OFFICE USE CUSTOMER COPY

Please quote the reference no. for future reference.

*Please staple the relevant documents here Acknowledgment date : D D M M Y Y Y Y

along with the applicants latest visiting card.

Signature of Bank official:_______________________

(Please staple all documents in the space provided above)

FIXED DEPOSIT FORM

(To be filled by applicant only)

Please open my Fixed Deposit Account at your Branch

(Please fill the form in BLOCK LETTERS only-All fields marked " * " are MANDATORY) Application Date
(A) *PERSONAL DETAILS
APPL. PREFIX Full Name (Please leave one space between words for e.g.) A J A Y R A M M I S H R A

1st
2nd
3rd
If you are an existing customer please move directly to section “C”.
*NAME TO BE DISPLAYED ON CORRESPONDENCE *DATE OF BIRTH Category *Male / Female
1st Appl. D D M M Y Y Y Y M F
2nd Appl. D D M M Y Y Y Y M F
3rd Appl. D D M M Y Y Y Y M F

(B)*PAN No. (If not available please attach Form 60/61) FORM 60 / 61 ATTACHED *MOTHER'S MAIDEN NAME
1st Appl. Y N

2nd Appl. Y N

3rd Appl. Y N
• In case the applicant is a minor, please write parent/guardian's name (as an applicant) below the minor's name.
• As per Section 139A(5A) of the Income Tax Act, every person receiving any sum of income or amount from which tax has been deducted under the provisions of the Income Tax Act shall
provide his PAN number to the person responsible for deducting such tax.
• In case the PAN number is not provided to the Bank as required, the bank shall not be liable for the non availment of the credit of tax deducted at Source.
MAILING ADDRESS : For existing customers, address given below will be updated for the primary applicant in all accounts held with the bank.
*Company Name / Flat No. &
Bldg. Name "Please mention
a prominent
* Road No./Name landmark to ensure
* Landmark that the deliverables
reach you"
* City *PIN Code
*State Country:
* Tel. (O) EXT. No. STD Code * Tel. (R)
Mobile No. Email ID
The Fixed Deposit advice will be dispatched to your recorded mailing address within 3-4 working days of account opening.

(C) If any of the applicants are EXISTING ACCOUNT HOLDERS, please mention the Customer Identification No.
1stAppl. Cust Id 2nd Appl. Cust Id 3rdAppl. Cust Id

(D) INTRODUCTION DETAILS HDFC BANK Customer(Introducer's) Name

ACCOUNT NO . CUSTOMER ID
I confirm that I am an account holder with HDFC Bank Ltd for over six months . I confirm that I personally know the applicant/s detailed above for more than
6 months and confirm his /her identity, occupation and address.
Attach copy of any one : FOR BANK USE
Date:___________________
Signature Verified : Yes
PAN Card Passport
Date of A/c. Opened :
Election ID Card/Ration Card/Driving License** Signature of PB :
Signature___________________________
**Accompanied by cheque signed by you PB Code:

#
NOMINATION: Yes Name of nominee
No, I declare that I do not wish to make a nomination in my deposit account. #
(Please attach Nomination Form)
PAYMENT DETAILS
Amount Rs. ps. Cash (To open an account with cash, the customer must deposit the cash, in person, only at the account branch)

Cheque No. dated D D M M Y Y drawn on Bank, Branch.

The cheque should be crossed A/c Payee and drawn payable to “HDFC Bank Ltd. A/c. (Customer Name)”
Account Operating Instructions
Single Either/Any one or Survivor Jointly ##

##
In the event of the death of one of the joint account holders, the right to the deposit proceeds does not automatically devolve on the surviving joint deposit account holder, unless there is a survivorship clause.

