Application For Internet Banking, Mobile Banking & Phone Banking

Branch Manager,
Bank of Maharashtra,

------------------------~Branch
We wish to apply as under:
Name of the Applicant/Account title. M/s.
CORPORATE
I I I I I I I I I I I I
Mailing Address:•
I I I I I I I I I I I I
City* ...................... . State• ................................ Pin Code• I I I I I I I I I I I I
Email Address:• ................................................................................................... ..
Phone No. with STD Code. • I I I I I I I I I I
Mobile No(s)of Authorised Signatories To Account.) • _____________________________ _
Account No*:: ____________ _
Date of incorporation I Establishment: ______ Activity: ............... PAN No ..................... TAN No. __
DD MM YY
Constitution* : D Sole Proprietorship
(Pl. tick. appropriate box.Q Pvt.Ltd co.
Internet Banking •
O HUF
D Public Ltd.Co.
0 Partnership
D Society
D Trust
D Others Pl. Specify: ........
D We want to apply for Bank of Maharashtra Internet Banking. Please link our accounts given below.
D I I We have an Internet Banking User Id, but do not remember it and I /We want to be resent to me along with passwords.
0 My/Our Internet Banking User Id is Please send me Ius Login/Transaction/both password(s).
0 My/Our Internet User Id is _________________ . Please link my/our other accounts given below to it.
Mobile Banking •
0 We want to apply for mobile banking services of Bank Of Maharashtra in respect of all our accounts mentioned below.
D We forgot/lost our mobile banking TPIN, please send us the new mobile banking TPIN.
Phone Banking •
0 We want to apply for Bank Of Maharashtra Phone Banking. Please link our accounts given below.
D We have a Phone Banking User Id, but do not remember it and we want it to be resent to us along with TPIN(s)
D Our phone banking User Id is _____________ . Please send us Login /Transaction I both TPIN(s)
0 Our Phone Banking User Id is . Please link our other accounts given below to it.
Account Details.* •
Sr. No. Account Number Branch Name Branch CODE Mode of Operation CIF Number [For office use]

Sr.No. Full Name Details of Divisions/Sections within the corporate Details ofRole/Designation with in
Corporate
(Start from <>=Lowest)
Corporate User Details* (A)
Sr.No. Name & Address of User Birth Place of Birth Mother's Maiden Name Access Signature of
Date Option VIR/T User
V=View only. R=Request for Nc opening, Renewal of Term Deposit, Request for Cheque Book, Issue of D.D., Pay Order, LC/Guarantee
Opening, Renewal &Amendment. T=Online Transfer/Schedule transfer of funds to own account, to Govt.A/c & third party Ale within
the Bank. Online transfer/Schedule transfer of funds from linked ale.
Sr.No. Name of User Individual Designation/role initiating Approving Limit Individual
login Id Limit (Rs.) User ld by
In case of More than One approval which
approval reqd.
No of
From Rs. To Rs. Approvals
Reqd
1. Initiator is the Individual user initiating the fund transfer request. 2. Approver is the person who authorizes the fund transfer request
keyed in by the initiator.3. Initiator and approver cannot be the same individual. 4. Any fund transfer request necessarily will involve
initiator and approver.
Please attach separate sheet if more details to be furnished.
I/We hereby confirm that mandate from the competent authority has been obtained. Necessary Resolution I Authorization is enclosed
on the letterhead.
Signature:
l. _________ Name Designation&Address. __________________________ _
2. ________ Name,Designation&Address. __________________________ _
3 .. ________ Name,Designation&Address. ________________________ _
4. ________ Name,Designation&Address. __________________________ _
1. Details of official Authorised to do Phone Banking. Name: ___________ __,Designation. ________ _
Address: _____________________________________ _
2. Details of official Authorised to do Mobile/SMS Banking. Name: __________ Designation. ______ _
Address_&Mobile No. ··-------------------------------------
Place: __________ _
Date : __________ _
Declaration
We affirm, confirm and undertake that we have read and understood the Terms and Conditions applicable for usage of Bank Of
Maharashtra Internet Banking, Mobile Banking and Phone Banking services of the Bank. We are aware that the usage of Bank of
Maharashtra Internet Banking, Mobile Banking and or Phone Banking- is governed by the terms and conditions which are displayed on
www.bankofinaharashtra.in the site maintained by Bank Of Maharashtra and we have read & understood the contents of the same.
Further, we unconditionally accept the terms and conditions governing internet banking, mobile banking and or phone banking of Bank of
Maharashtra applicable for bank accounts as displayed on bank's website. We accept and agree it. We are aware of the contents of terms
and conditions and that all our rights and liabilities would be governed by the said terms and conditions by our act of accessing on
www.bankofinaharashtra.in. We hereby agree to be subject to and comply with all the provisions of the terms and conditions which are
incorporated by reference herein and deemed to be part of this application form to the same extent as if such provisions have been put forth
in full herein. Necessary Resolution/ Authorisation are en dosed on the Letterhead.
We hereby declare that all particulars and information given in this application form (and all documents referred or provided there with)
are troe, correct, complete and up-to-date in all respects and we and other authorized account users have not withheld any information
from bank. We understand that certain particulars given by us are required by the operational guidelines governing banking companies.
We agree and undertake to provide any further information that Bank Of Maharashtra may require.
We do hereby indemnify and forever keep indemnified the Bank and its successors and assignees from and against and all claims, actions,
penalties that may be made, suffered or incurred by reason of non observance of any of the terms and conditions mentioned therein.
We agree and understand that Bank Of Maharashtra reserves the right to reject any application without providing any reason. We agree
and understand that Bank of Maharashtra reserves the right to retain the application form and documents provided therewith and will not
return the same to us.
Signature:
1. ___________ Name & Designation ____________ PAN No. ________ _
2. Name & Designation ____________ PAN No. ________ _
3. Name & Designation ____________ PAN No. ________ _
4. Name & Designation ____________ PAN No. ________ _
Pl~e: _____________________ __
Date : ____________________ _
FOR OFFICE USE ONLY
(To be certified by branch only)
The details mentioned in the application form including signature of the customer and mode of operation of the account/sis/ are verified
and found correct. The KYC norms are also adhered to while opening the account. The application is sanctioned and forwarded to
Internet Banking Cell, at Lokmangal, Central Office, Pune. 411005.
Branch Seal
Place: __________ __
Date : __________ __
FOR USE OF INTERNET BANKING CELL
Application Accepted I Rejected I PINtrPIN Issued
Place: __________ __
Date : ____________________ _
Signature of the Branch Manager.
Signature Code No:
Name & Designation:
Authorised Official