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Ekyc Self Declaration Form

This document is an application for a credit card using Aadhaar or e-KYC, where the applicant voluntarily submits their Aadhaar information for verification. The applicant acknowledges that submission of Aadhaar is not mandatory and consents to the Bank's use of their information for KYC processes and related purposes. Additionally, the applicant declares their current mailing address and agrees to keep the Bank informed of any changes.

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0% found this document useful (0 votes)
321 views1 page

Ekyc Self Declaration Form

This document is an application for a credit card using Aadhaar or e-KYC, where the applicant voluntarily submits their Aadhaar information for verification. The applicant acknowledges that submission of Aadhaar is not mandatory and consents to the Bank's use of their information for KYC processes and related purposes. Additionally, the applicant declares their current mailing address and agrees to keep the Bank informed of any changes.

Uploaded by

jollysamuel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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APPLICATION FOR CREDIT CARD USING AADHAAR / E-KYC

To,
The Manager, Credit Cards Division
HDFC Bank Limited (“Bank” which term shall include its successors and assigns)

Subject: Aadhaar - informed consent


1. I voluntarily opt for Aadhaar OVD KYC or e-KYC or offline verification, and submit to the Bank my Aadhaar number, Virtual ID,
e-Aadhaar, XML, Masked Aadhaar, Aadhaar details, demographic information, identity information, Aadhaar registered
mobile number, face authentication details and/or biometric information (collectively, “Information”).
2. I am informed by the Bank, that:
(i) submission of Aadhaar is not mandatory, and there are alternative options for KYC and establishing identity
including by way of physical KYC with officially valid documents other than Aadhaar. All options were given to me.
(ii) For e-KYC/authentication/offline verification, Bank will share Aadhaar number and/or biometrics with CIDR/UIDAI,
and CIDR/UIDAI will share with Bank, authentication data, Aadhaar data, demographic details, registered mobile
number, identity information, which shall be used for the informed purposes mentioned in 3 below.
3. I authorise and give my consent to the Bank (and its service providers), for following informed purposes:
(i) KYC and periodic KYC process as per the PML Act, 2002 and rules thereunder and RBI guidelines, or for establishing
my identity, carrying out my identification, offline verification or e-KYC or Yes/No authentication, demographic or
other authentication/verification/identification as may be permitted as per applicable law, for all accounts, facilities,
services and relationships of/through the Bank, existing and future.
(ii) collecting, sharing, storing, preserving Information, maintaining records and using the Information and
authentication/verification/identification records: (a) for the informed purposes above, (b) as well as for regulatory
and legal reporting and filings and/or (c) where required under applicable law;
(iii) enabling my account for Aadhaar enabled Payment Services (AEPS);
(iv) producing records and logs of the consent, Information or of authentication, identification, verification etc. for
evidentiary purposes including before a court of law, any authority or in arbitration.
4. I understand that the Aadhaar number and core biometrics will not be stored/ shared except as per law and for CIDR
submission. I have downloaded the e-Aadhaar myself using the OTP received on my Aadhaar registered mobile number. I will
not hold the Bank or its officials responsible in the event this document is not found to be in order or in case of any incorrect
information provided by me.
5. The above consent and purpose of collecting Information has been explained to me in my local language.

SELF DECLARATION OF CURRENT RESIDENCE ADDRESS

• I have been provided various options by HDFC Bank for establishing my identity/address proof for the purpose of KYC and have
voluntarily submitted my Aadhaar to HDFC Bank for biometric / Aadhaar + OTP based e-KYC authentication and also hereby
confirm to HDFC Bank that my mailing address is different from the address as per the identity information available in the Unique
Identification Authority of India's Central Identities Data Repository (Aadhaar central database).
• I hereby declare that the mailing address mentioned in this application to be considered as my current address upon successful
authentication through biometric / Aadhaar + OTP based e-KYC authentication.
• I shall take the responsibility of keeping HDFC Bank informed about any such change in the residential address as submitted herein
vide this declaration.

Address Line 1 : _____________________________________________


Address Line 2 : _____________________________________________
Address Line 3 : _____________________________________________
City : _________________________________ State______________________________
Pin code : _________________________________
Customer Signature:
Customer Name : _________________________________
Date : _________________________________

Bank Use section (to be filled by Bank Staff, all fields are mandatory)
Application Form No. :___________________________________

Employee Role : Sales Officer Sales Manager Others (please specify) _______________________________

Employee Name :___________________________________ Employee ID :__________________________

Employee Signature :______________________________

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