Bajaj DBS SuperCard Branch Customer Request Form

Customer Profile Update Form – Credit Cards
To
The Branch Manager,
DBS Bank India Limited
______________Branch
*Customer Name: _______________________________________________________________

(As on Credit Card)
CIF ID: _____________________________ *Credit Card Number (last 4 digits) _______

(DBS Bank Account holders)
*Registered Mobile Number (given at the time of application): ____________________________
A - Contact Details (Please tick appropriate box)

I request the bank to update my contact details given below, against my aforementioned Credit Card Account only.
Mobile Number: Country Code Number
E-mail ID:
B Address Change / Updation (Please tick appropriate box)

I request the bank to change / update my address details given below against my aforementioned Credit Card Account only.
There is no change in my Mobile Number / Email address
Mailing address: Current residence address Office address
Update Current Residential Address:
Landmark City
PIN code State
ACKNOWLEDGEMENT Date:
Customer Name:
Request related to:

Name of Bank Official: Bank Official (Sign and stamp):
CUSTOMER CARE (24X7):

Cards helpline (India) - 1860 267 6789
International helpline- +91-44-6904 6789
WEBSITE: www.dbsbank.com/in
EMAIL US AT:
SuperCardCare@dbs.com
Office address:
City
PIN code State
ID proof(s) submitted along with the form:

PAN Passport Driving License Aadhaar NREGA
• For Communication address change, PAN card is mandatory and additionally any one of the following must be submitted – Voter’s Card, Aadhaar, Driving
License, Passport or NREGA
• For Office address change, only a photo identification is required
Note:
1. Please fill this form and visit your nearest branch for submitting the change request
2. You must carry your original ID proofs and submit the self-attested photocopies of KYC proofs (wherever required), as per RBI guidelines applicable,
from time to time.
3. Deliverables, if any, will be sent to the mailing / communication address as per the latest records available with the Bank.
Terms & Conditions:
I confirm having read and understood the terms and conditions governing Credit Cards and respective services linked to my Card Account and hereby agree to
be bound by the terms and conditions and amendments governing the Credit Card accounts or changes thereof and further amendments made by the Bank from
time to time. The copy of Credit Card terms and conditions is available on the Bank's website www.dbsbank.com/in and I have read and understood the terms
and conditions and agree to keep the Bank indemnified against all liabilities, claims, proceedings, actions and damages in relation to or arising out of the Bank
accepting my / our request and transmitting information through electronic means. Bank shall not be held responsible for any loss that I may suffer due to incorrect
mobile number / email address / mailing address furnished by me / us and non delivery / delays of all correspondence / alerts due to any other technical reasons.
I further confirm that the above mentioned information with respect to my Credit Card held with your bank is true & correct. I am aware of charges applicable for
various services offered and I accept and agree to be bound by the said Terms & Conditions.
I am aware of charges applicable for various services offered and I accept and agree to be bound by the above mentioned Terms & Conditions.
I understand changes requested would be effected in the Bank's Credit Card records by the Bank within the committed period from the date of receipt at the
Branch and the said changes would be effective in the systems from that date only.
Signature
(as per Card Application/ID proof submitted)
FOR BANK USE

Certified that this Request Form is complete in all respects, all relevant documents have been checked and
obtained. Please process this request.
Request received through: Walk in- Self Bearer Mail-Courier
ID proof submitted along with the from: PAN Passport Driving License Aadhaar Others (please specify)
Attending Officer’s: Name

Signature
Employee ID

Bajaj DBS SuperCard Branch Customer Request Form

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Customer Profile Update Form – Credit Cards

*Customer Name: _______________________________________________________________

CIF ID: _____________________________ *Credit Card Number (last 4 digits) _______

*Registered Mobile Number (given at the time of application): ____________________________

A - Contact Details (Please tick appropriate box)

Mobile Number: Country Code Number

B Address Change / Updation (Please tick appropriate box)

There is no change in my Mobile Number / Email address

Mailing address: Current residence address Office address

Update Current Residential Address:

PIN code State

Request related to:

CUSTOMER CARE (24X7):

PIN code State

ID proof(s) submitted along with the form:

Terms & Conditions:

FOR BANK USE

Request received through: Walk in- Self Bearer Mail-Courier

Attending Officer’s: Name

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CIF ID: _______________________ *Credit Card Number (last 4 digits) _