CUSTOMER INFORMATION
| Name: __________________________________________ New User [ ] Existing User Modification [ ] |
| Address: _____________________________________________________________________________ |
| City: __________________________ State: _____________________ Zip: _______________________ |
Primary Contact for Account(s):
Email Address: _________________________________________________
REQUESTED SERVICES
[ ] Account Access: View ( ) Transactions ( )ACCOUNT INFORMATION
| Account # Account Description (/Account Title) Type |
| 1. ____________________ (P)______________________________________ ____________ |
| 2. ____________________ ______________________________________ ____________ |
| 3. ____________________ ______________________________________ ____________ |
| 4. ____________________ ______________________________________ ____________ |
| 5. ____________________ ______________________________________ ____________ |
| 6. ____________________ ______________________________________ ____________ |
| 7. ____________________ ______________________________________ ____________ |
(P) Indicates Primary Checking
Account from which charges you incur will be debited. USER INFORMATION (Required to activate your account) All account owners or authorized signers must sign below. USER INFORMATION (To Be Completed by Bank)
[ ] New Date:
_______________________________________________________
Date
______________________________________________________________
Branch:_____________________________________________________________
Cust
ID : __________________________________________________________
Account type: CH = Checking
MMA= Money Market SAV= Savings RLOC= Revolving Line of Credit
IL= Installment Loan
User Name
Account # (S)
List all
users you authorize to utilize ONLINE BANKING
ALL is appropriate if
you will have FULL privileges on ALL accounts.
I/We understand that submission of this form only constitutes application for enrolment in the Services. I/We have read the “State Bank of India (California) Consumer Online Banking Agreement and Disclosure” and “e-sign Disclosure Statement” on Internet Banking Service and the terms are acceptable to me/us. I/We understand that the Bank may, at its sole discretion, request for additional documentation from me/us to complete this enrolment process.
SIGNATURES: By signing below, I/We authorize THE BANK to issue a temporary (login and/or transaction) passwords on my/our behalf which I/We will be forced to change to a private passwords the first time I/We log in to the system. We also authorize the Bank to send the OTP scratch card at the above address.
________________ _______
________________ _______
Signature
Date
Signature
Date
________________ _______
________________ _______
Signature
Date
Signature
Date
________________ _______
________________ _______
Signature
Date
Signature
Date
CUSTOMER INFORMATION
[ ] Existing since:
Officer:_____________________________________________________________
Received by:
_____________________________ Date:_____________________________
Processed by: ___________________________
Date:_____________________________
Verified by _______________________________
Date:_____________________________