in its absolute discretion to accept or reject this application. It is my responsibility to obtain the Terms and Conditions applicable to the HDFC Bank International Credit Card(s) separately and read the same. I will be bound by the Terms and Conditions as may be in force from time to time and receipt/use of the Credit Card shall be deemed to be acceptance of those Terms and Conditions. I authorise HDFC Bank and/or its associates to verify any information or otherwise at my office/residence or to contact me/my employer/banker/credit bureau/RBI or any other source to obtain or provide any information that may be required for confirming membership requirements or maintaining my account in good credit standing. I agree to be charged my card fee in my first statement. In case I have applied for Add-on Card(s) (available for Resident Indian parent / spouse /brother / sister /child over 18 years of age at special rate) I will be billed for such an Add-on Card in the normal monthly statement. I, the Primary applicant will be liable for all charges incurred with the Add-on Card(s) issued on the account and each Add-on applicant will be liable for all charges incurred with the Add-on Card jointly and severally with the holder of the Primary Card. The facility of Add-on Card(s) being a special facility at a concessional fee/rate, continuation of the Add-on Cardmember will be dependent on the continuation of my membership. I understand and undertake that the usage of the HDFC Bank International Credit Card(s) shall be strictly in accordance with the exchange control regulations of the Regulatory Authorities as applicable from time to time which I undertake as my responsibility to keep myself updated of, and in the event of any failure to do so, I will be liable for action under the Foreign Exchange Management Act, 1999 or its statutory modification or re-enactment thereof. I confirm that I have no insolvency proceedings pending against me nor have I ever been adjudicated insolvent. I agree that my signature on the chargeslip will amount to an unconditional undertaking by me to pay HDFC Bank the amount stated therein and agree that a copy of my periodic statement of accounts will be a conclusive evidence of my liability for the charges stated therein. My liability under the chargeslip signed by me shall not withstand any dispute I may have with respect to the quality/quantity of goods purchased or quality of services obtained. I will not hold the Bank responsible if any outlet/franchisee refuses to accept the card. I authorise HDFC Bank to disclose, from time to time, any information relating to my Credit Card(s), (including any default in payments) to any other card issuer, credit bureau, financial institution, any parent/subsidiary, affiliate, Co-brand partner and associate of HDFC Bank, and to third parties engaged by HDFC Bank, for purpose such as marketing of services, proper operation of Credit Card accounts and other administrative services. The Bank will be entitled to cancel my card(s) at any time without assigning any reasons. I understand Service Tax as applicable from time to time will be levied on fees, interest and other charges, as per government guidelines.I understand that Service Tax is not applicable on my regular purchases. I am aware that the Bank reserves the right not to return the supporting financial documents given by me along with the application.I have received and read the detailed Terms and Conditions and agree to abide by them, once I am allotted the Credit Card. I hereby confirm that I have also read and understood the contents of the Schedule of Charges and disclosure details, and agree to be levied variouscharges mentioned therein as and when applicable to me. I confirm that basis my eligibility HDFC Bank shall at its sole discretion reserve the right to issue any existing card product in their portfolio. Credit Limit on any card account may be reviewed as per the Bank policies specified from time to time and the Bank reserves the right to revise (increase or decrease) and/or unconditionally cancel the limit assigned on a card without any prior notice to the Cardmember. I also understand and agree to the fact that the Bank is authorised to change any or all of the Terms and Conditions of the Schedule of Charges at its own discretion. I authorise the Bank to record specific conversations between me/my representative and the Bank's representative, in case of grievance-related conversations or payment-recovery related conversations or any other conversation that the Bank may deem fit, at its own discretion. I agree to abide by any Terms and Conditions as may be added/amended by the Bank from time to time without giving notice to me, regarding this Credit Card and any other facility/loan product that I avail through this Credit Card or any other Credit Card that I may be issued by the Bank in the future. I agree to receive my card statements through email on the email IDs mentioned in the Application Form. I am aware that my new Credit Card would be automatically registered for NetBanking in case I am already an HDFC Bank NetBanking customer. I understand that HDFC Bank will issue the Credit Card according to the Bank's internal guidelines. I hereby give my consent to the Bank to provide me a different card in case I am not eligible for the product applied for. I authorise HDFC Bank to transfer my accrued reward points periodically to my JetPrivilege Frequent Flyer Program membership number as provided by me in the Credit Card application form.

