CUSTOMER ACKNOWLEDGMENT FORM (MID)

Date: D D M M Y Y Y Y Application Number:

Barcode

APPLICANT INFORMATION
Name:
(Mention Tatkal Kit Account Number
Mobile Number: Account Number: in case of Tatkal Account)
CHOOSE ACCOUNT TYPE
Savings Account Current Account
TATKAL KIT ACKNOWLEDGEMENT (If Applicable)
I/We had received a sealed ‘Account Opening/Debit Card’ welcome kit with A/C Number as mentioned above with the following material enclosed
a) Chip Debit Card b) Chip Debit Card PIN Mailer c) Mobile Banking PIN d) Steps for Online Registration e) Cheque Book (Only for Non MAMN Kits)
I/We confirm having opened the welcome kit in presence of the Bank official and I/We have signed on the signature band of the Debit Card in his/her presence. I confirm that the relevant
rules, regulations and charges for opening and operating the Account/Debit Card have been explained and understood by me/us.

DECLARATION FOR DIGITAL ACCOUNT OPENING

I/We confirm that I/We have read and understood the detailed terms and conditions on www.indusind.com/tabdeclaration.html and that the contact details provided on the
form/during digital account opening process are correct. I/We hereby confirm that all the information entered by Bank’s official on my/our behalf through Bank’s digital platform is
accurate & the same has been provided by me/us for the purpose of banking services. I/We do not have any objection that this information has been filled in as a part of digital account
opening process. Further, I/We agree that all the information submitted by me/us to the Bank shall be deemed and remain property of the Bank and the Bank will be free to use this
information for the purpose of providing banking services to me/us from time to time.
Consent to Use, Share and Disclose Registered Communication Contact Details
I/We hereby ACCEPT, AUTHORISE, CONFIRM AND PERMIT IndusInd Bank Limited (“Bank”) to USE, SHARE AND DISCLOSE any/all of my/our registered communication contact addresses/details
(postal, e-mail, mobile number, social media platforms/channels etc.), that I/we have willingly registered/shared with the Bank for the purpose of (A) receiving information, either from the Bank, Central
KYC Registry and/or through any of the Bank’s authorised Service Providers / Agency(ies)/Professional Advisors related to the operations of my/our account(s)/services availed by me /us from the Bank;
and/or (B) API based authentication where my/our details are being auto fetched/ populated to process my banking requests/applications on/throughthe Bank’s Web Applications/Systems; and/or (C) any
kind of promotional/research/feedback based exercise about the Bank’s products/services that I/we must/may be made aware for general consumption or to provide feedback as an existing customer of the
Bank; until such time I request/notify the Bank to stop sending communication to any/all of my/our registered communication addresses/details as per the Bank’s defined process and knowing that the Bank
will ensure security and confidentiality to all my communication contact details provided by me/us. If I am /we are or become a Non Resident Indian (NRI) / foreign national, I confirm that the following
consent is well within my capacity as a Non-Resident Indian and by doing so I do not violate or breach in any manner the regulations or statutes of the country of my residence as are applicable to me.
Notwithstanding anything contained herein above, in case I/we opt out from the aboveand tick‘NO’below, the Bank shall be entitled to use/share/disclose my communication contact addresses/details to send
me/us all communication either through select/mandated communication channels, those that are deemed necessary for the (A) smooth processing of my/our account operations/service request(s) (B) for
general awareness and/or (C) any statutory action required to be undertaken by me/us as per the applicable laws and guidelines/ regulations/directions/notifications prescribed by the Reserve Bank of India,
Ministry of Finance India, government/quasi-government authorities and any other authorities governing the financial and banking operations whether in India or outside India.
ü Yes No
DISCLAIMER: This material is for general informational purposes only and is not investment advice nor does it constitute an offer, recommendation or solicitation to buy or sell a particular financial
instrument. It does not have regard to the specific investment objectives, financial situation, risk profile or the particular needs of any specific person who may receive this material. No representation is
made that the information contained herein is accurate in all material respects, complete or up to date. Recipients of this document are to contact the representative in their local jurisdiction or contact
details given in this document with regard to any matters or questions arising from, or in connection with, the document. The information contained herein is not intended for distribution to, or use by,
any person in any jurisdiction where such distribution or use would be contrary to applicable law or regulation or which would subject IndusInd Bank to additional licensing or registration
requirements. It may not be copied, reproduced, posted, transmitted or redistributed in any form without the prior written consent of the Bank. This publication is for general information only, without
addressing any particular needs of any individual or entity, and should not be relied upon without obtaining specific advice in the context of specific circumstances.

