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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
Please fill the entire form in CAPITAL LETTERS only.
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.

Leave one box space between each word. (Example)

Name :

Male Female

Address for Correspondence :

Town / City

State

Pin Code

Telephone

2nd Telephone / Mobile :

e-mail :

Fax :

My account/s on which I require ATM services :

Primary AccountSavings

OR Current

Branch

Secondary AccountSavings

OR Current

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

ATM Branch Code
Issue Card Yes / No
Card Issuing Branch Code
Issue Card Yes / No

Application Sr. No. .................................................
Old ATM Card No. ...................................................
New ATM Card No. ...................................................