7/29/2019 Suvidha Joint Account Application Form

http://slidepdf.com/reader/full/suvidha-joint-account-application-form 1/2

Give your spouse, parent, sibling or child the privilege of a

Citibank Suvidha Joint Account

CBDT Form 60 (Mandatory)

My Name is :

My Account No. is :

For Joint Applicant :

If you do not have a PAN / GIR No. please fill in the following :

PAN / GIR No. : Please provide a photocopy of the PAN Card (mandatory)

Introduction

Please enclose any two of the following attested documents (photocopies only) with the application form for the Joint Applicant.

*One document from Section A is mandatory.

IMPORTANT NOTICE: Photocopy to be attested by the primary account holder and a Citibank officer.

Signature of Primary Applicant

Yes I would like to convert my Citibank Suvidha Account into Joint Account with either or

survivor signature requirement.

If yes,

(i) Details of Ward/Circle/Range where the last return of income was filed : _________________________

(ii) Reasons for not having PAN / GIR No. : ______________________________

Are you a tax assesse?

Yes No

JOINT APPLICANT

Bank Statement : Credit Card Statement : Telephone Bill :

Section B

Joint Applicant

Joint Applicant

Photo Credit Card/Debit Card

Credit Card Statement (within last 30 days)

Bank Statement (within last 30 days) Utility bill with Name and Address

If the address in the attached introduction document is not one of the addresses you are currently staying/working at,

please enclose any one of the following in original.

Ration Card (without Photograph)

Citibank Credit Card

Registered Lease Deed TDS Certificate

Certified Marriage Certificate

Section A

Valid Driving Licence : Valid Passport : Ration Card (with Photograph) : Valid PAN Card :Valid Electoral Card :

About Joint Applicant

(Please leave one box space between names and underline the surname)

Name: Mr. Mrs. Ms. Dr. Prof.

Male Female Date of Birth: D MD M Y Y Y Y

Document Number :

Document Number :

nking\Form\India\Suvidha Joint Account Application Form CITI10270\02\14-12-11

-006\E:\Murugesan\Banking\Suvidha Joint Account Application Form CITI10270-22112011

7/29/2019 Suvidha Joint Account Application Form

http://slidepdf.com/reader/full/suvidha-joint-account-application-form 2/2

Agreement & Signature

I/We hereby apply for the Citibank Suvidha Account and declare that the information included in this application is true and correct and that I

and my Joint Applicant are residents of India. I/We accept that Citibank is entitled in its absolute discretion to accept or reject this

application without assigning any reason whatsoever. It is my/our responsibility to obtain the Terms and Conditions mentioned in your form

no A-T(1999) / 07 applying to the Citibank Suvidha Account and read the same. If this application is accepted, I will be bound by the said Terms

and Conditions as may be in force from time to time and use of Citibank Suvidha Account will be deemed to be acceptance of those Terms and

Conditions. I/we agree that the Bank may debit my/our account for service charges as applicable from time-to-time. I/we conform that the

attached photographs are the present true identity of myself/ourselves, which I/We authorise Citibank, N.A., to apply to my/our ATM / Debit

Card and for which I/We accept full responsibility and agree not to make any claim against Citibank, N.A., in respect thereto. And that this

condition applies in addition to the Terms and Conditions which govern the use of my/our ATM / Debit Card.

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Signature of Joint Applicant(Please sign within the box using black ink)

Would you like to opt for a photocard? Yes No

Name:

Date: D MD M Y Y Y Y

Time: H H M M

Signature of Joint Applicant

JOINT APPLICANT

Citibank and Arc Design are service marks of Citibank, N.A., or Citigroup Inc., used and registered throughout the world.

Please paste your

passport size colour

photograph here.

Do not use pins, tape,

staples to affix thephotograph.

Please visit your nearest Citibank branch with this application.