Customer Requests Form 1
Customer Details (To be filled in by the customer)
To, The Branch Manager,………......……….………………………..Branch
Customer’s Name & Account Number Date D D M M Y Y Y Y
Customer ID.
(Please tick boxes as per service requested)
A CUSTOMER DATA UPDATE B MOBILE BANKING
Name Update: Register for Mobile Banking
Deregister from Mobile Banking
C INTERNET BANKING
KYC for Name Update:
Register for Internet Banking
Document Type1:
Deregister from Internet Banking
Document Number:
D CHEQUE BOOK
Date of Birth Update1: D D M M Y Y Y Y
Account No.
Phone Number Update: +91
New cheque book request 10 25 100 Leaves
Email ID Update:
Personalized Non Personalized
Preferred delivery :
PAN Details Update1:
Branch Current address (confirm if the address is updated)
Aadhaar Update2:
Current Address Update E STATEMENT
(Please leave space between two words)
Account No.
Statement required for the period* From D D M M Y Y Y Y
To D D M M Y Y Y Y
Half
Register for e- statements Monthly Quarterly
yearly
State: Deregister from e-statements
Pin Code: Request for new Passbook Request for Duplicate Passbook*
KYC for Address Proof: DORMANT / INACTIVE ACCOUNT
F
Document Type1: Activation of dormant account / inactive account
Document Number: Account No.
Permanent Address Update
(Please leave space between two words) Reason for not operating ……………………………….…...………..
G SMS BANKING AND ALERTS
Avail SMS Banking Services
Register for the following SMS alerts*:
Credit / Debit Alert
Balance Alert Periodicity: Daily Weekly
State: Fortnightly Monthly
Pin Code: Overdraft Alert
Same as Current Address
KYC for Address Proof: De-register from the following alerts:
Document Type1:
Credit / Debit Balance Overdraft
Document Number:
1 *Applicable charges will be levied as per rules
I have attached photocopy of necessary documents as mentioned above.
2 I submit my Aadhaar number and voluntarily give my consent to:
• Seed my Aadhaar/UID number issued by the UIDAI, Govt. of India in my name with my account
• Map it at NCPI to enable me to receive Direct Benefit Transfer (DBT) from Govt. of India in my account.
• I understand that if more than one Benefit is due to me, I will receive all Benefit Transfers in this account
• Use my Aadhar details to authenticate me from UIDAI
Request you to kindly update/ activate the data/services as selected above.
SIGNATURE OF THE CUSTOMER (AS PER BANK RECORDS)
Acknowledgement Slip (To be filled in by the Bank Staff)
Received from : ……………………………………….. A/c No. Request for A / B / C / D / E / F / G / H / I
Date D D M M Y Y Y Y
Syndicate Bank Branch Name ……………………………………..…………....…....
SIGNATURE OF BANK OFFICIAL
Customer Requests Form 2
H DEBIT CARD J STANDING INSTRUCTION
Debit Card Issue Request Set Standing Instruction for *
Account No.
Amount ₹
New Card Add on card
Monthly Quarterly Yearly
Visa Rupay Maestro Global Frequency
Instant Personalised From D D M M Y Y Y Y To D D M M Y Y Y Y
Classic Gold Platinum
DEBIT A/C No.
Customer ID of Joint Applicant
Preferred delivery : Name ..........................................................................................................
Branch Current Address
CREDIT A/C No.
Hotlisting of Debit Card Number
Unblocking of Debit Card Number Name ..........................................................................................................
Issue Debit Card Duplicate Pin K STOP PAYMENT
Card Number:
Cheque Number: To
Date: D D M M Y Y Y Y
Photo of account Amount of cheque:
holder in case of Payee's Name ..........................................................................................
Gold/ Platinum
Reason :
Debit Cards
L ACCOUNT TRANSFER
Request to transfer account number:
Request to link debit card of customer ID From Old branch To New branch
Existing/old Account no: B/C B/C
Name Name
New Account no:
Reason for transfer
I BALANCE CONFIRMATION M INTEREST CERTIFICATE
Request for balance certificate for Account No: Request for interest certificate for Account No:
For the year
Reason :
FY: Y Y Y Y To FY: Y Y Y Y
N NOMINEE ADD/CHANGE REQUEST
I/We _______________________________ cancel the nomination made by me/us in favour of Name _________________________,
Relationship _________________________, Age ____________________ and hereby nominate the following person
Nominee Name
(in full)
KYC No.
Relationship Date Of Birth D D M M Y Y Y Y
Address
Village / Town / City District
State Pin code Print name on Passbook Y N
If nominee is a minor,
As the nominee is a minor on this date, I appoint the following to receive the amount of the deposit on behalf of the nominee in the event of my / minor's death during the minority of the nominee
Guardian Name(in full)
Relationship with minor Date of Birth D D M M Y Y Y Y
Address
Nominations under Sections 45 ZA of Banking
Regulation Act, 1949 and Rule 2(1) of the Banking
Companies (Nomination) Rules 1985 in respect of
Bank Deposits. I nominate the person mentioned Signature / thumb impression Signature / thumb impression Signature / thumb impression
above to whom in the event of my / minor's death, the of Primary applicant of Joint applicant 1 of Joint applicant 2
amount of deposit in the account may be returned by
Syndicate Bank by the account opening branch.
*Applicable charges will be levied as per rules
Request you to kindly update/ activate the data/services as selected above.
SIGNATURE OF THE CUSTOMER (AS PER BANK RECORDS)
