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Samba Debit Mastercard Application Form

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Samba Debit Mastercard Application Form SAMBA DEBIT MASTERCARD ® APPLICATION FORM (DD) (MM) (YY) ( ) ( ) ( ) Name of the Branch Debit Card Application Date Account Holder's Information Account Title (ALL CAPS) (DD) (MM) (YY) ( ) ( ) ( ) CNIC / SNIC / NICOP/ POC No. ID Expiry Date (DD) (MM) (YY) ( ) ( ) ( ) Passport No. (for Foreign Nationals only) Passport Expiry Date Gender Male Female Nationality Pakistani Other: (DD) (MM) (YY) ( ) ( ) ( ) Mother's Maiden Name Date of Birth Debit Card Information Existing Primary Debit Card Number (if available) Issue me a New MasterCard Debit Card Link account to existing card (please mention your card no. in the space provided above) Primary Gold Card Blue Card Supplementary Gold Card Blue Card Change my card category from Blue to Gold Replace my existing card Change my card category from Gold to Blue (DD) (MM) (YY) ( ) ( ) ( ) Base No. Account Type (PKR Only) Account Operation Current Savings Single Joint (E/S) Account No. Default Account (please Current Savings Single Joint (E/S) tick one Account No. only) Current Savings Single Joint (E/S) Account No. Current Savings Single Joint (E/S) Account No. SMS Alerts YES NO If YES, please state your mobile number + 9 2 - - Supplementary Card Type of Supplementary Card New Card Replacement Card Full Name of the Supplementary Cardholder (ALL CAPS) (Maximum 19 characters including spaces) CNIC/SNIC/NICO/POC No. (DD) (MM) (YY) (DD) (MM) (YY) ( ) ( ) ( ) ( ) ( ) ( ) CNIC/SNIC/NICOP/POC Expiry Date Date of Birth Mother's Maiden Name Gender Male Female (DD) (MM) (YY) ( ) ( ) ( ) Passport No. (for Foreign Nationals only) Passport Expiry Date Account No. E-Mail (A/c to be linked to the Supplementary/Add-on Card) Existing Card Number Nationality Pakistani Others Occupation Phone No. (With Country & City Code) Permanent Address (Complete address with Country) Correspondence Address (Complete address with Country) Relationship with Primary Cardholder Replacement Card Type of Replacement Card Primary Supplementary Lost Stolen/Theft Damaged PIN Forgotten/Disclosed Existing Card Number Debit Card Limit Structure Primary Card Supplementary Card Daily ATM Limit (National) Default Other: Daily ATM Limit (National) Default Other: Daily ATM Limit (International) Default Other: Daily ATM Limit (International) Default Other: Daily POS Limit (National) Default Other: Daily POS Limit (National) Default Other: Daily POS Limit (International) Default Other: Daily POS Limit (International) Default Other: Declaration of Samba MasterCard ® Debit Card Holder "I / We have understood and accepted the Terms & Conditions mentioned in the overleaf and agree to abide by the same. The Terms & Conditions in relation to your debit card will be sent to you through courier along with the card. The activation and/or use of debit card will be deemed that you have understood and agreed to aforementioned terms and conditions. You are requested not to activate/use the card, if in case of non-delivery of terms & conditions. SBL may revise the terms and conditions from time to time (DD) (MM) (YY) ( ) ( ) ( ) Signature of the Primary Cardholder Date (DD) (MM) (YY) ( ) ( ) ( ) Signature of the Supplementary Cardholder Date For Bank Use Only (DD) (MM) (YY) Base No. Date (DD) (MM) (YY) Card Number Approval Date FATCA Clear Yes No (If No, Requires Management Approval) NADRA Verisys Clear Yes No World Check Clear Yes No Received KYC CDD Update form Individual Yes No Checked By: Approved By: Samba Bank Limited Debit MasterCard Terms and Conditions incurred as a result of the loss, theft, misuse or unauthorized use the Card, require the Cardholder to return the Card or suspend the the same. All charges are non-refundable unless otherwise indicated consolidating, combining or setting off any such credit balances Cardholder may terminate the Agreement comprised in these Terms to time by notice (whether general, specific or by publication in the of the Card. The Bank shall take reasonable steps to deactivate use of the Card at any time in its absolute discretion and the Bank by the Bank. existing in such other accounts against the Transactions charged or and Conditions by notifying the Bank in writing, cutting the Card in Bank’s Schedule of Charges) to the Cardholder(s). Any such changes the Card upon it being reported stolen or lost, subject to the shall not be liable for any loss suffered by the Cardholder as a result to be charged by the Cardholder against the Account. half and returning the Card to the Bank. Such termination shall be will be effective from the date stated on the notice or Schedule of Cardholder providing information to establish his/her identity to thereof. The Card shall only be used by the Cardholder. The effective, subject to the provisions of the following paragraphs of this Charges or such later date as may be expressly specified therein by The Cardholder understands that by signing this Application Form, the 2. Card Usage the satisfaction of the Bank. However, the Bank will not assume Cardholder is not