Fill and Sign the Curriculum Evaluation Form

……….. United Bank of India Telebanking Services APPLICATION-CUM-AGREEMENT FORM THE BRANCH MANAGER UNITED BANK OF INDIA …………………………………….BRANCH Dear Sir I/We request you to enrol me /us as a Telebanking subscriber for enquiry and financial transactions. As such, I /We furnish below the particulars of my /our account(s) in your Bank for updation. Personal Details: FULL NAME: First Name Middle Name Surname MAILING ADDRESS: CITY: PIN CODE: STATE: COUNTRY: * CONTACT NO: FAX NO: E-MAIL ID: * DATE OF BIRTH [DDMMYYYY] * MOTHER'S MAIDEN NAME :________________________ [* mandatory fields] User Account Details: Customer ID Account number Primary / Joint Tele Banking Services is provided only in case of single accounts, joint accounts operated by, either or survivor / former or survivor [former only]. ---------------------------------------------------------------------------------------------------------------------UNITED BANK OF INDIA TELEBANKING SERVICES ACKNOWLEDGEMENT Customer Name: Customer ID: Please dial [033] 22428940 for availing the telebanking services on 24x7 basis. You can get assistance of the telebanking officer from 10.00 A.M. to 6.00 P.M. on working days, for PIN generation and other services. Authorised Signatory with Seal General Conditions: 1. Each joint account holder desirous of availing the service shall use a separate application form. 2. The account number and customer details should be as per the Bank records 3. Transaction rights are strictly as per mode of operation registered in Bank records 4. Tele Banking Services is provided only in case of single accounts, joint accounts operated by , either or survivor / former or survivor [former only]. 5. In case of joint accounts, all account holders must sign. Declaration: I/We affirm, confirm and undertake that I have read, understood and I/We agree to abide by the provisions contained in the Terms & Conditions, Privacy Policy and Disclaimer displayed on Bank’s website: www.unitedbankofindia.com for usage of United Telebanking and accept them. Further, I/We also agree that the transactions and requests executed in the above mentioned accounts through Tele Banking under my User ID and Password will be legally binding on me and I/We am/are responsible for maintenance of secrecy and confidentiality of the information passed on to me/us by the Bank through Email/Telephone. I/We have the mandate from the other joint holders to view/inquire/operate the joint accounts mentioned above. I/We declare that all the particulars and information given in this application form are true, correct, complete and upto date in all respects. I/We agree and understand that United Bank of India reserves the right to reject my/our application without assigning any reason. The Bank reserves the right to retain the application forms, the documents provided therewith including photographs, and will not return the same to me/us. Date: APPLICANT’S SIGNATURE(S) FOR OFFICE USE ONLY Customer ID: Signatures, account no. and names of the applicant/s verified and found as per Bank’s records. Details has been updated in the system for availing telebanking services Date: Stamp Signature of Officer Signature of Manager ------------------------------------------------------------------------------------------------------------------------------------------------- • Application to be submitted to respective branch. • 033-22428940 to be dialed to use the telebanking facility. • PIN to be generated during 10 AM to 6 PM on any working day. • Service is available 24x7 hours for authorized customers. • First time caller needs to generate self PIN after agent verification. • Account will be activated for service with in 24 hours of PIN generation. • Activated customer need to enter Customer ID and PIN to use the telebanking facility.