• ~~b~t~~m~~!~~~~P~~:?~~~!~Y!.v~!~Kc~!!!~:~~~!~rs~_ To, The Branch Manager, The Commercial Co-operative Bank Ltd • ...... Branch, Jamnagar. Passport 1/ We wish toapply for THE COMMERCIAL CO-OPERATIVEBANK LTD. Debit-Cum-ATM Card. Size Photo Name of Applicant * : I - . I Name as required on Card" : I I I I I I I I I I I I I I I I I I I I (CAPITAL LETTERS IN ENGLISH ONLY) (Max. 19 Characters including spaces) Date of Birth * DJITJl I I Il Gender * : Male·· D Female D ·DDIMMIYYYY Mailing Address >I< - :~ .~ - ~ Mobile No. >I< mllill I I I I E-mailID I - -= ] Pin Code I I I I I I I :: Account for which Debit-Cum~ATM Card facili!! Reguired :: 1. Savings / Current A/eNo. I I I I~ I I I I I I I I I I I -

*MaDiI!lil[! Elillds I DECLARATION I DEBIT -CUM -ATM CARD ·UNDERTAKING I I / We have read and understood the Terms and Conditions, given on the back of this application form, governing the usage of The Commercial Co-operative Bank Ltd., Debit-Cum-ATM Card. I / We accept to be bound by the said terms and conditions or to any . changes made therein from time to time by the Bank at its sole discretion without notice to me / us. I / We confirm that I !We am/are the sole account holder(s). ( / We accept full responsibility for the safe keeping or My / Our Debit -Cum-ATM Card and the secret PIN. IlWe agree not to make any claims against The Commercial Co-operative Bank Ltd., in case of misuse of the Card and Pin due to my/ournegligence,I / We agree to provide any information from My / Our accountto The CommercialCo-operativeBank Ltd. ..

.. I I Signature of First Ale Holder Date * :DJuJi I I I I :-. DD IMMIYY.y Y Place. * : I I Signature of Other Ale Holders

:: For Office Use:: .We recommend issue ofDebit-Cum-ATM Card to above mentioned customer. We certify that the account is KYC Compliant and signature(s) of account holder(s) has I have been verified. The above details including mobile number are updated in the CBS. :: Verifying Authority::

FOR USE IN BRANCH NAME OF THE OFFICER I MANAGER SIGNATURE CUSTOMERID Signature Verified By