BELOW FIELDS ARE MANDATORY

F P N
ACCOUNT NO . CUSTOMER ID
Please tick in case permanent address is the same as mailing address
Name : (Please leave one space between words )

PERMANENT ADDRESS
Account Opening Rules: Tax Deduction at Source
• All necessary documentation as mandated by the Regulatory/Bank authorities should be provided for opening the accounts.
• TDS rates will be as applicable from time to time as per the Income Tax Act, 1961 and Income Tax rules. The current
• In terms of Reserve Bank of India Directives, interest will be calculated at quarterly intervals on Term Deposits and paid at the rate
rates applicable for TDS would be displayed by the Bank on its website. Currently, TDS is deducted when interest
decided by the bank depending upon the period of deposits. In case of Monthly Deposit Scheme, the interest will be calculated for
the quarter and paid monthly at discounted value. payable or reinvested per customer, per branch,exceeds Rs. 10,000/- in a Financial Year
• In case of premature withdrawal of the fixed deposit based on depositor’s instructions or the instructions of all the joint depositors • No deductions of tax shall be made for taxable interest in the case of an individual resident in India, if such individual
in the case of joint deposit, the bank has the right to recover interest already paid or the penalty, if any, from the proceeds of the furnishes to the Bank, a declaration in writing in the prescribed Form (Form 15G / Form 15 H as applicable) to the effect
fixed deposit in accordance with prevailing regulations of the bank and the Reserve Bank of India. that the tax on his estimated total income for the year in which such interest income is to be included in computing his
• In case the Supersaver / Sweep-in facility is withdrawn, the depositor has to maintain the stipulated Average Quarterly Balance total income will be Nil
for that entire quarter and also in subsequent quarters. • Form No. 15G / 15H to be submitted in Duplicate. A fresh Form No. 15G / 15H to be submitted in each new financial year
• The Deposits of the bank are insured with DICGC and in case of liquidation of the bank, DICGC is liable to pay each depositor through • The Bank shall not be liable for any consequences or loss arising due to delay or non submission of Form 15G / Form
the liquidator, the amount of his deposit upto Rupees one lakh within two months from the date of claim list from the liquidator. 15H. To enable us to serve you better kindly submit the Form No. 15G / 15H latest by May 31st of the new financial year
• Copy of the Terms & Conditions, Service Charges & Fees brochure and the Code of Bank’s Commitment for Individual
Customers can be obtained from the branch/website. Note:- The above is subject to change as per directives of Finance Ministry Govt. of India.
• In case of any complaint relating to features of any of the products, the Grievance Redressal Cell within the bank can be • HDFC Bank computes interest based on the actual number of days in a year. In case, the Deposit is spread over a leap and a
approached for a resolution at [email protected] and if not resolved satisfactorily within 30 days, the non-leap year, the interest is calculated based on the number of days i.e., 366 days in a leap year & 365 days in a non leap year
Ombudsman appointed by the Reserve Bank of India in charge of the region, may be approached

FIXED DEPOSIT DETAILS

Amount : ps. Tenure : Months Days Rate of Interest: p. a.

SIMPLE FIXED DEPOSIT REINVESTMENT DEPOSIT :

INTEREST PAYMENT
Monthly Interest MATURITY INSTRUCTIONS
Quarterly Interest
Payment of Interest Renew Principal and interest Renew Principal and pay Interest
Manager’s cheque to Mailing address Transfer to Current/Savings
Payment of Interest on Maturity by
A/c. No.
Transfer to Current/Saving
MATURITY INSTRUCTIONS
Renew Principal and interest Renew Principal and pay Interest
A/c. No
Payment of Interest on Maturity by
Transfer to Current/Saving Manager’s cheque to Mailing address
A/c. No Do not Renew
Manager’s cheque to Mailing address
Do not Renew Payment of Deposit on Maturity by
Payment of Deposit on Maturity by Transfer to Current/Saving
Transfer to Current/Saving
A/c. No A/c. No
Manager’s cheque to Mailing address Manager’s cheque to Mailing address
Senior Citizen Yes No
If Yes, attach a copy of document showing proof of age. ( Driving Licence/Passport Ration Card Election ID Card)

SUPER SAVER FACILITY SWEEP-IN INSTRUCTIONS

I wish to avail of SuperSaver facility in my Current/Savings I wish to avail sweep-in facility against the above mentioned
A/c. No. deposit and in case of insufficient balance in my Current/Savings
Account Number ,
against the above mentioned deposit.
please honour my cheque/allow withdrawal by transferring funds to my
I wish to avail of this facility for Agricultural Purposes
current/savings account by breaking units of my fixed deposit.

