Minor Turned Major Form (*Fields Are Mandatory)

Minor Turned Major Form (*Fields are mandatory)

Branch ______Tracker Reference No.: ______Date: D D M M Y Y Y Y

*Account Type: Normal Simplified (for low risk customers) Small *Customer Id:

Customer Name: KYC Number:

(Title) (First Name) (Middle Name) (Last Name)

*Account Number:

Name of the Father / Guardian:

(Title) (First Name) (Middle Name) (Last Name)

*Mother’s Full Name:

*Mother’s Maiden Name:

*Father's Full Name:

*Spouse’s Full Name:

Religion: Hindu Muslim Christian Sikh Buddhist Jain Parsi Others

*Residential Status: Resident Individual Non Resident Indian Foreign National Person of Indian Origin

Passport Number: Passport Expiry Date: D D M M Y Y Y Y Required if Passport or Driving License Driving licence Driving License: Expiry Date: D D M M Y Y Y Y provide as Identity / Voter Identity Card: Address proof

NREGA Job Card: *Occupation:

Please fill FATCA Declaration Form if you are U.S.A. *Nationality: Indian Other (pl. specify) or other country citizen / resident

*Country of Birth: *Place of Birth:

*Citizenship: *Residence for Tax Purposes:

U.S. Person: Yes No Category: General MBC OBC SC ST Others ¨ Rupay Short Name for New Debit card Debit / ATM & ¨ Visa Debit Card: Rupay / Visa card will be International Debit Card required Yes No DCB – On The Go (Mobile Banking) Internet Banking issued as per product feature Personal Details of Account Holder:

There is no change in my Permanent and Communication Addresses

I wish to change my address Communication Address Permanent Address Both (Communication Address and Permanent Address)

City: Pin:

Landmark:

State: Country:

I confirm that as on ____ / ____ / ____ a sum of ` ______(In words) ` ______only, is the Account balance in the aforementioned account. Mobile number will be automatically Update of Other Details: registered for SMS Alerts. You will receive Bank related promotional calls, Change of Mobile Number New Mobile Number: + 9 1 SMS alerts

Change of Telephone Number New Telephone Number: STD Code

New email Change of Email ID New Email ID: address will be updated Form 60 to be provided if PAN Card copy is Update my PAN Number PAN Number: only in the not provided. account number mentioned Update my Aadhaar Number Aadhaar Number: above

Fixed Deposit A/c No.: Close and Rebook Fixed Deposit Joint Applicant 1 *Customer Id: Customer Name:

(Title) (First Name) (Middle Name) (Last Name)

*Mother’s Full Name:

*Mother’s Maiden Name:

*Father's Full Name:

*Spouse’s Full Name:

Religion: Hindu Muslim Christian Sikh Buddhist Jain Parsi Others

*Residential Status: Resident Individual Non Resident Indian Foreign National Person of Indian Origin

NREGA Job Card: *Occupation:

Please fill FATCA Declaration Form if you are U.S.A. *Nationality: Indian Other (pl. specify) or other country citizen / resident

*Country of Birth: *Place of Birth:

*Citizenship: *Residence for Tax Purposes:

(Title) (First Name) (Middle Name) (Last Name)

*Mother’s Full Name:

*Mother’s Maiden Name:

*Father's Full Name:

*Spouse’s Full Name:

Religion: Hindu Muslim Christian Sikh Buddhist Jain Parsi Others

*Residential Status: Resident Individual Non Resident Indian Foreign National Person of Indian Origin

NREGA Job Card: *Occupation:

Please fill FATCA Declaration Form if you are U.S.A. *Nationality: Indian Other (pl. specify) or other country citizen / resident

*Country of Birth: *Place of Birth:

*Citizenship: *Residence for Tax Purposes:

Close the existing account

Convert the said account in my name

Continue the said account as a Joint account with operations as per Mandate. Declaration

