DCB Fixed / Recurring Deposit Application Form

1 Maturity Payment Instructions DetailsIssue a Demand DraftPayable atThrough NEFTI nstructions for payment of interest and maturity proceeds through NEFTP lease attach a cancelled cheque copy for below bank Name (As per Beneficiary's Bank record, should be same as applicant name):This facility is not available for NRI deposits and Fixed deposits with maturity instruction as Auto Renew Principal and Pay Interest Transfer to own DCB Bank Account Type:SavingsCurrentOverdraftBank Name:Branch Name:Account Number:Diamond Khushiyali / NRE / NRO Recurring Deposit DetailsDeposit PeriodMonthsInterest Instalment Amount ` (in figures)Amount (words)per monthof every monthDDInstallment DateDiamond Khushiyali Deposits are available for a minimum tenure of 12 months (1 year) and maximum tenure of 120 months (10 years).

2 Ensure sufficient funds in your account on the funds transfer date scheduled for your Diamond Khushiyali Deposit (s). Minimum amount for Diamond Khushiyali Deposits is ` Fixed / Recurring Deposit Application Form(For existing customers only)(* Mandatory Fields)Date of Birth:YYYYMMDDA pplicant 2: Customer ID:Form 60 Permanent Account Number (PAN):TitleMiddle Name*Name:First NameLast Name*Mobile Number:*Mode of Operation:SelfEither or SurvivorJointlyFormer or SurvivorGuardianAnyone or SurvivorApplicant 1: Customer ID:Form 60 Permanent Account Number (PAN):Date of Birth:YYYYMMDDT itleMiddle Name*Name:First NameLast Name*Mobile Number:Email Id.

3 Senior Citizen:YesNoIf PAN is not available please fill in Form 60If PAN is not available please fill in Form 60 For joint Application witha Resident Indian the DCB NRE / NRO / FCNR (B) / RFC Deposit /s will be opened on a "Former/ Survivor" basis only.*Type of Account: Deposit DetailsPeriodDaysMonthsInterest ` (in figures)Amount (words):Half Yearly Interest Payout*Monthly Interest PayoutInterest Frequency(Tick anyone)Quarterly Interest Payout (QIC)*On Maturity (RIC)Annual Interest Payout*Maturity Instruction s:Auto Renew Principal and InterestAuto Renew Principal and Pay InterestRepay Principal and InterestResident and NRO Fixed Deposits are offered from minimum tenure of 7 days to maximum tenure of 120 months (10 years).

4 For FCNR, RFC and NRE deposits, the minimum tenure is 12 months andmaximum tenure is 60 months (5 years), for RFC Deposit 36 months (3 years) and for NRE Deposit 120 months (10 years).Tenure for Tax Saver Deposit is 5 amount of Fixed Deposit is `10000 for INR depositFor FCNR / RFC:USDGBPEUROAUDCADINRC urrencyIn the absence of maturity instructions, the Deposit will be auto-renewed for the same tenure at the prevailing interest rates with the applicable terms and conditions . Auto renew instruction is not applicable for FCNR and RFC confirmation advice will be sent to your email ID registered with the Bank.

5 Minimum amount for the Tax Saver Deposit is `10,000/-Note: *Monthly interest payout and quarterly interest payout are not applicable for FCNR and RFC Deposits. Half yearly interest payout is not applicable for NRE Deposits. Annual interest payout option is not available for NRE, NRO, FCNR (B) Deposits. Interest on RFC Deposits will be paid upon maturity :YYYYMMDDFor NRO Fixed / Recurring Deposit created from the balance available in NRE account, the Credit, on/ before maturity ( premature closure) can only be made to the linked NRO from DCB Bank Account Number:Cheque Number:Date:Bank:Branch:YYYYMMDDI nitial Payment Details:For Resident Indians:Note: For senior citizen no additional rate of interest for NRE / NRO TD / RD and FCNR.

6 Non-callable minimum amount 2 Crore. Non-callable Deposit cannot be closed Non Resident Indians: Fixed DepositNRE DepositNRO DepositDiamond Khushiyali / Recurring DepositNRE Diamond Khushiyali / Recurring DepositFCNR DepositNon-callableNRE Non-callable DepositNRO Non-callable DepositNRO Diamond Khushiyali / Recurring DepositTax Saver Fixed DepositNRO Tax SaverRFC Deposit (for returning NRIs / OCIs)Auto renewal option is not applicable for FCNR (B)/ RFC DepositDCB RemitTerms and conditions apply. Nominationunder Section45ZA of the BankingRegulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules 1985 in respect of :Nominee Name:Relationship with Applicant, if anyYYYMMDDDate of Birth:YearsAge.

7 Y* As the nominee is a minor on this date, I / we appoint (Name & Address)to receive the amount of the Deposit in the account on behalf of the nominee in the event of my /our / minor s death during the minority of the you have specified a nominee above, please indicate if you wish to make mention of the nominee s name on the passbook, statement and term Deposit receipt issued in respect of your / We do hereby declare that what is stated above is true to the best of my / our knowledge and 1 Signature / Thumb ImpressionI / We nominate the following person to whom in the event of my / our / minor s death the amount of the Deposit in the account may be returned by DCB Bank case of thumb impression, attestation isrequired by2 witness isrequired in case of customer signature.

8 * Strike out if nominee is not a minor. Where Deposit is made / account is held in the name of the minor the nomination should be signed by a person lawfully entitled to act on behalf of the (es):Applicant 2 Signature / Thumb ImpressionName :Signature :Address :Place : Date:Place : Date:Signature :Name :Address :Nomination Details (Form DA 1)Yes, I want to nominate the following personNo, I do not wish to nominate anyoneBank Use(* Fields are Mandatory)Date:YYYYMMDDB ranch: Tracker :Source Code:Scheme Code:FD / RD Account Number:YYYYMMDDV alue Date.

9 I want to apply for a DCB PayLess Card linked to my Fixed Deposit .* If yes, please complete DCB Payless Card Application : Not applicable for Tax Saver, NRE, NRO and FCNR / RFC (please specify)IFS Code:The quickest way to send funds abroad online at zero transfer Currencyof(applicant name)onYYYYMMDDA pplication received for _____ (type of Deposit )Acknowledgement to CustomerNomination:YesNoResident Type:ResidentNRIDCB Bank LimitedSignature of branch officialInterest rate per : DaysMaturity Instruction:(Tick any one)Auto renew Principal and InterestAuto Renew Principal onlyRepay Principal & InterestName of branch official:BranchPeriod:Please contact DCB Customer Care (Resident Indians) 022 68997777 or 040 68157777 email NRI customers +91 22 61271000 email or please visit FCNR:USDGBPEUROAUDCADINRT erms and ConditionsTerms and conditions for payment of interest and maturity proceeds through (National Electronic Funds Transfer) NEFT:I/We hereby accept, acknowledge and abide by the following terms and conditions :1.

10 I/We hereby authorize DCB Bank to facilitate, remittance our payment of interest and maturity proceeds through I/We hereby have understood, accepted and acknowledged that the remittance is to be sent at my/our own risk, and I/We hereby hold entire liability of the transaction and have the distinct understanding, acceptance that no liability whatsoever will to be attached to the DCB Bank in following events: b. In this connection, any message received by me/ us hereby deciphering the message for whatsoever cause or from its misinterpretation when received.