Feg-01 Note

https://www.centralbank.net.in/jsp/Register.htm

TO: The Branch Manager Central Bank of India _____________________

APPLICATION FORM for Delivery Channel Services
Application Branch Sl.No.: Date:

For Office use only

I / we wish to apply as an end user to Internet / Mobile / Tele Banking services offered by you (Strikeout whichever is not applicable). The terms and conditions mentioned by the Bank over their official website are acceptable to me/us. First Name Middle Name Surname Applicant’s Name: Address: Pin:
Date of Birth :( DD-MM-YY)

Telephone

(O): (R): Operation Condition*

PAN Number* Mobile No: E-mail ID: Own Account / EOS/FOS/HUF EOS- Either or Survivor, FOS-Former or Survivor, HUF- Hindu Undivided Family Specify the mode of Operation

My Account Details: SAVINGS A/C CURRENT A/C CC/OD TIME DEPOSITS

Account No

In case of joint account(s), the delivery channel services shall be provided only to owned and either or survivor type only. I. INTERNET BANKING FACILITIES REQUIRED: YES / NO
(Tick whichever is applicable)

OTHERS

II. MOBILE BANKING FACILITIES REQUIRED: YES / NO (Tick whichever is applicable) (Bank shall intimate the customer about the new facilities offered through their website). Mobile Number to which alerts need to be sent: ______________________________________ E-mail Id to which the alerts need to be sent: __________________________________________ III. TELE BANKING FACILITIES REQUIRED: YES / NO (Tick whichever is applicable)

General Conditions: 1. The Joint Account holder(s) desirous of using the delivery channel services shall submit a separate application form. 2. In case of joint account(s), the delivery channel services shall be provided only to owned and either or survivor type only. 3. Bank reserves the right to offer/discontinue the service(s) selected herein without any further notice. 4. Initially, Bank is providing following services through Internet Banking – Account Statement, Balance Enquiry,