Account Opening Form - Axis Bank

1 Savings & CurrentNew & Existing Customers - Resident Individuals/HUFS elect Account typeSavingsor CurrentScheme CodeInstaor Non InstaSelect add on productsCredit CardHealth InsuranceDemat A/cTrading A/cTerm DepositPPFAxis ActivePHOTO35mm x 35mmPlease fill the form in BLOCK LETTERS only. Fields marked * (star) are MANDATORYA ddress Details For all payroll accounts of defence personnel, the communication address should be only of the Unit. Civilian address should not be mentionedCommunicationResidence Address*Landmark*Pin code*State*Country*City*Residence Type Owned*Rented/LeasedAncestral/ParentalCom pany ProvidedThe property that is situated in the communication address registered with the bank shall only considered for coverage underthe Fire&Burglary insurance on Business Supreme Debit Card.

2 For updating the communication address, the customer needs to apply for the same with the bank with relevant address proof. The insurance shall be subject to the terms and conditions as prescribed by the insurance company from time to NoEmail Address No. (R)Tel. No. (O)Please ensure to furnish correct email ID. You will be sent monthly Account statements at the email ID mentioned abovePermanent Address*Same as communication addressPlease note the address belowLandmark*Pin code*Residence Type Owned*State*City*Country*Rented/LeasedAn cestral/ParentalCompany ProvidedPreferred Language of Communication*Know Your Customer* Account Opening through e-KYCT ransaction IDIf No.

3 Please provide KYC documents (Attach photocopies of the following documents and produce the original copies of these documents for verification)YNFor office Use only*Identity Proof Document Type*Address Proof Document Type*ID No.*ID AuthorityIssuing AuthorityPlace of IssuePlace of IssueFor Office Use:Branch Name_____Branch Code:Date:Insta Sticker Customer onboarding Section - Primary Applicant Name*Existing Customer*If Yes, Customer IDAadhaar NoIndividual orHUFC urrency Code (for Current A/Cs)*Please attach self-attested copy of Aadhaar Card Enrollment receipt YN*orAadhaar Enrollment NoAadhaar Enrollment DateFollowing fields for new customers, any KYC Modifications or Re-KYC Only (for existing customers, address, contact details given below will be updated in all accounts held with the bank )

4 Date of Birth*#Gender*^** MinorMarried*Nationality INDIAN^ T stands for third gender # If minor/ senior citizen, please provide proof of DOB **If minor please fill Minor Declaration Section**If PAN is not available, please fill up Additional declaration Form 60 PAN**Mother s maiden Name*orFORM 60 Father s Name*In case of minor Account , guardian's father name to be mentionedMFTYNYNA ccount Information (Mandatory*) (Only Numeric & absolute value to be filled)Constitution CodeAnnual Income (Salary/Business) IlliterateStatus Blind Physically ChallengedPardanashinNormalAnnual Business Turnover (lakhs)#<1>1-5>5-10>10-15>15-25>25-50>100>50-100# Applicable for Current Account OnlyNS001 Savings/Current Account Opening SectionSelfMode of Operation*Jointly by allEither/ survivorMinor A/C operated by Guardian Former/ survivorOthers_____Anyone/ survivorJoint Applicant DetailsPlease mention no.

5 Of Joint Applicants1st JointApplicant:2nd JointApplicant:3rd JointApplicant:Initial Payment DetailsDeposit Amount forSavings A/C `Total Deposit Amount `(in wordsTcount with cash, customer must deposit the cash in Account Opening branch onlyCheque Cheque should be crossed A/C payee and drawn payable to " axis bank Ltd. A/c <Applicant Name>"Drawn on_____Bank_____Branch)_____Signature___ __Applicant Signatureonly for A/Office use only: Initial Deposit Tran IDValue DateFor Salary / Defence AccountFor Salary Accounts - Employee CodeLabel CodePlease tick any of the followingTick for a Salary Reimbursement Account with Salary AccountLetter from Employer verifying identity and permanent address ORC DebitIntroduction by a designated Company Official and KYC documents as aboveSignature_____Applicant Signatory with Company Seal Nomination (DA1 Form)* (Only one individual nominee permitted and to be signed also in case of no nomination)

6 I wish to nominateI do not wish to nominate**Print Nominee Name Yes NoNomination under Section 45 ZA of the Banking Regulation Act, 1949 and Rule2 (1) of the Banking Companies (Nomination) Rules 1985 in respect of bank depositsI/We (Name) _____ (Address) _____Nominate the following person to whom in the event of my/our/minor's death the amount of deposit in the above Account may be returned by axis bank :Same as Primary ApplicantIf different from Primary ApplicantRelationship with depositor, If anyAgeYearsIf nominee is Minor, Date of Birth *As nominee is minor I/We appoint (name)Relationship with minor*Address.

7 Same as Primary ApplicantIf differentto receive the amount of deposit on behalf of the nominee in the event of my/our/ minor's death during the minority of the nomineeSignature of Witness** _____Name _____Address _____Date,_____, Place _____Signature of Primary Applicant** _____Name _____Address _____Signature of the Joint Applicant(s) _____**Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of the minor.** In case of thumb impression, nomination to be filled in as an annexure ** I have understood the benefits of nomination and still do not wish to nominate*Strike out if nominee is not a minorAccess Your Account * Primary Applicant (Nominee will be same as Account nominee, insurance cover applicable only for debit card)Speed banking facilities activatedMobile BankingInternet BankingValue Added Alerts (SMS & Email)(Fee of `5/- applicable per month)

8 Phone BankingAccount Statement OptionsCheque book facilityFor Terms and Conditions and product specific offerings please refer to standard option if email provided(Physical statements will not be sent)Passbook/Physical Statement(Physical statements will be provided to premium segments only)Information On Other Products & Offerings*I hereby agree to axis bank /Subsidiaries/Affiliates/Agents contacting me for various other product updates, marketing promotions, special offers Third Party Products or any suchinformation from time to time.

9 I do hereby give my consent to receive such information through Email*This will override the DNC waiver and customer shall continue to receive the CallSignature_____ 2 0 Debit Card (Only for Non Insta)If yes, fill in details below Name on Card:Creator Limit is 18 Company Name(Application for Salary/SBEZ4 A/Cs or business cards Only)Image Card:Code+Upgrade Cards :Online Rewards*Value+*Delight*Business Platinum^^Business Supreme^^^^Issued to Current Account only*Additional Charges apply+Upgrade Cards are not applicable for priority, Burgundy and Burgundy Private schemes The usage category selected will be applicable for issuing cards to Joint holders, if applicable.

10 For all charge related information please refer schedule of charges and visit An ATM card will be issued for Minors below 12 years of age in the name of the Guardian {Separate Application to be filled}. If the Minor is above 12 years of age and operating the Account in his/her own capacity, the Minor qualifies for a Debit Card {Separate Minor DCAF to be filled}Activation/Deactivation of International on Debit Card can be donethrough - Internet Banking/Mobile App/ axis bank Call Customer will only be issued Domestic Chip Debit card will be a chip card activated with facility of using it at DomesticATM and POS merchant outlets within India debit card facility only for SBGOV