Declaration : I/We have read and understood the Terms & Conditions governing the opening of an account with HDFC Bank and those relating to various services including but not limited to (A) ATMs, (B)
PhoneBanking, (C) Debit Cards, (D) MobileBanking, (E) NetBanking, (F) BillPay facility. I/We accept and agree to be bound by the said Terms & Conditions including those excluding /limiting the Bank's liability. I/We
understand that the Bank may, at its sole discretion, amend any of the services completely or partially with atleast 30 days notice and /or provide an option to switch to other services to me/us. I/We confirm that I/We am/are
resident/s of India. I/We authorise the Bank to disclose, from time to time any information relating to my account to any parent/subsidiary, affiliate and associate of HDFC Bank, and to third parties engaged by the Bank, for
purposes as detailed in the Terms & Conditions Booklet. I/We confirm that I/We am/are in possession of and have read the Terms and Conditions booklet which details the rules governing account operations, the Service
charges and Fees brochure which specifies the charges applicable from time to time for various services and the tear away Customer copy detailing the instructions and account opening rules.

Sweep-in facility SuperSaver / Overdraft against

• Link your Fixed Deposit to your Fixed Deposit facility
Savings or Current Account and use it • Enjoy a high rate of interest along
to fall back on in case of emergencies. with the liquidity of a Savings Account
A deficit in your Savings or Current by opting for a SuperSaver Facility on
Please Paste Please Paste Please Paste
Account is taken care of by using up your savings account. Avail of an
PHOTO an exact value from your Fixed PHOTO overdraft facility of up to 75% of the PHOTO
of Deposit ((units of Re. 1/-) of value of your Fixed Deposit of
1st Applicant • In case of more than one deposit 2nd Applicant • For the amount withdrawn, the 3rd Applicant
linked for Sweep-In, the system will applicable rate is only 2% above the
first Sweep-In funds from the oldest fixed deposit rate for the period that
deposit opened, i.e., the deposit which the money is used
was first linked to the Savings Account
on a FIFO (First-In-First-Out basis)

1) Please sign in black ink inside the box provided below. Photographs should be signed across by the applicants.
2) Please ensure that all mandatory fields have been filled correctly else the form is liable to be rejected.

Sign Here Sign Here Sign Here

* I/We consent / do not consent to receive information/service etc for Marketing purposes through Telephone/Mobile/SMS/Email by the Bank/its agents. I/We agree and acknowledge that only direct
telephone numbers (not board/general telephone numbers of offices/corporates/employers) will be accepted for registration of “Do Not Call”. I/We am/are aware that post registration I/We may receive a call from the
Bank to verify the correctness of request for registration. I/We confirm that I/We have read and understood the above Declaration, and that the details provided on the form are correct. I/We also confirm that my/our
account been opened by Bank officer Mr./Ms. _________________________________________________ & I/We have signed in his/her presence.

FOR BANK USE ONLY

A/C No. CUSTOMER ID NO.

Branch code Product Code : LC CODE : LG CODE :

where FD is
to be opened
C314/V12.0/02-09-08/P0330

Preferred VALUE DATE FUNDS PARKED CPU USE

P B SIGNATURE DATE ONLY DATE

DVU
2 9 9 0 0 0 0
APPROVED BY (BM) FCU

(Lien/Special deposit)

SOURCING
BR CODE

Occupation Salaried Self-employed Retired Self-employed prof. Housewife Politician Student Others (pls specify) ______________
If salaried employed with Private Ltd. Partnership Proprietorship Public Limited Public sector Government Multinational Others (pls specify)_______________

Self Employed since Years Months

Nature of Business Manufacturing Service Provider Agriculture Stock Broker Real Estate Trader Others_____________
Date of Incorporation
Type of Company/Firm Sole Proprietorship Partnership Public Limited Co. Private Limited Co Others (pls specify)_______________________
Self Employed Professional Doctor CA/CS Lawyer Architect IT Consultant Others (pls specify)_______________

Source of Funds Salary Business Income Agriculture Investment Income Others (pls specify) ____________________
Gross Annual income < 50,000 50,000 - 1,00,000 1,00,000 - 3,00,000 3,00,000 - 5,00,000 5,00,000 - 7,50,000 7,50,000 - 10,00,000
10,00,000-15,00,000 > 15,00,000
Residence type Owned Rented / Leased Ancestral / Family Company provided ABOVE FIELDS ARE MANDATORY