Account Opening Form. 194-Ver 1.0-Jan 2013 DCB Bank Limited (Formerly Development Credit Bank Limited)

Transcription

1 Account Opening Form For Non Resident Indians 194-Ver 1.0-Jan 2013 CB Bank Limited (Formerly evelopment Credit Bank Limited) 009 / Jan 15 / 1.0

2 Introduction ocuments When filling the form please ensure that you fill Form A-1 enclosed with this form to avail the nomination facility. While the nomination facility is optional, we recommend that you avail of it. A) andatory documents for all categories Photocopy of the passport pages where your name, address, specimen-signature, photograph are recorded Copy of valid Visa / Work Permit / Residence Permit (the Visa could be either in the passport or issued separately) Proof of your mailing address. Please tick the documents submitted, from the table below Latest passport size photographs, duly affixed on the AOF and signed across Initial payment for each account or deposit selected on the account If you are a Person of Indian origin, please provide any of the following documents i. Person of Indian Origin (PIO) / Overseas Citizen of India (OCI) Card ii. Passport issued by a foreign country where nationality is mentioned as Indian, or Indian passport held by you at any point in time iii. Copy of the birth certificate or Indian passport held by parents or grandparents, along with proof of relationship iv.copy of the Indian passport of spouse along with relationship proof List of eligible documents for proof of communication address Copy of passport Copy of bank statement / passbook overseas or Indian (not more than 3 months old not downloaded from internet banking) if mailing address and statement of account provided is of India, the statement should be of an NRI account OR, the non resident status should appear / be certified by the bank on the statement of account. Copy of utility bill for electricity / gas / telephone / water / rent receipt (not more than 3 months old) Copy of driving license (for list of countries please refer to point B (i)) Certificate from employer confirming the address (on organisation s letterhead - with stamp) Copy of credit card statement (not more than 3 months old) Certificate from Indian diplomatic mission containing the contact address Copy of Govt. I Card (SSN / Green Card / PIO Card / OCI Card) Copy of appointment letter from employer indicating the address (on organisation s letterhead - with stamp, not more than 1 year old) Letter from warden of university hostel containing the address (for on-campus lodging) Copy of ration card Copy of registered purchase / sale deed or agreement Overseas Indian B) If you have not met our Branch staff in person while submitting your forms & supporting documents, the following procedure needs to be followed: The photocopies of the (a) Passport, (b) Visa / Work Permit / Residence Permit and (c) ailing Address must be attested by : (I) An overseas banker - (applicable only in Argentina, Australia, Austria, Belgium, Brazil, Canada, China, enmark, Finland, France, Germany, Greece, Bahrain, Qatar, Kuwait, Oman, Saudi Arabia, UAE, Hong Kong, Iceland, Ireland, Italy, Japan, Luxembourg, exico, the Netherlands, New Zealand, Norway, Portugal, Russian Federation, Singapore, South Africa, Spain, Sweden, Switzerland, Turkey, the UK and the United States of America) OR (ii) An overseas banker (other than in the countries listed above) - provided that, the account opening amount is through a cheque drawn on the same bank branch OR (iii) Any branch of an Indian bank abroad (in any country) OR (iv) Notary Public or equivalent authority OR (v) The Indian diplomatic mission in the country of residence OR If you are unable to get your documents attested as stated above, you will need to submit two self-attested proofs of your overseas address, among the list of eligible documents stated above. Instruction for filling Account Opening Form Please fill the form preferably in BLACK ink only Hint boxes give tips and highlight important points across the form A B C Please fill the form in CAPITAL LETTERS only Please tick the appropriate boxes Please write your NAE as it appears in all your support documents Specify the addresses along with City, State and PIN Code Please counter sign in full against any overwriting / alteration ALL PHOTOCOPIES of documents to be SELF-ATTESTE by the applicant

3 Personal etails : Applicant 1 (* Fields are andatory) *Name: r. rs. s. r. Prof. Others (First Name) (iddle Name) (Last Name) *Short Name: *ate of Birth: *Nationality: *Preferred *Passport etails: Passport No. *Visa etails: Indian *other s aiden Name: Type of Visa: Other (pl. specify) Existing Customer I (If applicable): *Gender: ale Female Third Gender *Telephone (with IS Code): *Preferred obile No.: *PAN: Form 60 (Country Code) (Area Code) (Number) (Country Code) *Valid Until: *Valid Until: (Number) arital Status: Single arried aximum 32 characters aximum 19 characters. This name would appear on the ebit Card All communication regarding your accounts will be through your Preferred obile number and Preferred I If PAN number is not available please fill in Form 60 *Overseas Address: City: Pin: State: Country: *India Address: City: Pin: Landmark: State: OR I do not have any permanent address in India. ailing Address: Overseas India (ou must tick mark one option, proof of your mailing address is required) *Are you a politically exposed person? es No Please refer to clause 23 under T&C for meaning Customer Profile *Education: Non Graduate Graduate Post Graduate Professionally Qualified Others *Occupation: Self Employed Salaried Housewife Retired Others Profession: Finance Art Legal Teaching Agriculture edicine Engineer anagement Architect Information Technology Others *Gross Annual Income (`): Less than 50K 50K - < 1.5 Lakhs 1.5 Lakhs - < 3 Lakhs 3 Lakhs - < 5 Lakhs 5 Lakhs - < 10 Lakhs 10 Lakhs - < 50 Lakhs 50 Lakhs and above Name of the Company: esignation: Please affix a recent photograph Sign across the photo Name: Signature ate: Please affix a recent photograph. Please sign in Black Ink within the box. Signature shall be considered for all Cheque clearances and any future communication with the Bank 3