I have read and understood the terms & conditions relating to various services offered by DCB Bank I agree to discontinue the physical statements being sent to me. I understand that the email statements are Limited (the “Bank”). I am aware of charges applicable for various services offered and I accept and agree for my convenience. The Bank shall not be liable or responsible for any breach of secrecy because the to be bound by the said terms & conditions. The terms and conditions for these services are available on statements are being sent to the above email ID. I shall verify the authenticity of the emails I receive. I shall the Bank's website www.dcbbank.com. I further authorize the Bank to debit my account towards any not hold the Bank responsible for any statement received from fraudsters / imposters. I shall not hold the applicable charges for any / various service / services provided as applicable from time to time. I Bank liable if any problem arises with my computer network because of me receiving statements from the understand that in the event of me already being registered for Phone Banking / Net Banking, this Bank. I have been authorized by the other holders to receive the statements on the above email ID. I shall application will be treated as an authenticated request for regeneration of my IPIN. I agree that the Bank immediately inform the Bank in writing if there is any change in the information given above. The Bank shall may debit my account for service charges as applicable from time to time. I agree to adhere to all the terms not be responsible if I do not receive statements due to incorrect email address and technical reasons. I and conditions of opening / applying / availing / maintaining / operating (as applicable) for usage of mobile confirm to have read and understood the terms & conditions pertaining to my account. This registration will banking service of the Bank as may be in force from time to time. I hereby expressly consent and authorise override any “Hold Statement” facility availed in the past. the Bank to make telephone calls, send SMSs or emails, IVR to voice out and enable Mobile Banking to That I / we shall not hold the Bank liable and responsible for furnishing of the processed information / data / inform / benefit me on any information or updates relating to the Bank's existing / new products / services / products thereof to other Banks / Financial Institutions / Credit Providers / Users as may be specified by account information including SMS when a Pull SMS is sent. I agree and understand that by agreeing to the Reserve Bank of India in this behalf. receive the Statement(s) via E-mail, I have at my own discretion accepted that such Statement(s) shall not Aadhaar Consent: be sent to me separately by post or in physical form, through whatever other means. I/We have voluntarily submitted my/our Aadhaar/UID Number mentioned above and consent to: That I / we authorize the Bank to issue a Debit cum ATM Card to me / us. That the issue and usage of the § Debit cum ATM Card is governed by the terms and conditions as in force from time to time and I / we agree Seed my/our Aadhaar/UID Number issued by UIDAI, Government of India in my/our name with my/our to be bound by the same. That the terms and conditions of Debit cum ATM Card are liable to be amended aforesaid account. by the Bank from time to time. That I / we unconditionally and irrevocably authorize the Bank, to debit my / §Map it at NPCI (National Payments Corporation of India) to enable me/us to receive Direct Benefit our account annually with an amount equivalent to the fee and charges for use of the Debit cum ATM Card. Transfer (DBT) from Government of India in my/our above mentioned account. I/We understand that if *I understand and agree that the consent given for updation / registration / requests for free Mobile alert more than one Benefit Transfer is due to me/us, I/we will receive all Benefit Transfers in this account. facility shall be valid till such time I withdraw the same in writing. Unless specifically advised, the Bank will §Use my/our Aadhaar details to authenticate me/us from UIDAI. continue to send SMS alerts on the number requested by account holder(s). §Use my/our mobile number mentioned in my/our account for sending SMS alerts to me/us I/We understand that the Bank is relying on this information for the purpose of determining the status of the §Consent for Authentication: I/We, the holder of the above stated Aadhaar number, hereby give my/our applicant named above in compliance with FATCA (Foreign Account Tax Compliance Act) / CRS consent to the Bank to obtain my/our Aadhaar number, Name and Fingerprint/Iris for authentication with (Common Reporting Standards). The Bank is not able to offer any tax advice on CRS or FATCA or its UIDAI. impact on the applicant. I/We shall seek advice from professional tax advisor for any tax questions. The Bank has informed me/us that my/our identity information would only be used for demographic I/We agree to submit a new form within 30 days if any information or certification on this form becomes authentication / validation / e- KYC purpose and also informed that my/our biometrics will not be stored / incorrect. I/We agree that as may be required by domestic regulators/tax authorities, the Bank may also be shared and will be submitted to CIDR (Central Identities Data Repository) only for the purpose of required to report, reportable details to CBDT (Central Board of Direct Taxes) or close or suspend my / our authentication. account. I/We certify that I/we provide the information on this form and to the best of my/our knowledge I confirm that all the details provided in the form are correct. and belief the certification is true, correct, and complete including the taxpayer identification number of the applicant.

Mode of Operation: Self Jointly Either or Survivor Former or Survivor

Signatures and Photographs of the Applicant and Joint Applicants

Name ______Name ______Name ______

Please affix Please affix Please affix a recent a recent a recent photograph photograph photograph

Sign across the photo Sign across the photo Sign across the photo

Signature / Thumb Impression of the Applicant Signature / Thumb Impression of the Joint Applicant 1 Signature / Thumb Impression of the Joint Applicant 2

Guardian Consent: I consent to the above mentioned request and attest the signature of my son / daughter / ward.

Date: D D M M Y Y Y Y Signature of Guardian Nomination Details (Form DA 1) Yes, I want to nominate the following person No, I do not want to nominate anyone Preferable for Single & Joint I / We nominate the following person to whom in the event of my / our / minor’s death the amount of the deposit in the account may be returned by Account holders DCB Bank Limited. Nominee Name:

Address:

Relationship with Applicant(s), if any Age: Years Date of Birth: D D M M Y Y Y Y Nomination * As the nominee is a minor on this date, I / we appoint (Name & Address) under Section 45ZA of the Banking Regulation Act, 1949 and Rule 2(1) of the Banking 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 the nominee. Companies (Nomination) In case you have specified a nominee above, please indicate if you wish to make mention of the nominee’s name on the passbook, Yes No Rules 1985 in statement & DCA issued in respect of your account. respect of bank I / We do hereby declare that what is stated above is true to the best of my / our knowledge and belief. deposits.

Signature / Thumb Impression of the Applicant Signature / Thumb Impression of the Joint Applicant 1 Signature / Thumb Impression of the Joint Applicant 2 * Strike out if nominee is not a minor. Where deposit is made / account is held in the name of the minor the nomination should be signed by a person lawfully entitled to act on behalf of the minor. Witness(es):

Name : Name : Thumb impression is required to be Signature : Signature : attested by 2 witnesses. Address : Address : for signature, no witness is required. Place : Date: Place : Date:

For Bank Use Only KYC verification carried out by

Employee Name: Employee Code:

Employee Designation:

______Branch: Date: D D M M Y Y Y Y Employee signature

2979-Ver 1.0-March, 2019 M066 / Dec 19 / 2.9

Acknowledgement to Applicant

We acknowledgment receipt of 'Minor Turned Major Request Form' from (Applicant Name) on D D M M Y Y Y Y

Account Number:

Name of Branch Official:

(Signature of Branch Official with Seal)

DCB Bank Limited