SBI CASH State Bank of India
APPLICATION FORM FOR ATM CARDS
Thank you for applying for the SBI 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 the SBI ATM Card.
IMPORTANT INSTRUCTIONS Leave one box space between each word.
Please fill the entire form in CAPITAL LETTERS only. (Example)
Complete all sections.
Do not write outside the provided boxes.
Joint a/c. to be either or survivor / anyone or survivor
Sign the declaration
Joint account holders to fill separate application forms.
Name :
Male Female
Address for
Correspondence :
Town / City
State Pin Code
Telephone 2nd Telephone/ Mobile Phone Number :
E-Mail : Fax :
My account/s on which I require ATM service :
Primary Account Savings OR Current Branch
Choose one account type of primary and
Secondary Account another account type (if necessary) for
Savings OR Current Secondary account.
Saving A/c. No.
Current A/c. No.
Declaration : I am aware of the Terms and Conditions (overleaf) governing the use of the ATM card and agree to abide
by them. The Bank may call me at my Residence / Office in connection with my ATM transactions.
For Office Use Only (Applicant’s Signature)
Mode of Operation SINGLE E or S F or S Anyone or S
NETWORKED ATM
Application Sr. No.
ATM Branch Code
Old ATM Card No.
Issue Card Yes / No
New ATM Card No.
Card Issuing Branch Code
Issue Card Yes / No
(Br. Mgr’s Signature & Stamp)