4 Joint Applicant (* Fields are andatory) (Guardian to fill a inor eclaration Form separately) *Residential Status: Non Resident Indian *Preferred *other s aiden Name: ## Resident Indian If applicable, please attach age proof *Name: r. rs. s. r. Prof. Others (First Name) (iddle Name) (Last Name) *Short Name: *ate of Birth: *Nationality: Indian Other (pl. specify) Existing Customer I (If applicable): *Gender: ale Female Third Gender *Telephone (with IS Code): *Preferred obile No.: *Passport etails: Passport No. *Valid Until: *Visa etails: Type of Visa: *Valid Until: *PAN: Form 60 (Country Code) (Area Code) (Number) (Country Code) (Number) arital Status: Single arried aximum 32 characters aximum 19 characters. This name would appear on the ebit Card All communication regarding your accounts will be through your Preferred obile number and Preferred I If PAN number is not available please fill in Form 60 *Overseas Address: City: Pin: State: Country: *India Address: City: Pin: Landmark: State: OR I do not have any permanent address in India. ailing Address: Overseas India (ou must tick mark one option, proof of your mailing address is required) *Are you a politically exposed person? es No Please refer to clause 23 under T&C for meaning Customer Profile *Education: Non Graduate Graduate Post Graduate Professionally Qualified Others *Occupation: Self Employed Salaried Housewife Retired Others Profession: Finance Art Legal Teaching Agriculture edicine Engineer anagement Architect Information Technology Others *Gross Annual Income (`): Less than 50K 50K - < 1.5 Lakhs 1.5 Lakhs - < 3 Lakhs 3 Lakhs - < 5 Lakhs 5 Lakhs - < 10 Lakhs 10 Lakhs - < 50 Lakhs 50 Lakhs and above Name of the Company: esignation: Please affix a recent photograph Sign across the photo Name: Signature ate: Please affix a recent photograph. Please sign in Black Ink within the box. Signature shall be considered for all Cheque clearances and any future communication with the Bank 4

5 Account etails This section is mandatory Preferred City: Preferred Branch: CB Elite Account Number (ention last 8 digits): Please visit for complete list of our branches Savings Accounts: Current Accounts: ode of Operation CB Classic NRE Savings Account CB Classic NRE Current Account Single Either or Survivor* CB Classic NRO Savings Account CB Classic NRO Current Account Joint andate CB Elite NRE Savings Account Former or Survivor CB Elite NRO Savings Account * If the joint applicant is a resident Indian then the CB NRE Account / CB NRE eposits / CB FCNR (B) eposits will be opened on a Former / Survivor basis. Account Usage This section is mandatory Source of Funds for Credits in the Account: Savings Salary Business Proceeds Sale of Property Investments Inheritance Professional Fee Other (please specify) Foreign Inward Remittances in a year: Approximate Value ` Expected Annual Turnover in the account: Less than ` 1 lakh Upto ` 1 lakh Upto ` 10 lakhs Upto ` 50 lakhs Upto ` 1 crore Upto ` 5 crores Upto ` 10 crores Upto ` 25 crores ore than ` 25 crores Expected number of transactions in a month: Up to to 50 ore than 50 ode of Funding Accounts Cash emand raft / Cheque No. rawn on Wire Transfer from ebit NRO Account No. for credit to new NRO Account (Remitting Bank's Name & Address) ebit NRE Account No. for credit to new NRE Account Currency & Amount (in figures and words) (If you are opening more than one account, please indicate appropriately for each account) Term eposit Accounts CB FCNR (B) eposit: Currency AU CA EURO GBP US CB NRE eposit CB NRO eposit CB NRE Recurring eposit: INR montly eposit CB NRO Recurring eposit: INR montly eposit CB NRO Tax Saver Fixed eposit (Note: CB NRO Tax Saver Fixed eposit maximum limit 1.5 lakhs and cannot be closed prematurely.) ode of Funding eposits Type of eposit: Ordinary Cumulative Amount (in figure) (in words) If you are opening more than one deposit, please indicate appropriately for each deposit. Tenure ays / onths / ears (Please refer to the interest rate table on for details on interest rates and tenure) Interest Payment: Credit my / our CB Bank Account No. inimum tenure for FCNR (B) and CB NRE eposits is 1 year. on Ordinary deposit Issue a emand raft and mail to my correspondence address aturity Instructions Renewed for The amount due to me / us on maturity should be ays / onths / ears Credited to my / our CB Bank Account No. at my correspondence address payable at 5

