BANK OF BARODA CREDIT CARD APPLICATION

APPLICATION NO : 230625900004109
I/We wish to apply for# PREMIER
Credit Card SWAVLAMBAN EASY SELECT PREMIER PRIME Preferred Mailing
First year*/Annual fee** `250/- `500/- `750/- `1,000/- NIL
Address# ✔
I agree to be charged for the first year credit card annual fee in my first statement.

*Reversed if spends within 60 days of card issuance : ₹ 2,500 for Swavlamban, ₹ 6,000 for Easy, ₹ 7,500 for Select and ₹ 10,000 for Premier
**Waived if spends in preceding year : ₹ 12,000 for Swavlamban, ₹ 35,000 for Easy, ₹ 70,000 for Select, and ₹ 120,000 for Premier
#

Mr./Mrs./Ms./Dr. First Name Middle Name Last Name

Full Name MR. PARVEEN
Name to be printed on Credit Card PARVEEN (Max. 20 characters including space)

Mother’s Maiden Name MEVA DEVI

Father’s Name BIRBAL SINGH
Date of Birth 12-08-1990 Gender ✔ Male Female TG Nationality ✔ Resident Indian NRI/PIO Foreign National

Marital Status ✔ Single Married Widow(er) AADHAAR No. XXXX XXXX 4281
PAN No. BRMPP9540G
Educational Qualification: Graduate ✔ Post Graduate Professional Other

Present Residential Address Permanent Residential Address

VILLAGE GULLARPUR POST OFFICE PEONT VILLAGE GULARPUR POST OFFICE PEONT
TEHSIL NISSING DISTRICT KARNAL TEHSIL NISSING DISTRICT KARNAL

City KARNAL Pin 132036 City KARNAL Pin 132036

Landmark NEAR SHIV MANDIR Landmark NEAR SHIV MANDIR
Tel. (with STD code) Tel. (with STD code

Mobile# 8901403337
Email ID#
IPS.KP013@GMAIL.COM
Alternate Mobile No. 9991386490

Employment Status# Business Professional ✔ Self Employed Salaried Others

Employer Type Govt. NGO ✔ Private Public

Name of Organisation / Employer ABHI MOBILE SHOP

Designation: OWNER Employee code (for Bank of Baroda/ its affiliates employees)#

Department No. of Years in Current Org. 7.0 Months

Office Address# KARNAL ASSANDH ROAD NEAR AXIS BANK

NEAR PEONT TOLL PLAZA City KARNAL
Pin 132036 Tel. (with STD code) Extn.

Gross Annual Income (in Rs.)

400000
BANK DETAILS

Bank Name
eSigned using Aadhaar
(Leegality.com - p0PWXo4)
Bank A/c No. Savings A/c Current A/c Other PARVEEN
Date: Sun Jun 25 14:42:24 IST
#
Mandatory fields. Do not leave blank as it may lead to delay/ rejection of the application. 2023
 (Photo Idenity Proof Required) (Must be over 18 Years of Age)
I Would like to apply for Add-on Cards for
Date of Birth#

Spouse Parent Sibling Child Mobile Number PAN No.

Date of Birth#

Spouse Parent Sibling Child Mobile Number PAN No.

#

I___________________________________________________________________(Name
PARVEEN in full) do hereby assign the moneys payable by the Insurance Company, in the event of my death due to

accident to my_____________________________
PARENT (mention relationship with the insured) Mr./Mrs./Ms._____________ and I further declare that his/her receipt shall be sufficient discharge to the Company.

MEVA DEVI
(Name in full) ___________________________________________________________Signature_____________________________ 25-06-2023 Place _____________________________
Date__________________

