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SBI Multipurpose Application Form

This document is a multipurpose application form for customers of the State Bank of India to request various services such as address changes, debit cards, statements, cheque books, internet banking, and account closures. Customers must provide their personal details and specify the service needed by ticking the appropriate boxes. The form also includes sections for office use to track the application and actions taken.

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vikaschauhanz8023
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1K views3 pages

SBI Multipurpose Application Form

This document is a multipurpose application form for customers of the State Bank of India to request various services such as address changes, debit cards, statements, cheque books, internet banking, and account closures. Customers must provide their personal details and specify the service needed by ticking the appropriate boxes. The form also includes sections for office use to track the application and actions taken.

Uploaded by

vikaschauhanz8023
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

MULTIPURPOSE APPLICATION FORM

To,
The Branch Manager
State Bank of India

Date: ______________

Name: ___________________________________

Account No.: ___________________________ Mobile No.: _______________________

Phone No.: ___________________________

Please Tick the Appropriate Box


[ ] CHANGE OF MAILING ADDRESS AS BELOW: (Please enclose proof of new address)

City: __________________ Pin Code: __________________

Tel. No: __________________ Mobile No.: __________________ E-mail ID: __________________

[ ] DEBIT CARD / PIN NUMBER (Please debit the charges to my A/c if any)

[ ] Debit Card not received.

[ ] Debit Card Lost/Misplaced. Please block the card or issue New ATM Card.

[ ] PIN NUMBER

[ ] Pin Number not Received

[ ] Forgotten the Pin Number, Please issue New Pin Number.

[ ] STATEMENT (Please debit the charges to my A/c if any)

Statement required from Date: ______________ to ______________

[ ] Statement not received by us.

[ ] CHEQUE BOOK REQUEST

[ ] Not received for New A/c

[ ] Request issue but not received

[ ] Please issue Cheque book of ______ Leaves.


[ ] INTERNET BANKING (Connect)

[ ] Password not received

[ ] User ID not enabled

[ ] Forgot Password

[ ] ATM COMPLAIN

[ ] A/c Debited Twice for Rs. ____________

[ ] Rs. ___________ withdrawn but not Received Cash & A/c is debited.

[ ] I withdraw Rs. ___________ But received Rs. ___________

[ ] STOP PAYMENT REQUEST

Cheque No.: ___________ No. of Leaves: ___________

Drawee Bank: __________________ Payee's Name: __________________

[ ] ACCOUNT CLOSURE REQUEST (Please debit the charges to my A/c if any)

[ ] Unused Cheque leaves submitted with Cheque No. from ___________ to ___________

[ ] Debit Card submitted for Name: __________________

[ ] For Transfer of Account: Please transfer my / our A/c to Branch Name: __________________

(Code): __________________

[ ] REQUEST FOR BALANCE CERTIFICATE (Charges to be debited to my A/c)

[ ] Please issue balance certificate as on date: __________________

[ ] ADD NAME IN MY SAVING A/c NO.

My A/c No. is: __________________

[ ] Addition Name: __________________

[ ] Mode of operation: __________________

[ ] Relationship with A/c Holder: __________________

[ ] SMS Facility: Please give SMS facility

Mobile No.: __________________ [ ] A/c No.: __________________

[ ] OTHER (Please mention here): __________________


Please debit the applicable charges to my Savings/Current A/c __________________

Signature of Customer: __________________ Date: ______________

For Office Use Only


Application received by: __________________ Action Taken by: __________________

Date: ______________

Remarked if any: __________________

Relevant Charges Denoted Rs.: __________________

Signature: __________________ Date: ______________

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