6 Bank Name: Address: Wire Transfer (please provide overseas Bank Name, Address and Account Number) Account No. Note : our Term eposit will automatically be renewed for the same period at the prevailing interest rates on maturity if we do not receive prior notice before maturity. Access Channels Note: CB ebit / AT Card and CB Internet Banking are being provided complimentary at no extra cost to all our Non Resident account holders. In case, you want to opt out of the said facility, you may please indicate by ticking the box below: No, I do not want CB ebit / AT Card to be activated for my account/s. * CB International Visa ebit cum AT Cards will be issued for NRE Accounts. CB omestic Visa ebit cum AT Cards will be issued for NRO Accounts No, I do not want CB Internet Banking to be enabled for my accounts. Nomination etails (Form A 1) es, I want to nominate the following person This section is mandatory No, I do not want to nominate anyone on my behalf Preferable for Single & Joint Account holders I / we nominate the following person to whom in the event of my / our / minor s death the amount of the deposit / in the account may be returned by CB Bank. Nominee Name: Address: Relationship with Applicant, if any Age: ears ate of Birth: Residential Status of the Nominee: Non Resident Indian Resident Indian * As the nominee is a minor on this date, I / we appoint (Name & Adress) to receive the amount of the deposit / in the account on behalf of the nominee in the event of my /our / minor s death during the minority of the nominee. In case you have specified a nominee above, please indicate if you wish to make mention of the nominee name on the passbook, statement & CA issued in respect of your account and / or the passbook issued to you es No I / We do hereby declare that what is stated above is true to the best of my / our knowledge and belief. Nomination under Section 45ZA of the Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules 1985 in respect of bank deposits. Signature(s) of depositor(s) Form 60 (to be filled by those who do not have either PAN or GIR) Are you a Tax Assessee: es No If es, a) etails of Ward / Circle / Range where the last return of income was filed: b) Reason for not having PAN / GIR No.: I, do hereby declare that what is stated above is true to the best of my / our knowledge and belief. Verified at this day of 20 Signature of the eclarant 6

7 eclaration cum Terms and Conditions I/We, hereby solemnly declare and undertake as under: 1. I am / We are Non-Resident Indian(s) of Indian Origin. 2. I / We understand that the above account will be opened on the basis of the statements/ declarations made by me / us and will be opened in the form and as per various Regulations framed under the Foreign Exchange anagement Act, 1999 ("the Act") and in particular, the Foreign Exchange anagement (eposit) Regulations, 2000 ("the Regulations") as amended from time to time. I / We also agree that if any of the statements/ declarations made herein found to be not correct in material particulars, you are not bound to pay any interest on the deposit made by me / us and to discontinue the services. 3. I / We further declare that the undersigned has / have the authority to give this declaration and undertaking on behalf of the firm / company. Applicable when the declaration / undertaking is signed on behalf of the firm / company. 4. The account will be put into use only for bonafide transactions not involving any violations of the provisions of any Government / Exchange Control Regulation. 5. I / We agree that the rate and the manner of interest to be paid shall be as per the Regulations and no claim will be made by me / us for any interest on the deposit/s for any period after date/s of maturity of the deposit/s. 6. I / We agree to abide by the provisions of the FCNR (B) / NRE / NRO / RFC Account schemes as laid down and the Regulations as amended from time to time by the Reserve Bank of India (RBI). 7. I / We hereby undertake to intimate you about my / our return to India for permanent residence immediately on arrival. 8. I / We authorise CB Bank Limited (Formerly evelopment Credit Bank Limited) (the Bank ) to automatically renew the deposit on due date for an identical period (unless otherwise specifically instructed before due date). The earlier eposit Confirmation Advice given to me/us will be treated as discharged receipt on due date. I / We understand that the interest applicable upon renewals will be at the applicable ruling rates on the date of maturity and that the fresh eposit Confirmation Advice will be made available. 9. I / We agree that if premature withdrawal is permitted at my / our request the payment of interest on the deposit may be allowed in accordance with the prevailing stipulations laid down by the RBI in this regard. 10. I / We shall not make available to any person resident in India, any foreign currency against reimbursement in rupees or in any other manner in India. 11. I / We confirm that all debits / credits to my / our account/s shall be as specified in the Act and the Regulations. Further, in case of NRO A/c, I / we undertake that all debits to my / our account/s for the purpose of investment in India and credits representing sale proceeds of investments in India shall be in accordance with the Regulations and which are covered either by general or special permission of the RBI. 12. I / We will be liable to comply with the Rules of the Act and the Regulations and the amendments thereof in force from time to time and as stipulated by the RBI. 13. I / We understand that the Bank may at its absolute discretion, discontinue any of the services completely or partially without any notice to me / us and without assigning any reason thereof. I / We agree that the Bank may debit my / our account/s for service charges as applicable from time to time. 14. I / We have read, understood and hereby accept and agree to the Terms and Conditions given for all the products and services I / We have requested. 