permitted to give his/her Card to third parties and clause, upon receipt by the Bank of such notice of termination by the the Bank. However, any charges or fees due to MasterCard in respect Cardholder agrees to all Terms and Conditions contained therein relating liability for any misuse of the Card until such time as it is is responsible for ensuring that the Card is not accessible to any such Cardholder. of the use of the Card and any variations thereto made by to the Samba Bank Limited (SBL) Debit MasterCard issued by Samba 2.1. The Cardholder shall be responsible for all facilities granted by deactivated. third parties. MasterCard shall be solely to the Cardholder’s Account only and the 24. Bank Account Terms and Conditions: Bank Limited (SBL) Limited (hereinafter referred to as "the Bank"). the Bank in respect of the Card and all related charges. The Card Bank shall not be liable for same. These Terms and Conditions shall be read in conjunction with the Terms may be used to withdraw money at any Automated Teller These Terms and Conditions are to be read in conjunction with the and Conditions for bank accounts as applicable from time to time. Machine ("ATM") or to access any additional banking services Account opening Terms and Conditions as shall be applicable to the offered through the ATMs (including, but not limited to transfer Account from time to time. of funds locally from one account to another within the Bank or any other bank in Pakistan and payment of utility bills). The Card may also be used for payment for goods and/or services at 9. Total Usage retailers or suppliers worldwide which display the MasterCard (or Maestro®/Cirrus®) & 1LINK, MNET sign and who accept the The total amount of any Transactions carried out in any one day 11. Refusal to Accept Card Card, subject to compliance with MasterCard rules and shall be limited to such amounts and by such other conditions as 13. Cancellation of Transactions regulations as applicable from time to time. 7. PIN shall be notified in writing to the Cardholder by the Bank from time The Bank shall not be liable for any loss resulting from the refusal of 25. Governing Law 1. Definitions to time with effect from the date of such notice irrespective of the any retailer, supplier, other bank or card operated machine to accept A Transaction cannot be cancelled by the Cardholder after it has 18. Agreement to Remain in Full Force and Effect 7.1 At the request of the Cardholder, the Bank will issue a PIN to the credit balance in the Account. The Cardholder is not authorized to use of the Card in connection with any Transaction. No claims of the been completed. These Terms and Conditions are to be read in conjunction with the 1.1. "Card" shall mean the Samba Bank Limited (SBL) Debit Cardholder. If the Bank issues a PIN, the Cardholder must take all enter into Transactions using the Card to a value in excess of the Cardholder against any retailer or supplier may be the subject of The Agreement comprised in these Terms and Conditions, shall be 22. Disclosure Terms and Conditions which govern the issuance and usage of debit MasterCard, which shall include any re-issued, replacement and 4.2 The Cardholder must co-operate with any officers, employees, reasonable precautions to avoid unauthorized use, including but credit balance (if any) of the Account from time to time. If the Bank is set-off, claim or counterclaim against the Bank. The Bank shall not be deemed to remain in full force and effect if and in so far as any cards issued by the Bank. These Terms and Conditions are subject to supplementary/add-on Card. representatives or agents of the Bank and/or law enforcement not limited to, destroying any correspondence containing the PIN asked to authorize a Transaction, the Bank may take into liable in any way for the quality, quantity, sufficiency, acceptability, Transaction is completed but not debited to the Account prior to The Cardholder authorizes the disclosure to any company within the the rules and regulations, circulars and directives of the State Bank agencies in any efforts to recover the Card if it is lost or stolen. promptly after receipt, never disclosing the PIN to any third consideration any other Transactions which have been authorized merchantability of goods and/or services booked, used or purchased 14. Posting termination thereof. Bank’s group of companies, to any third party processors, service of Pakistan (as may be applicable from time to time) and will be The Bank is authorized to disclose information about the party, never writing the PIN on the Card or any other item but which have not been debited to the Account (and any other by the Cardholder through the use of the Card or for any breach or providers and/or card personalization firms utilized by the Bank from governed by the substantive and procedural laws of the Islamic Cardholder and the Account if the Bank ascertains that it will normally kept with the Card and never writing the PIN in a way transactional activities upon the Account) the limits and other non-performance of any Card Transactions by a retailer or supplier.
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