DECLARATION
In consideration of BOB Financial Solutions Limited (BFSL) granting facility to use the credit card, I do hereby declare and confirm that I have personally read, understood and interpreted the MITC (Most Important Terms & Conditions)
fully as available on Company’s website www.bobfinancial.com. I confirm that I have received the MITC along with the application form and have read all details in it. The MITC provided is in English language and I am fully conversant
with English to understand the MITC. Further, I request BOB Financial Solutions Limited to provide any information with regard to Bank of Baroda Credit Card in English language.I will be bound by the terms and conditions as may
be in force from time to time and receipt/use of the card shall be deemed to be acceptance of those terms and conditions. I agree to be charged for the first year fee in my first statement. In case of application of add-on card(s), I agree
that I will be billed for such add-on card(s) in the monthly statement. I declare and understand that the Credit Card issued to me, if used overseas, shall be utilized strictly in accordance with the relevant exchange control regulations
issued and as amended by the Reserve Bank of India (RBI) from time to time. In the event I exceed my entitlements as per the exchange control guidelines of RBI, I undertake to bring the same immediately to the notice of BFSL in
writing. In the event of any failure to comply with the prevailing exchange control guidelines issued by RBI by me, I shall be liable for any action under the Foreign Exchange Management Act, 1999, as amended and be debarred from
the Credit Card facility either at BFSL instance or RBI. I agree that credit limit on my card account may be reviewed as per the Company policies specified from time to time and the Company will be entitled to cancel my application/-
cards or to alter the credit/cash withdrawal limits or update the product at any time without assigning any reason. I understand that BFSL will provide the credit card as per its internal guidelines and I give consent for issuance of any
different credit card in case I am not eligible for the credit card applied for. I am also aware and agree that in the event of my application getting approved, E-statements would be sent every month to the email id as updated in BFSL
records. Also, all SMS related to the card account will be sent to the registered mobile number provided in the application. I would like to partner with BFSL on ‘The Go Green’ initiative. Please mail my credit card billing statement on
the email ID provided in this form. [Please note that no hard copy of monthly statement shall be provided. In case you require hard copy of monthly billing statement, please login to your online card account and raise request for a
hard copy bill]. I hereby give my consent to BFSL for obtaining my KYC details from CERSAI CKYC portal and to receive information from Central KYC Registry through SMS/Email on the above registered number/email address.
I hereby authorize BFSL to provide and collect information about the applicant and/or the card account to the financial credit bureaus/regulatory authorities. I confirm that the attached photograph presents true identity of me and that
of my additional card applicants, which authorizes the Company to apply it to my credit cards and for which I accept full responsibility and agree to not make any claim against the Company, in respect thereto. And that this condition
applies in addition to the terms of the Card Member Agreement which governs the use of my card. I also confirm that I am not a defaulter of any Credit Institute/Bank and my repayments are regular. By signing this application, I
understand that all the transactions are effected through my card account. I, including my successors, legal heirs, assignees shall be lawfully responsible for making payments for the same, as per the schedule in force from time to
time. I further understand that mere disputing the transactions shall not absolve my prime liability to defer/delay the payment of my credit card dues and I along with my successors, legal heirs, assignees will be fully responsible for
making payments of the same, as per the payment schedule in force from time to time.
I further authorize BFSL and/or its associates/subsidiaries/affiliates to verify from, and disclose to, any information pertaining to me /my office/residence and/or contact my family members and/or my Employer/Banker/Credit Bureau/CI-
BIL/RBI and/or any third party including but not limited to Financial credit bureaus/regulatory authorities etc. as they deem necessary and/or to do any such verification as they deem necessary. I confirm that I have no insolvency proceedings
pending against me nor have I ever been adjudicated insolvent. I agree that my signature on the charge slip will amount to an unconditional undertaking by me to pay BFSL the amount stated therein and agree that a copy of my periodic
statement of accounts will be a conclusive evidence of my liability for the charges stated therein. I understand applicable taxes from time to time will be levied on fees, interest and other charges, as per government guidelines.
I also understand that the BFSL reserves the right to vary any or all of the Terms & Conditions of the Schedule of Charges from time to time. Changed Terms & Conditions shall be communicated through the BFSL’s website and/or
by other acceptable modes of communication treating it as a due intimation to the cardholder.
I am maintaining individual/joint account in Bank of Baroda and I/we have irrevocably authorized Bank of Baroda/BOB Financial Solutions Limited (BFSL) to debit any of my accounts maintained with you against the demand raised
by BFSL (previously known as Bobcards Ltd.)

I/we am/are maintaining individual/ joint accounts in Bank of Baroda. I have applied for Bank of Baroda credit card and I/we irrevocably authorize the Company to debit eSigned using Aadhaar
(Leegality.com - p0PWXo4)
my/our A/c No. _________________________________________ maintained with Bank of Baroda _________________________________________________ branch, PARVEEN

against monthly/ any dues in Credit Card issued to me on the basis of this application form. Yes No Signature
Date: of
SunJoint
Junaccount HolderIST
25 14:42:24 if applicable
2023

Total Amount Due Minimum Amount Due Customer specific % (if not specified total amount due will be debited)