15. I / We agree and undertake that in case of FCNR (B) Accounts, if the remittance from outside India is not in designated currency and the same is converted to the designated currency as stipulated in the Regulations, it shall be at my/our entire risk and costs and I/we shall not challenge the rate of conversion. 16. I / We hereby agree and confirm to bear any losses or claims that may arise directly or indirectly on account of the Bank acting on any instructions received by it by fax or any electronic media given by me/us or on my / our behalf and agree to keep the Bank indemnified from any such losses and / or claims. 17. I / We do hereby declare that the information furnished in this form is true to the best of my / our knowledge and belief. 18. I / We hereby agree to indemnify and forever keep indemnified the Bank and its successors and assigns of, from and against any and all claims, actions, penalties that may be made, suffered or incurred by the Bank by reason of my / our non-compliance with the Act and / or the Regulations as amended from time to time. 19. FEA eclaration: I/We hereby declare that any transaction involving foreign exchange hereunder shall not involve and shall not be designed for any purpose of any contravention or evasion of the provisions of the Act or any rule, regulation, notification, direction or order made thereunder. I/We also hereby agree and undertake to give such information/documents as shall satisfy the Bank with regard to any foreign exchange transaction in terms of the above declaration. I/We also understand that if I/we refuse to comply with any such requirement or make any unsatisfactory compliance therewith, the Bank shall refuse in writing to undertake any transaction on my/our account and shall, if it has reason to believe that any contravention is contemplated by me/us, report the matter to the RBI and/or any such authority as the Bank deems fit. 20. PIO declaration (where applicable): (i) I/We confirm that I/we am/are a Person / Persons of Indian Origin (PIO) by virtue of having (a) at any time held an Indian passport or (b) I/We or either of my/our parents or any of my / our grandparents were citizens of India by virtue of the Constitution of India or the Citizenship Act, 1955 or (c) my/our spouse is an Indian Citizen or a person referred to in (a) or (b); (ii) For Citizens of Bangladesh or Pakistan Only : I/We have obtained specific approval from the RBI to open accounts for Non-Resident Indians and a copy of the same has been submitted along with my/our application form. 21. ECLARATION FOR LOANS / AVANCES: The Bank may, on receipt of a written application from r./s. and / or the former / the latter / the first named or either or Survivor of us / any one of us or survivors or survivor of us in his / her / their discretion and subject to such terms and conditions as the Bank may stipulate, (a) Grant a loan / advance against the security of the term deposit to be issued in my/our name/joint names. In case of loan or overdrafts against FCNR (B) or CB NRE eposits, premature withdrawal of the Term eposit is not permitted. 22. ECLARATION FOR PRE-ATURE PAENT: Subject to 21 above, the Bank on request from the depositor would allow withdrawal of the Term eposit before completion of the period of the deposit agreed upon at the time of placing the deposit. The Bank shall declare their penal interest rates policy for premature withdrawal of the Term eposit. The Bank shall make depositors aware of the applicable rate for premature withdrawal of such deposits along with the deposit rate. In case of deposits held jointly for the instructions, premature termination must be signed by all holders. 23. EFINITION OF POLITICALL EXPOSE PERSON: Politically Exposed Persons are individuals who are or have been entrusted with prominent public functions in a foreign country, e.g., Heads of States or of Governments, senior politicians, senior government/judicial/military officers, senior executives of state-owned corporation, important political party officials, etc. In addition, a Politically Exposed Person includes the immediate family members of a Politically Exposed Person such as spouses, children, parents and other relatives. Politically Exposed Person includes even close associates like advisors, secretaries and other associates of a Politically Exposed Person who conduct transactions on behalf of a Politically Exposed Person. 24. The Bank is authorised to arrange a correspondent bank/agent for realising the proceeds of foreign currency cheques deposited. The Bank has a Cheque Collection Policy in place, under which if the instrument(s) for collection is / are returned unpaid at any time, the returning and other charges may be debited to my / our account/s. If any Cheque / draft credited to my / our account/s provisionally prior to final realisation under your special cash letter services is returned unpaid, the amount may be recovered from my / our account/s at the appropriate exchange rate along with interest applicable at such rates as may be decided by you. I / We undertake to refund the amount, if already drawn by me / us, immediately on demand if my/our account/s does not have sufficient balance to recover the amount with interest and / or any other charges. 