Customer Request Form

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DEP - 16

SVC CO-OPERATIVE
, BANK l_fp. rv,,s**reo,*a*r
1
CRF-I
Customer Request Form - lndividual
(General instructions a) Form to be filled in English and in BLOCK letters, b) Please read
the instructions carefully and
submit supporting documents and annexure as applicable.)

The Manager,

SVC Co-Operative Bank Ltd Branch Date

I I. Customer Data Modification Request

Name
CBS id number CKYC number/Attach CKYC-1
1. ChangeofAddress Permanent address
INllriting address
FlaVBlock Bldg name

Road Name Landmark


Area City-State Country
(Note - Mailing address will be updated for all accounts where the customer is primary holder)

lz. Change/Updatemobilenumber*m
This mobile number is registered under
Note - Mailing address will be updated for all accounts where the customer is primary holder
= (Name)

3. Change/Updateouremailaddress*
Note- Email id will be updated for all accounts and services availed with the bankwhere the customer is primary holder
*ForinternetbankingandSMSbankingregistration pleasesubmite-ServicesFormalongwiththisform.

l_l+. Change/UpdateourtelephonenumberResidence(withSTDcooeyl-T-l--l[T-fTT]-l
Office (with STD code) III Ext.

5. Updatemydateofbirth as perthe document submitted

! o. Update PAN (id number)


CKYC-1 tobe

7 . Update myAadhar card (id number)


CKYC-I to be submifted along

8 Please activate lnternational usage facility on my Debit Card no. XXXX


il Account Related Modification Request (Account number 15 digits)

1 Change of Mode of operation forA,/c

[s"rr ! eitn"rorsurvivor I rorr"rorSurvivor I


Ilointty AnyoneorSurvivor

!uinoroperated byGuardian I uinoroperated byGuardian I Otn",


2. Request to add below mentioned joint holde(s)

Title Surname First Name Middle Name

Ptease submit CKYC-1 form for each ioint holde(s) with valid KYC clocuments
tr 3. Requestto delete below mentioned joint holde(s)

Title Surname First Name Middle Name

4. Update Power of Attorney (POA) for my/our account mentioned above


'
CKYC-I formto be submifted along with valid KYC documents.
5. Update/Delete nomination forA,/c no.
Please submit Nomination form duly signed by all holders.

6. Upgrademyminoraccount Generalaccount.
CKYC-1 form to be submitted along with valid KYC documents.

7. Changethe accountschemeto -to from- as perthe


product declaration attached herewith.
CKYC-1 formto be submitted alongwithvalid KYCdocuments.

tr 8. Any other request (please specify)

1st holder Signature 2nd holder Signature 3rd holder Signature 4th holder Signature

Name Name Name Name

For Branch Use


Application received
/ Signature verified by
/ Declaration and Supporting documents attached
Branch official's signature & PA/RP no. with Branch stamp
and verified
/ Details checked in the CKYC portal
/ Request updated in the tracker on l

For CCDM Team


/ Request received on
/ Supporting documents checked Scrutiny done raised on I \
/ Details updated in systemData entry done Authorization done by

Acknowledgement to the customer


We acknowledge receipt of 'Customer Request Form" from
on for

Name of the Branch Official Signature_ Branch


Please note:
' Requestwill be processed within 8 working days from the date of receipt of this form along with applicable supporting documents.
' Ghange of password for debit card/internet banking will be blocked for48 hours from the date of change in contact details.
' Debit Card, lnternet Banking & UPI services will be de-registered post change in mode of operation.Kindly re-apply as perthe requirement.
' ln case of any query/additional requirementwe will contact you on the details registered with us.

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