I have an active Bank of Baroda Credit Card : Yes No I have an existing Merchant relationship (POS) with BFSL : Yes ✔ No (If yes, provide MID number : ________________ )
I undertake that all the documents submitted by me with this application are self-attested true copies of the original documents and are deemed to be submitted by me to BFSL. I further understand that in case application is not
considered favourably, the Company reserves the right to retain the documents submitted with this application.
I agree to abide by terms and conditions as may be amended by the Company from time to time, without giving notice to me. The MITC (Most Important Terms & Conditions) as available on the Company’s website has been read by
me and I agree to abide by them.
I undertake not to use the Credit Card on Internet or otherwise for purchase of prohibited items like lottery tickets, banned or proscribed magazines, participation in sweepstakes, payment for callback services, remittance in any form
towards overseas forex trading, margin calls to overseas exchanges/overseas counter party, trading in foreign exchange in domestic/overseas markets etc.
I understand that the Company reserves the right to withdraw any of the existing features/conditions including Personal Accidental Death Cover, in which case the nomination details obtained would stand null and void. I further
understand that in the event of settlement of claim by the Insurance Company against Personal Accidental Death Cover, BFSL dues, if any shall be appropriated first and balance shall be paid to the nominee. In case of default in
payment of the card outstanding, Company may refer the matter to the sole arbitrator to be appointed by the Company. The arbitration shall take place in Mumbai and/or Delhi and I undertake to abide by terms and conditions whatsoev-
er of the award, if any passed by such arbitrator. I confirm and authorize BFSL to (a) Use my Aadhaar details to authenticate me from Unique Identification Authority of India (UIDAI) (b) UIDAI to release my demographic details to
BFSL through biometric authentication which BFSL may use for KYC verification (identity/address proof) for the purpose of Credit Card.
I hereby authorize BFSL to share cardholder information/transaction details with parent, subsidiaries, affiliates, business partners and/or associates of BFSL for the purposes of marketing and offering various products and services
✔
of BFSL or its group companies, subsidiaries, affiliates, business partners and/or associates. (Yes____No____)
I am interested to know more about the various other product(s)/service(s) of BFSL and/or affiliates/subsidiary/holding company of BFSL or agents authorized by BFSL and hereby provide my consent to and/or affiliates/subsidiary/hold
ing company of BFSL or agents authorized by BFSL to contact me for the same and this consent shall have an overriding effect on any National Do Not Call (NDNC) registry made/opted by me.
I confirm that the attached address proofs are presently valid and true verification documents of myself. I will notify BFSL immediately when there is a change in my current residential address, by giving a request along with required
KYC documents. In case any of the above information is found to be false , I am aware that I may be held liable for it.
I/we hereby ✔submit my Aadhaar number/Aadhaar Card/Aadhaar Details (“Aadhaar Details”) as issued by UIDAI as proof of identity and Address for KYC purpose. Further, I/we voluntarily provide my/our independent consent for
submitting my/our Aadhaar Details to BOB Financial Solutions Limited (BFSL), as per regulations of Aadhaar Act, 2016 for processing my credit card application. I confirm and agree that BFSL shall not be liable in any manner
whatsoever due to my submitting Aadhaar Details with BFSL. I further state and declare that while sourcing the application of Bank of Baroda Credit Card: No Cash has been collected from me. No credit limits / additional gifts etc.
have been promised to me. I shall contact the BoB Credit Card Customer Helpline in case I have any doubts/clarifications.

eSigned using Aadhaar For BFSL Use For Branch Use

Version: 3.0 AUG 2020

(Leegality.com - p0PWXo4)
PARVEEN # Source Campaign Promo Branch Employee Branch Head
Code Code Code SOL ID Code (EC No.) EC No.
Date: Sun Jun 25 14:42:24 IST
2023 ______________
DIY001 ______________
351001 ______________
EPLPR ______________ ______________ ______________

BOB Financial Solutions Limited (formerly known as Bobcards Limited)

Date__________________
25-06-2023 Regd. Office: “BARODAHOUSE”, 2nd floor,Behind Dewan Shopping Centre,S.V. Road,
Place__________________
KARNAL Jogeshwari (W.), Mumbai - 400 102. INDIA.Phone: 91 22 4206 8502; Fax: 91 22 2677 7560
CIN: U65990MH1994GOI081616 www.bobfinancial.com
 AADHAAR
APPLICATION NO. - 230625900004109

eSigned using Aadhaar

(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023
eSigned using Aadhaar
(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023
 AADHAAR
APPLICATION NO. - 230625900004109

eSigned using Aadhaar

(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023
eSigned using Aadhaar
(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023
 CREDIT CARD STATEMENT AND FRONT COPY
APPLICATION NO. - 230625900004109

eSigned using Aadhaar

(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023
eSigned using Aadhaar
(Leegality.com - p0PWXo4)
PARVEEN
Date: Sun Jun 25 14:42:24 IST
2023