25. I / We confirm having read and understood terms and conditions for all the services I/we have requested above. I / We accept and agree to be bound by the said terms and conditions for the use of the above selected services. I / We authorise the applicant to access the account(s) via the channels selected and authorise to link new account/s opened by the applicant to the channels selected. I / We accept and agree to be bound by the said terms and conditions for the use of the above selected services. The Terms and Conditions are as per current regulatory environment; the same are bound to change without prior notice as per changes in the regulatory framework. 26. For Application Forms submitted online: I / We understand, agree and undertake that in case of my/our submission of the duly filled-in online Application Form on the Bank s website I/we am/are required to send a scan copy of all KC documents to nri@dcbbank.com immediately and also submit the signed physical copy of my/our Application Form and KC documents within 30 (thirty) days of my/our submission of online Application Form. I / We understand and agree that my/our cheque book/s and ebit/at card/s will be inactive and withdrawals from / debits to my/our account/s will not be allowed by the Bank, until physical copies of my/our Application Form and KC documents are submitted by me/us and received by the Bank. I / We also understand and agree that in case I/we fail to submit my/our Application Form and KC documents within 30 (thirty) days of my/our submission of online Application Form, the Bank is entitle at its sole discretion to close my/our account/s. If there are any funds remitted by me/us into my/our account/s, they will be sent back to the address mentioned in the Application Form vide a emand raft. I / We understand and agree that the associated charges/costs incurred by the Bank will be debited from my/our account/s, before remitting the funds back to me/us. I / We also understand and agree that in case of foreign exchange transactions, the rate of exchange applied by the Bank will be as per the prevailing market rates and shall not be questioned / disputed by me/us for any reason whatsoever. Signature of Applicant Signature of Joint Applicant 7

8 Terms & Conditions for instructions to be given by Fax, Telephone and other means of Electronic Communication To, CB Bank Limited (Formerly evelopment Credit Bank Limited) Notwithstanding anything to the contrary contained in any other document / agreement, I / We, the undersigned, hereby request and authorise you to rely and act on all instructions or communications for any purpose (including but not limited to the instructions / communication pertaining to the operation of all my / our accounts or to any other facilities or services that may be provided by you from time to time) which may from time to time be or purported to be given by telephone, facsimile, untested telexes and faxes, telegraph, cable, or any other form of electronic communication by me / us (including such instructions / communication as may be or purported to be given by those authorised to operate my / our account(s) with you) "Instructions" - I / We understand and acknowledge that there are inherent risks involved in sending the Instructions to you via telephone, facsimile, untested telexes and faxes, telegraph, cable, or any other form of electronic communication and hereby agree and confirm that all risks shall be fully borne by me / us and I / We assume full responsibility for the same, and you will not be liable for any losses or damages including legal fees arising upon your acting, or your failure to act, wholly or in part in accordance with the instructions so received. In consideration of you agreeing, subject to the terms and conditions hereunder, to act upon the instructions as aforesaid, I / We hereby irrevocably agree and undertake: That you shall be entitled to act or refuse to act as you see fit, without incurring any liability whatsoever to me or to any other person, upon any Instructions for any purpose which may from time to time be or purported to be given by telephone, facsimile, untested telexes and faxes, telegraph, cable, or any other form of electronic communication by me / us (including such instructions as may be or purported to be given by those authorised to operate my / our account(s) with you), even if such Instructions or communication are not followed up by written confirmation to you.; That the Instructions shall be conclusively presumed for your benefit to be duly authorised by and legally binding on us, and we shall be fully responsible for the same. ou shall not be responsible to ensure the authenticity, validity or source of any instructions and shall not be liable if any instructions turn out to be unauthorised, erroneous or fraudulent. That you shall be entitled (but not obliged) to keep records of our instructions given or made by telephone, facsimile, untested telexes and faxes, telegraph, cable, or any other form of electronic communication in such form, physical or electronic, as you may in your sole discretion deem fit, and your records shall be conclusive and binding on me / us. ou shall be entitled to dispose of or destroy any such records at any time as determined by you at your sole discretion; That you shall be authorised to disclose all instructions as you may deem fit, to your affiliates, counterparties, service providers, regulators and other authorities or where you are required by law to do so. That you shall be entitled to require any instruction in any form to be authenticated by use of any password, identification