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APPLICATION FORM FOR ATM CARDS MYBANK CASH

Thank you for applying for the SBM ATM Card. To help us process your request quickly, please fill this form as per the instructions below.
If you have any questions, please check with your branch manager. We are committed to make your life simpler with SBM ATM Card.
IMPORTANT INSTRUCTIONS:
Please fill the entire form in CAPITAL LETTERS Only. Leave one box space each word.
Complete all sections. Sign the declaration.
Do not write outside the boxes provided. Joint account holders to fill separate application form.
Joint a/c to be under 'either or survivor' / anyone or survivor' clause
Your Name
(Name as you would loke it on the card( including space max 25 letters) with title.
For example :
R A V I K U M A R
Male Female
Address for
Correspondence
Town / City Pin Code
Telephone ( Office) 2nd Telephone / Mobile Number
Residence
My designated account/s on which I require ATM services:
Primary Account Saving Or Current Branch
Saving A/c No
Current A/c No
E-Mail ID
Declaration I am aware of the terms and condition ( overleaf) governing the use of the ATM Card and agree to able by6 them
The bank may call me at my residence/office in connection with my ATM transactions.
For Office Use Only
Mode of operation SINGLE E or S F or S Anyone or S Applicant's Signature
STANDALONE ATM or NETWORKED ATM Application Sr No……………………………………………………………………..
ATM Branch Code Card Issuing Branch Code Old ATM Card No……………………………………………………………………..
Link Branch Code Issue Card Yes/No
Daily Limit (3000/5000/9900) New ATM Card No……………………………………………………………………
Issue Card Yes/No

(Br. Mgr's Signature & Stamp)