AADHAAR/DBT SUBSIDY DECLARATION (If Applicable)

I wish to seed my Aadhaar with NPCI mapper, enabling my IndusInd Bank Account to receive Direct Benefit Transfer (DBT) benefits from Govt. of India. I do not wish to further receive
DBT benefits in my previous account as declared during the digital account opening process.

FIXED/ RECURRING DEPOSIT TERMS & CONDITIONS

In the event of the death of the depositor(s), premature termination will be allowed without levy of penal charges as under:
1. With Nomination: In the event of the death of all depositors, the nominee will have the right to seek premature withdrawal of Term Deposit account; 2. Without Nomination: In the event of
the death of all depositors, premature withdrawal will be permitted on joint request by all legal heirs (or any of them as mandated by all the legal heirs) and upon verification of the
authority of the legal heirs; 3. Term Deposit with survivorship clause: Bank may permit withdrawal of Fixed/Term Deposits in accordance with the mandate of ‘Either or Survivor’,
‘Former/Latter or Survivor’, ‘Anyone of Survivors or Survivor’, etc. as the case may be; 4. Term Deposit with Mandate Jointly: Premature withdrawal will be permitted on joint request by
the Survivor and legal heirs of the deceased depositor (or any of them as mandated by all the legal heirs) and upon verification of the authority of the legal heirs.
l Interest (simple) on Fixed Deposits with tenure less than or equal to 180 days will be only paid on the maturity date of such deposit. l Linked Current/Savings Account will be applicable for initial
payment, interest/maturity payment, and sweep-in facility, if selected. l For Term Deposits: Mandate provided in the application will be applicable to premature withdrawal at any point of time , including
death of any one but not all holders. In case of joint Term Deposits having operating instructions as ‘Either or Survivor’, ‘Anyone or Survivor’ or ‘Former or Survivor’, the Bank shall repay the deposit(s) before
maturity of the deposit(s) in case such a request is received in accordance with the operating instructions of the respective deposit(s), along with relevant documents as may be specified by the Bank from
time to time. The same would be applicable even in the event of death of the joint depositors prior to maturity of the deposit. Any such repayment before maturity shall constitute a valid discharge of the
Bank’s obligations against all concerned including, but not limited to, the nominee/legal heirs of the depositors or anyone claiming under them. l For bulk deposits, please refer to the deposit policy at our
website for T&C on your Fixed Deposits. In case of any discrepancy in KYC or FD funds not received the FD will be liquidated without any interest payment and FD advice will be null & void.

Applicant Name:________________________ Guardian/Joint Account Holder Name:

______________________________________ ________________________________________ Guardian/Joint Account
Applicant Signature
Holder Signature
Date: D D M M Y Y Y Y ___________________________________________

FOR CORPORATE SALARY CUSTOMERS

We hereby authorise account opening with IndusInd Bank of the below individual who is a bonafide employee of our organisation:
Employee Name Father’s Name ID Type ID Number

Company Name:
Name of Authorised Signatory:

Date: D D M M Y Y Y Y Signature of Authorised Signatory

VER01/PIONEER/CAF/07-2021

with Company Stamp

BANK USE SECTION

I confirm having met the customer at Residence Office and I hereby confirm that I have verified the copies with the original and customer’s details including all documents have
been signed in my presence. All documents of KYC are complete and match the details provided in AOF. In case of Corporate Salary Account, I confirm that the customer is the active
employee of the corporate and the same is verified by me as part of the sourcing process. I hereby certify that the above information is true. Later if it is found to be incorrect and the Bank
suffers any loss due to fraud or otherwise, I may be held accountable and shall be liable for any loss suffered by the Bank.
Sourcing Executive ECN: Signature