code or test as may be specified by you from time to time and I / We shall ensure the secrecy and security of such password, code or test and I / We shall be solely responsible for any improper use of the same; That, notwithstanding the above, you may, under circumstances determined by you in your absolute discretion, require from me / us confirmation of any instructions in such form as you may specify before acting on the same; and we shall submit such confirmation to you immediately upon receipt of your request. Pursuant to receipt of instructions, you shall have the right but not the obligation to act upon such instruction; That you shall not be liable to us or any third party for, and that I / We (jointly and severally) agree to indemnify you and keep you indemnified from and against all claims either by me or any other, actions, demands, liabilities, costs, charges, damages, losses, expenses and consequences of whatever nature (including legal fees on a full indemnity basis) and howsoever arising, which may be brought or preferred against you or that you may suffer, incur or sustain by reason of or on account/s of your having so acted whether wrongly or mistakenly or not, or of your failing to act wholly or in part in accordance with the Instructions and the terms of this letter. In consideration of CB Bank agreeing to accept instructions issued by me from time to time in respect of my non-resident account/s to be opened with CB Bank Branch, in the form of transmission from my I not bearing an original signature ( instructions"). I confirm that: I am aware and understand the possible risks involved in connection with giving of any instructions. CB Bank is hereby irrevocably and unconditionally authorized to act on my instructions, which CB Bank in its sole discretion believes to have been sent from my I as has been registered with CB Bank or otherwise appear to comply with the terms of the mandate for my non-resident account/s to be opened with CB Bank and CB Bank shall not be liable and/or responsible for acting in good faith on instructions which have been sent from my I referred to herein in any circumstances whatsoever. I undertake to keep CB Bank, its officers, directors and any employees indemnified at all time from and against, all actions, proceedings, claims, loss, damage, cost and expenses which may be brought against you or suffered or incurred by you and which shall have arisen either directly or indirectly out of or in connection with your accepting instructions from me and acting thereon, whether or not the same are confirmed in writing by me or not. That I / We confirm that I / We have the capacity and authority to accept this document and that this document constitutes our valid, legal, effective and enforceable obligation. That this declaration shall be governed and construed to be in accordance with the laws of India and I / We hereby irrevocably submit to the non-exclusive jurisdiction of the courts in umbai. Signature of Applicant Signature of Joint Applicant TAA Self eclaration To, CB Bank Limited (Formerly evelopment Credit Bank Limited) ear Sir/adam, I, (insert full name and address) having understood the provisions of the Indian Income-tax Act, 1961, in particular those related to tax residence and the scope of income taxation, declare and confirm that: I am / will be a non-resident within the meaning of the Indian Income-tax Act, I am a tax resident of the (name of the TAA Country) within the meaning of the Agreement for Avoidance of ouble Taxation between India and the (name of the TAA Country) ( the tax treaty for short) and therefore, entitled to the benefits of the tax treaty. y PAN (Permanent Account Number) is. In case I do not provide my PAN details, I shall not be given the TAA benefit. I undertake to keep the Bank informed of any change in my residency. I also understand that on any change in my country of residency, I will be required to submit revised documentation for benefiting from lower deduction of taxes under TAA for the country I will be now residing in. Until such time, the Bank will withhold taxes at the applicable rate of 30% + cess. I currently hold Passport No. and Visa No. issued by the Government of, copies of which are attached herewith. I am the beneficial owner of the funds from which the bank fixed deposit/s will be made as well as of the interest paid by the Bank thereon and Article (relevant article dealing with interest) of the tax treaty will govern the Indian income tax liability on such interest. As such, the Indian income tax will be limited to (TAA Tax Slab as per Reckoner) of the gross interest paid. I shall provide Tax Residency Certificate and Form No. 10F (if applicable) as defined under Indian Income Tax provisions. I acknowledge that TAA benefit would be effective subject to the Tax Residency Certificate. I undertake to promptly inform the Bank in writing should there be any change in the facts given above. I also undertake that the benefit of TAA is applicable for the current financial year and for the period commencing 1st April of the next financial year I will submit fresh set of similar documents to avail the benefit. I undertake to indemnify the Bank for any tax loss (including but not limited to tax, interest and penalty) suffered by the Bank as a result of either relying on this declaration or my delay/default in confirming the change, if any, in the facts mentioned above. This obligation shall survive indefinitely. I undertake to indemnify the