“I/We hereby authorize and give consent to the Bank to disclose, without notice to me/us, information furnished by me/us in application form(s)/related documents executed / to be executed in relation to the facilities to be availed from the Bank, to the Bank's other branches/subsidiaries/affiliates/ Credit Bureaus/Rating Agencies, Service Providers, banks/financial institutions, governmental/regulatory authorities or third parties for information verification, credit risk analysis, or for other related purposes that the Bank may deem fit. I/We waive the privilege of privacy and privity of contract"

Primary Applicants signature

Date----------

*

Online Application

I agree to participate in any or all of the Card upgrade programs and limit enhancement programs that the Bank may conduct on my card account from time to time as part of periodic portfolio reviews basis relationship / income details available with the bank as per prevalent policy conditions of the bank. I do not to receive information/service for marketing purposes through Telephone/Mobile/SMS/e-mail/any other mode from the Bank/or its agents * I Confirm that I have read and understood the MITC (Most Important Terms and Conditions), Product Features & Pricing and fully accept it. * I hereby give my consent and specifically confirm that the Online Application form submitted to HDFC Bank shall be valid, effective and legally enforceable against me though it is not electronically signed by me. For the purpose hereof, a document shall be deemed to be ELECTRONICALLY SIGNED if it has been encrypted / Authenticated by using an electronic method or procedure in accordance with the provisions of the Information Technology Act, 2000 or in any other manner / method / procedure / technique as is recognised / envisaged as a valid method of encryption / authentication under the provisions of the Information Technology Act, 2000. Below mentioned box has to come next to above Information Technology ACT confirmation:

HDFC Bank customers need to sign as per bank records

This application has been authenticated by Name---------------------------------------------------11-mar-2019 05:09:41:PM on Date & Time-----------------------------------------

122.177.86.127 at IP address----------------------------------------

Kindly note that approximate Credit Card processing time is about 2 -3 weeks from the date of submission of completed form FormNo.60(seeThirdProvisontoRule114B) Form of declaration to be mandatorily filled by a person who does not have a Permanent Account Number 4. Address proof attached: [ ] Passport [ ] Driving Licence [ ] Utillity bill(incl.Mobile postpaid bill)

[ ] Ration Card [ ] Voter ID

1. Full Name & Address:---------------------------------------------[ ]Bank account statement/passbook [ ] Leasedeed/Rent agreement copy [ ] registration documents/Ownership proo --------------------------------------------------[ ]Others(Please specify) --------------------------------------------------VERIFICATION --------------------------------------------------do hereby declare that what is stated above is true to the best of my knowledge I---------------------------and belief.Verified today the-------------------------------[ ] Yes [ ] No 2. Are you a tax assessee Primary Applicants signature 3. If YES Date--------------* A.Details of ward/circle/range where the last ITR was filed---------------------------- day of--------------------------Online Application Place----------------------------B. Reason for not having PAN Number----------------------------------------------HDFC Bank customers need to sign as per bank records Acknowledgement of Credit Card application We acknowledge the receipt of your application for a credit card from HDFC Bank. In case of any queries you may contact our Customer Service call centers or mail us at [email protected]. Signature of DSA/HBL Rep : Date-------------------------* HBL/DSA Name : -----------------------------------Online Application Mobile no of HBL/DSA -----------------------------Please indicate your choice of HDFC Bank international Credit Card

HDFC BANK REGALIA INTERNATIONAL ENABLED Track your Credit Card application Status in our HDFC Bank Website through 16 digit unique application reference number which you will receive on your mobile number. www.hdfcbank.com -> Cards -> Credit Cards-> Track Your Credit Card

CREDIT CARD BROCHURE CUM APPLICATION FORM SMARTPAY

We Understand Your World

Name of the Company

City

Details 1

Details 2

Details 3

Telephone Electricity Mobile Co 1 Mobile Co 2 Insurance Co 1 Insurance Co 2 Insurance Co 3 * To set a maximum limit of payment that can be made towards the billing company; *Mandatory Field.

E-mail ID (Mandatory for LIC) -----------------------

1) You can apply from only the list of the billers provided in the table under smartpay on Regular Card Offerings 2) Please sign on the reverse side for smartpay after reading the terms and conditions 3) Please provide a copy of the latest bill (any of the last three bills received from your utility company); for each utility company opted above to enable us to verify the customer account details. 4) Only duly completed forms will be accepted. 5) Continue making bill payments towards the above mentioned utility company bill outstandings until you receive a SmartPay activation confirmation through email /SMS / Letter. I agree to be levied processing fee of Rs. 10/- plus service tax for ...