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 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 Joint Applicant 2 *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 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 Account Information: 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.