Bank for any tax demand (including but not limited to tax, interest and penalty) suffered by the Bank as a result of either relying on this declaration or my delay/default in confirming the change, if any, in the facts mentioned above. I also authorize CB Bank to recover the said demand from any of my bank accounts / fixed deposit placed with the Bank. I shall provide CB Bank with all information/documents that may be necessary for any proceedings before Income-tax / Appellate Authorities in India. I confirm that, I have read and understood the applicable terms and conditions of this product/service and the relevant provisions of the ouble Taxation Avoidance Agreement between India and (country of residence) and the relevant provisions of the Income Tax Act, 1961 which can also be referred on the website I hereby declare that the contents above are correct, complete and truly stated. ours faithfully Name: Address: Signature ate: Place: 8

9 andate Holder eclaration Complete ISA of mandate holder to be furnished (Separate forms required for ultiple Accounts) ate: The Branch anager, CB Bank Limited (Formerly evelopment Credit Bank Limited) Branch ear Sir, Account Numbers: CB NRE eposit CB NRO eposit OR (Account Holder's Name): OR Joint Account Holder Name: I / We hereby request you to issue the andate Holder facility on the above account numbers to : Name: r. / s. Address: City: Pin: State: Country: Telephone: (with ST Code) Preferred 1. I / We hereby authorise the andate Holder to: a) raw cheques on the said account. b) To deposit and/or discount cheques and other instruments in the said account and for this purpose to endorse on my / our behalf cheques, drafts, pay orders and other instruments payable to me / us. c) To make deposits from balances available in the account in my / our names and renew such deposits for such periods as may be given in writing by the mandate holder. d) To certify balance confirmation statement of accounts issued by the Bank in respect of the said account. e) To give instructions in writing involving debits to the said account transfers there from etc. f) To make withdrawals for investments in India where necessary permission from RBI has been obtained by me/us. g) To use the CB AT / ebit Card issued in respect of the mentioned account. h) I / We and the mandate holder acknowledge that the issue and usage of the card is governed by the terms and conditions as in force time to time and agree to be bound by the same. I) I / We and the mandate holder acknowledge that it is my / our responsibility to obtain a copy of Exchange Control guidelines and read the same. j) I / We and the mandate holder accept that the terms and conditions are liable to be amended by CB Bank from time to time. k) I / We further unconditionally and irrevocably authorize CB Bank to debit my / our account annually with an amount equivalent to the free and charges for the use of the said CB AT / ebit card if any. 2. I / We declare that as per Exchange Control guidelines issued by RBI. a) The mandate holder can exercise the authority conferred by this letter to withdraw for local payments only, and make investment in India where I / we hold general permission or have obtained specific permission from RBI. b) The mandate facility permits the mandate holder to remit funds in foreign currency to the account holder(s) only. 3. I / We hereby undertake that I / we and our / my mandate holder shall comply with the provisions of the Exchange Control (Guidelines issued by the RBI and the Foreign Exchange anagement Act, 1999 and all regulation thereof, including the Foreign Exchange anagement (eposit) Regulations, I / We hereby undertake to indemnify CB Bank against any loss, damage, claim, action, proceedings, costs, charges and expenses that may be suffered or incurred by CB Bank on account for any activity undertaken by the mandate holder by the use of the AT Card. 4. The specimen signature of the mandate holder who has been authorized to operate upon the account is given below. The signature has been duly attested and verified by me / us. 5. This authority shall continue in force until I/we expressly revoke it by a notice in writing delivered to you. ours faithfully, Account Holder : st 1 Holder s Signature nd 2 Holder s Signature I have read and understood all the conditions stated above and hereby agree to comply with the same. I will operate the account by signing as under: andate Holder: Signature of andate Holder Signature of andate Holder has been verified by me / us: Photograph of andate Holder (Sign across Photograph) ate 9

10 inor eclaration Form etails of inor: Name of the inor: Relationship with Guardian etails of Guardian: Name of the Guardian: Nature of Guardianship Natural Legal (Please furnish copy of court order) Source of funds Own funds inor s funds I hereby declare that I shall represent the said minor in all transactions connected with this account until the said minor attains majority. I declare that the account will be operated for the benefit of the minor. I shall indemnify the Bank against the claim on the account of the minor for any withdrawal transaction made by me in his/her account. ate: Signature of Guardian erchant Navy eclaration Form I hereby confirm that I have just returned after completion of my contract with (name of company) registered in (address of the principal). I am on a break for days / months and will be joining on a new contract on/ by (date / time frame). I request you to kindly open an