1. No category

CUSTOMER REQUEST FORM - For Individuals
To be filled in by customer in CAPITAL LETTERS ONLY
To,
Date: 
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The Branch Service Manager
_____________________________________ Branch
I/ We request you to process the following as indicated below with reference to
Account Number* _______________________________ / Customer Relationship No.(CRN) ________________________________
Customer’s Name (as in the account) ____________________________________
Note: Please fill complete details and provide signature in the designated section on this form.
* Indicates a mandatory Field
DEBIT CARD (For Domestic and International Use)
 Issue a new debit card
 Reissue Debit Card
ATM CARD (For Domestic Use only)
 Issue a new ATM card
 Reissue ATM Card
 Supplementary ATM card in the name of
_____________________________________________________________________
(max 30 characters)
Issue PIN for Debit/ATM card no
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Hotlist Debit/ATM card no
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Reason for Reissuance / Hotlisting: _________________________________________
FIXED DEPOSIT
Existing Fixed Deposit Number: ____________________________________________
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Maturity Date: 
Changes in Maturity Instructions **(please refer point no. 7 under Important points to note)
For Fixed Deposits on Compounding Interest
 Credit maturity proceeds into my RBS account no _________________________
 Pay maturity proceeds as Cashier’s Cheque and send to mailing address on records
 Auto Renew maturity amount at the prevailing rate for same tenor
For Fixed Deposits on Simple Interest
 Credit interest into my RBS account no__________________________________
 Pay interest as Cashier’s Cheque and send to mailing address on records
 Credit principal amount into my RBS account no __________________________
 Pay principal amount as Cashier’s Cheque and send to mailing address on records
 Auto Renew principal amount at the prevailing rate for same tenor
Tax Related
 Update Form 15 G/15 H for FD no _________________________________________
 Enclosed
 Form 15 G
 Form 15 H
Liquidation **(please refer point no. 7 under Important points to note)
 Close my Fixed Deposit number _______________upon maturity and rebook as
per the form attached.
(New Term Deposit Account opening form to be attached)
Closure (Imp - Please strike off this portion, if not selected)
 Close my Fixed Deposit number _______________
in part for INR ______________ / or in full; and
 Issue me a Cashier’s Cheque and send to mailing address on records
 Credit into RBS account no __________________________________________
STATEMENT
Issue a statement of transaction account/loan account from
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Change Statement frequency to
 Annual
 Half Yearly
 Quarterly
 Monthly
CERTIFICATE(S)
 Issue Fixed deposit advice for FD No ____________________________________
 Issue Balance confirmation certificate as on ______________________________
 Issue Account Maintenance certificate
 Issue Interest certificate for the financial year ____________________________
 Issue duplicate TDS certificate for the financial year(s) ________ , ____________
 Issue Service Tax / Charge Debit advice for month (s) ______________________
 Provide the transaction / debit advice for transaction dated___________________
Amount _______________________ Cheque no ________________________
Copy of RBS cheque required  Yes  No
Note - if you have selected yes, the copy of the cheque will be couriered to you
 Provide the ATM details (City/Bank) for non - RBS ATM
withdrawal(s), dated ____________________________________________
Amount _______________________ Reference no ______________________
NETBANKING
 Login User Id
 Issue User Id
 Re-issue User Id
 I am a new NetBanking User, please issue me both NetBanking Login &
Transaction passwords
 I am an existing NetBanking User, please re-issue my Login password
 I am an existing NetBanking User, please re-issue my Transaction password
 Disable my NetBanking  Re-set my Security Questions
 Limit Change
 Upgrade ________  Downgrade _________
(For upgrade, Limit enhancement form to be attached)
BBP
 Issue an IVR Pin
STATIC DATA UPDATION/ CHANGE
 Update my Mother’s Maiden name as ___________________________________
 Update my Passport number as - ______________________________________
(A copy of the Passport needs to be submitted as proof at branch)
 Update my PAN as _________________________________________________
(A self attested copy of the PAN card needs to be submitted as proof at branch)
 Update my Aadhar Card/UID number ___________________________________
(A self attested copy of the Aadhar Card needs to be submitted as proof at branch)
 Update my Date of Birth as __________________________________________
 Type of document attached to support the Date of Birth
 Passport  Driving License  PAN  Others (Please specify) _______
IMPORTANT POINTS TO NOTE
PASS BOOK
 Issue a Passbook
CHEQUE BOOK
 Issue cheque book(s)______
STOP PAYMENT
 Place stop payment on cheque no _____________________________________
Payee_________________________ Reason ____________________________
 Place stop payment on cheque no(s) __________________________________
Reason __________________________________________________________
 Revoke stop payment from cheque no(s) ________________________________
Payee_________________________ Reason ____________________________
 Issue a mini cheque book of 5 leaves
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2.
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Please provide your signatures as per Bank records
Joint account holders needs to sign as per the mandate
Please strike off the portion that is not relevant to your request
Any alteration in the form needs to be counter signed
Charges, if applicable will be as per Schedule of Benefits
Request will be processed only on receipt of complete information and documents
Change of deposit instructions can be accepted only 2 days prior to maturity date**
Transactions post issuance/reissuance date will be printed in the passbook
This document is subject to the T & Cs governing the Account(s) and policies of the Bank in force, as on date.
___________________________
SIGNATURE OF CUSTOMER
(CRN) ______________________
___________________________
SIGNATURE OF CUSTOMER
(CRN) ______________________
___________________________
SIGNATURE OF CUSTOMER
(CRN) ______________________
Name of the receiver: _________________________________
Employee id: ___________________________
Received on: 
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Actioned by: ________________________________________
on date: 
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Signature: __________________________
Documents received and attached: (1) _______________________________________ (2) _______________________________________
(3) _______________________________________ (4)_______________________________________
ACKNOWLEDGEMENT
Date: ________________________
Received from (Name of A/C holder) __________________________________________
_____________________________________ Account number ______
Request for _____________________________________________________________
Ref no. (if applicable) _________________________________________
Documents received and attached:(1) _________________________________________
(2) ________________________________________________________
(3) _________________________________________
(4) ________________________________________________________
Signature of receiving officer____________________________
Name ______________________________________________
RBS branch _________________________________________________
CRF1_JAN_2015
For Bank use
24x7 BANK BY PHONE
Location
Number
Location
Number
Bengaluru
(080) 4124 5555
Mumbai
(022) 6627 1111
Chennai
(044) 2821 5151
New Delhi
(0124) 411 1111
Gurgaon
(0124) 411 1111
NOIDA
(0124) 411 1111
Hyderabad
(040) 6666 1234
Pune
(020) 6642 1111
Kolkata
(033) 4434 1111
Vadodara
(0265) 661 9999
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