psb@Mobile

Application for Registration for Mobile Banking Services
(For Individual, Former or Survivor, Either or Survivor, Anyone or Survivor)
(for Savings / current / Overdraft Accounts)

DATE: DD/MM/YYYY
REGISTRATION FOR MOBILE BANKING SERVICES
[1] I/We request you to register me/us for Mobile Banking Services of Punjab & Sind Bank. I/We have read the Terms and Conditions of the same and agree to abide by the same.
[2] Particulars of my/our account are given below:
DETAIL OF PRIMARY ACCOUNT (Mandatory)
ACCOUNT HOLDERS NAME
ACCT.
TYPE
ACCOUNT NUMBER
DETAIL OF ADDITIONAL ACCOUNTS (optional)
ACCOUNT HOLDERS NAME
ACCT.
TYPE
ACCOUNT NUMBER
[3] Name of the account holder authorized for availing Mobile Banking Service:
Mr./Ms. __________________________________________ customer-ID ____________________________
[4] MOBILE NUMBER:
+ 9 1
(Mobile number of authorized person is to be mentioned. This number shall also be used for sending SMS Alerts for all Debit/Credit transactions of the above said accounts.)
FULL NAME OF SIGNATORY: Signature
FOR BRANCH USE
ENTRY
NO.:
ENTRY DATE: Name
PF Code Br. code Signature
DD / MM / YYYY
[Note: In case of Joint Accounts (E or S, F or S, Any One Singly or Survivor) consent to be provided as per overleaf.]
LETTER OF CONSENT FROM THE JOINT A/C HOLDERS
DATE: __/__/____
THE BRANCH IN-CHARGE
PUNJAB & SIND BANK
B/O ____________________
Dear Sir,
REG: Consent/ Authorization to Application for Registration of Mobile Banking Services (psb@Mobile) submitted by
Mr./Mrs._________________________________________________________________.
I/We, the undersigned hereby declare that we are holding the following Accounts with your Bank jointly with
Mr./Mrs._______________________________________, who is the First Joint Holder for these Accounts:
Sr No Branch Code 14-Digit Account Number Name of All Joint A/c Holders(including First Holder)
Mode of Operation
1.
2.
3.
1.
2.
3.
I/We understand that the said First Joint Holder has submitted an Application for availing psb@Mobile Mobile Banking Services from your Bank in respect of above mentioned Account(s).
I/We hereby give consent to the said Application and also authorize to the First Joint Account to View/Access and to conduct operation in the above Account(s) individually through psb@Mobile Mobile Banking Services.
I/We affirm, confirm and undertake that I/We have read and understood the Terms & Conditions for usages of psb@Mobile Mobile Banking Services which are displayed on the Bank’s website www.psbindia.com and that I/We agree to abide by the said Terms & Conditions.
I/We hereby state that should I/We wish to revoke the above consent/ authorization, I/We shall issue a letter of revocation to Punjab & Sind Bank, ______________________ Branch Office in this regard. I/We agree that until fifteen
business days after receipt of such revocation letter by the Bank, the above said authorization shall hold good.
Signatures and Names of the Joint Holders (other than the First Joint Holder)