Eiligibility Verified By 1. Meaning of certaIn tenns : The term ·Bank· refers to The Commercial Co-operative Bank Ltd .• ·ATM· ~efers to the Automated Teller Machines. and" Card Holder" refers to an account holder who has been issued a RuPay Debit Cum ATM Card. . 2. Bank RuPay Debit Cum ATM Ca~d : Bank shall issue a RuPay Debit Cum ATM Card to an approved account holder in respect of his account to . enable him to operate the ATM and at Point of Sale (POS). 3. ATM·Facllltlell: The facilities offered under ATM faCility will include withdrawal of cash by the Card Holder from his account up to a stipulated amount limit only during a cycle of 24 hours, enquiry about the balance in the account(s), request for changing PIN and such other facilities as the Bank may declde to provide, from time to time. . . 4. Minimum Balance In Account: The Card Holder shall maintain, at all times, .such minimum balance in his account. as the Bank may decide from time to time and the Bank may at its discretion levy such penal or service charges as per the Bank's Nles from time to time, or withdraYf the ATM facility, if at any time the amount of deposit falls short of the required minimum as- aforesaid, without giving any further notice to the Card HoIder(s) and I or without Incurring any liability or responsibility whatsoever by reason of such withdrawal. 5. Fees:' The Card Holder shall pay RuPay Debit Cum ATM Card issue charges and transaction charges as prescribed by the Bank from time to time. . . 6. Bank's Lien: The Bank shall have the paramount right of set-off and lien, irrespective of ar:'lYother lien or charge, present as weil as future on the deposits of any kind and nature (Including fixed deposits) held I balances lying In any accounts of the Card Holder/s, whether In single name or joint name(s) and on any monies'lsecurilies, bonds and all other assets, documents and properties held by I under the control of the Bank (whether by way of security or othelWile pursuant to any contract entered' to be entered into by the Card Holder's in any capacity) to the extent , of aU outstanding dues, whatsoever, arising as a result of any of the Bank'S services extended to and / or used by the Card Holder I sand / or as a result of any other facilities' that may be granted by the Bank and / or Its group companies to the Card Holders. The Bank Is entitled Without any notice to the Card Holders to settle any Indebtedness whatsoever owed by the Card Holder's to the Bank hereunder ~ under any other document I agreement. by adjusting. seHing.olf any depoj;lt(s) and' or transferring monies lying to the balanc;e of any account(s) held by the Card Holders with the Ban.k. The Bank's rights hereunder shall not be affected by the Card Holders bankNplcy, death or winding-up. It shall be the Card Holders' sole respon~lblUty and liability to settle all disputes / objections with any such Joint account holders. (I) In addition to the above mentioned right or any other rt9ht. whlch,ihe Bank may at any Ii'me 'be entltied Whether by opirallOn of.law, contrilct or otherwise, the Card Holder authorises the Bank: (a) to combine Of cOnSOlidate at any time all or any of the aCcounts and liabilities of the Card . Ho!der with or to any b,!!nch of the Bank: (b) to sell any of the Card Holders' securities'or properties held by the Bank by way of public or private sale without having to Institute any judicial proceeding whatsoever and retain I appropriate from the PfOC88ds derived therafrom tha total amounts outstanding to the Bank from the C~rdf.0lder/s. Includi~ coats and expenses In connection with ~uch sale: .' . , .. '. 7. Multiple Carda: In case of joint account(s, Either or. Survivor 'anyone or S~rvlvOt where more than one person has been Issued Bank ATh1 Cum Debit Card. all the Card·Holders put !ogether. shall withdraw only upto the permissible limit allowed to single Card account(s), within the cycie tlme of 24 hours. . O. Joint account: In case of joint accounts where only one card Is issued to a joint account holder, the other joint account hoIder(s) tlhall expressly agree with and give his f her consent on the application fcwm ror issue of.1he RuPay Debit Cum ATM Card. In case any of the joint account holder(s). gives 'stop payment stop transactions" Instructions In respect of operations through the use of RuPay Debit Cum ATM card, on any of the accounts held Jointly by them, nC!oparations will be allowed on such account(s) through the use of RuPay Debit Cum ATM Card. The ·stop payment step transactions· inSlNcIi~n' can be glvn only in respect of such accounts in which he I aha is a joint account holder. 9. Non-Transferability: The RuPay D.eblt Cum ATM Card is not u8nsferable under any circumstance and &.hall be used only by the Card Holder. 10. Pel'8onal ·Identlflcatlon N'umber (PiN' : Each Card Holder will b4i Issued a sealed envelope containing a four digit number called Personal Idenllfjcalion Number (PIN) to gain access to the ATM services. This number can be changed to any other convenient four dlglt number by the Card Holder, at the ATM. The PIN shaU under no circumstances be revealed to any third party. The Card Holder shall be lIOIely responsible for the consequences arising out of the disclosure of his PIN and' or unauthorised use of RuPay Debit Cum ATM Card. If the card Holder forgets the PIN. he Ishe shou.1d make .an 8ppll~tion In writing tor a rresh PIN. The. sel.ectlon .of a new P.ersonal, Identification Number and / or the , replacement of RuPay Deb~ Cum ATM card shall not be construed as the commencement of a new contrad.· . 11. Funds In the accounts: The Card Holder should not use or attempt to use RuPay Debit Cum ATM Card without sufficient funds In the linked ~~ " ...... 12 L~ .. i Theft. of C~rd. : Th~ Card HOld~~shall be responsible for iafe Cuat~y' of RuPey D~blt Cum ArM card. In case of lOIS or theft of the RuPay Debit Cum ATM Card, The Card Holder shalllnfcwm through registered mobile number to customer car. & tha RuPay Debit Cum ATM qard Issuing branch as promptly as pesslble in writing, of tha loss of RuPay Debit Cum' ATM Card. Card Holder shall, however, be responsible end liable for all transactions effected by the user of the Card until II is confiscated' canceled. New replacement of RuPay Deblf Cum ATM Card . will be issued to tbe Card Holder, In lieu of lost I stolen Rup'ay Debit Cum ATM Ca~ e . upon request in writing and payment of prescribed issue fee of the Bank. . 13 Authority to Debit the Account :The Card H'atder along with the joint accOunt holder(s); If any, shall authorise the Bank to debit the account(s) . with the amount of wlthdrawals. or transfers affected by the use of RuPay Debit Cum ATM Card, as per tJie Bank's records. The Bank's record for transactions processed by the ATM machine. shall be binding on all the joint account holders, Jointly and sev~rally. . . 14. Responsibility for all transactions Rrocessed through the ATMs : Operations through the ATM facility on the Card Holders account(s)can only be through the use of RuPay Detil! Cum ATM Card on the machine. The Card Holder shall in all circumstances, accept full responsibility for all transactions' processed by the usJrof his' her RuPay Debit 'Cum ATM Card. whe'ther or not Pr0c8ssed with the Card Holder's knowledge or authority, express or Implied. The prin~ oulput that is produced at the time of operation of the ATMs is a raCOl'd of the operatiOn of the ATMs and shall not be construed sS.the Bank's record. The Bank's records of transactions shall be. accepted as conclusive and binding for all purpose. ~, ... . 15. Closure of eccount(s): If the card H~det desires to close his '~unt(s) or withdraw any RuPay De.blt Cum ATM Card linked Deposit, or even otherwise decldes 10terminate the u~of the Bank ATM Cum Debit Card facilit)', he shall give a written notice of at least two days and surrender RuPay Debit Cum ATM Card to the Bank. The Card Holder shall also, pay dues, if any, payable to the Bank in connection with the ATM facility. 16. Change oherms,and conditions: ·lifa Bank has the absolute discretion to withdraw RuPay Debit Cum ATM Card, the' service thereby provided, or amend or supplement any of the abOve terms and conditions at any time without prior notice 10 the Card Holder. 17. Honouring the Card:The Bank sha!l~I~ no circumstances be held liable to the Card Holder If RuPay Debit Cum ATM card is not honored in the desired manner for whatsoever reasen, or if the ATM' is destroyed or not functioning due to power failure, temporary insufficiency of cash in the . ATM or any olher reason. The Bank ~II not be liable for any consequential or indirect loss or damage ariSing therefrom. '. . ". ft.4<.. . . . '. . . .. 18. Ownership of RuPay Debit Cum ArM. Card: RuPay Debit Cum ATM Card shall be the property of the Bank and will be surrendered to the Bank on request orin the event of the Card!f,folder no longer requiring the service. The Bank reserves the right to disclose,ln strict confidence, to other Institutions, such Information concemlm, the Card Holder's account as may be necessary or appropriate in connection with its participation in any ATM or Electtonic Fund Transfer Net~rk.. .' . . . . .: ,.., .. . . Disclaimer: ,~Bank may, at its sale dlsaEitlon, utilize the services of external service provlder/s or agentls and on such terms as required or necessary, in relation to its products' services'. . .' '. .

Signature of First Ale· Holder Signature of Other Ale Holders'