c CB FCNR (B) eposit c CB NRE account c CB NRO account in my name on the basis of the documents submitted I also confirm that I will inform the Bank incase I am unable to proceed on a new contract or choose not to go on a new contract, and have the non-resident accounts opened in my name redesignated to Resident / RFC accounts (if eligible). ours Sincerely ate: Signature of applicant Temporary entry work / residence Visa declaration I / We (name of a/c holder/s), the undersigned, are desirous of opening an c FCNR (B) eposit c NRE account c NRO account with CB Bank Limited. I / We have submitted to the Bank my/our Entry Work/Residence Visa(s) dated (Visa issuance date) expiring on (Visa expiry date) for this purpose. I / We hereby agree to furnish the Bank with the copy/ies of my/ our regular Visa(s) immediately on issuance and confirm that I /we have no objection if the Bank freezes transactions in the said account/s or closes the said account/s in case of my / our non-submission of regular Visa (ies) prior to the date of expiry of the Visa/s i.e. I / We also confirm that this procedure will also apply in case I / we are joint holders of the account/s. Signature/s of account holder/s: (Applicant) (Joint Applicant) Letter From Customer - Recording A ifferent Signature (When Signature recorded on any of the document provided for Signature Proof is different from the one recorded on the AOF) To be signed by the Customer in the presence of the Bank Official attesting the Signature The Branch anager CB Bank Limited (Formerly evelopment Credit Bank Limited) Branch ate: Sir / adam, With reference to the (name of the document on which the signature differs) provided by me as proof of my signature along with the Account Opening Form, I request you to please record with yourselves my specimen signature as below, as the signature on the above referred document differs from the one provided on the Account Opening Form : (Signature as per document submitted) (Signature now requested to be admitted) This difference in the signature is because ours faithfully, (Signature of the Customer) (Name of the Customer) Signed in my presence Name & Signatures of the Officer along with Signature Code Number 10

11 Bank Use only Customer I: Account No.: Application Number : Segment Code R / CSE / RO / CBE (Code): Branch: SOL Code: ate: NPC Funding Txn. / I No.: ate: Value ate: For Branch Use Customer has been et in Person Customer has opened the account through the Non-Face to Face process eclaration if the customer has been met by the branch Staff: I / We declare, that we have met the above prospective customer/s personally at ) and that he / she / they have signed the AOF and other forms in my / our presence. I / We have inspected the documents of proof of identity and address in original and that the copies thereof enclosed to the AOF (and mentioned in Checklist) have been duly verified by us against the originals and are satisfied with the same. Name of the Branch Staff HRS No.: Signature of the Branch Staff eclaration if the customer has sent his documents through the Non-Face to Face process: I/We declare that we have not met the customer in person and have not seen or verified any of the documents. The customer has been contacted through phone/ and have submitted the documents as per the Non-Face to Face process. I have inspected the documents and noted that they are in order with the process requirements. Name of the Branch Staff HRS No.: Signature of the Branch Staff eclaration to be signed by the Branch Head/BO certifying that the documents have been sourced per process (et in Person/Non Face to Face): I hereby confirm that the above named r./ s. HRS No. is a Branch Staff / CBE and I am satisfied with the above declaration regarding the ISA documents and verification of other contents in this due diligence form. Name of the Branch Head / BO HRS No.: Sep 15 / Ver 1.0-Jan 2013 CB Bank Limited (Formerly evelopment Credit Bank Limited) Signature Nomination Form Received: es No 1st Applicant s Name: Acknowledgement Application Number : Please provide this number for future reference Joint Applicant 1: Joint Applicant 2: Name of the Nominee: Name of the Bank Official: Employee code: ate: Branch: Signature of Bank Official 11

12 CB NRI Services Earn great rates on CB NRE deposits. Returns are exempted from Indian Income tax and freely repatriable. Invest in FCNR (B) deposits in US, GBP, AU, CA and EURO at no exchange risk. edicated relationship managers to manage your portfolio. Complete suite of wealth management products for all your investment needs. edicated 24-Hour Customer Care to address all your requirements. Remittances Transfer money from anywhere in the world to your loved ones in India. Wire Transfer: Available in 11 currencies namely US, EUR, GBP, JP, CHF, KK, NOK, SAR, AU, CA and AE, at competitive exchange rates. oney Transfer Service Scheme (TSS): Receive money in India with International oney Transfer Service Providers from anywhere in the world. Online oney Transfer: In association with timesofmoney ( you can transfer funds online from 23 countries and in 9 currencies to your CB Bank accounts. Terms and conditions apply. Please call CB 24-Hour Customer Care to enquire about your account application status CB 24-Hour Customer Care nri@dcbbank.com < Call India Toll Free < Website CB Bank Limited (Formerly evelopment Credit Bank Limited) th 6 Floor, Tower A, Peninsula Business Park, Senapati Bapat arg, Lower Parel, umbai Tel: ; Fax: