Merchant Registration Form – UPI
Customer Detail
Entity Type □ Individual □ Proprietorship Firm □ Partnership Firm □ LLP □ Pvt. Ltd. □ Public Ltd □
TASC □ HUF □ Govt □ If any Other (Please specify)
Customer Name
Existing Customer (Yes/No) CIF ID:
(If Yes, mention CIF ID)
Address 1
Address 2
Address 3 Pin Code: City: State:
Website URL
Type of Business
Email ID
Contact Detail
Sector
Business Category
Annual Turnover □ Less than 5 Cr. □ 05 Cr -25 Cr.
□ 25 Cr.- 50 Cr. □ 50 Cr-100 Cr
□ 100 Cr-150 Cr □ 150 Cr-250 Cr
□ 250 Cr – 500 Cr. □ 500 Cr. -750 Cr □ 750 Cr and more
Customer Bank Detail
Type of Accounts □ Saving A/c □ Current A/c □ Escrow/Nodal A/c
Account Name
Account Number
Bank Name
Bank Branch
IFSC Code
*Authorized Signatory Details
Name
Date of Birth
Aadhar No.
Mobile No.
Pan No.
Address
Address 1
Address 2 City: State: Pin Code:
*In case of additional authorised signatory kindly provide details in company letter head.
Terms & Conditions
Customers hereby undertakes and agrees that it shall not hold the bank liable for any delay, loss, cost, expenses, damages, outgoing, claims,
proceedings and action that may be suffered or incurred by Marchant and or the merchant in relation to:
i. Any failure or bug in the application.
ii. Non availability of UPI facility by the bank owing to any reason beyond the reasonable control of bank.
iii. Non eligibility of customers to utilize the UPI facility to make payment to the client.
iv. Technical disruptions /outages or any other technical issue which causes a delay or failure in processing payments under UPI.
v. Any other reason beyond the reason control of the bank owing to which any transaction under the UPI facility is delayed or fails.
SBM Bank India through its service provider communicated various new products/special features of existing products/promotional offers
which are of significant benefit to its customers. SBM Bank may, in its sole and absolute discretion, change these Terms from time to time.
The Customer is responsible for the accuracy and authenticity of the instructions provided to SBM Bank and the same, if is in the form and
manner prescribed by SBM Bank, shall be considered to be sufficient to operate the UPI Facility. SBM Bank shall not be required to
independently verify the instructions. SBM Bank has no liability if it does not or is unable to stop or prevent the implementation of any
Payment instruction issued by the Customer. Once a Payment instruction is issued by the Customer the same cannot be subsequently
revoked by the Customer.
Aadhaar Updation of Authorized Signatory/Beneficial Owner: I submit my Aadhaar number and voluntarily give my consent to: (i. Use my
Aadhaar Details to authenticate me from UIDAI. ii. Use my Mobile Number provided for sending SMS alerts to me. iii. Link the Aadhaar
Number to all my existing/new/future accounts and customer profile (CIF) with your Bank.) B. I have been explained about the nature of
information that may be shared upon authentication. I have been given to understand that my information submitted to the bank herewith
shall not be used for any purpose other than mentioned above, or as per requirements of law. C. I hereby declare that all the above
information voluntarily furnished by me is true, correct and complete.
Internal
Authorized Signatory (Rubber Seal of Company
Required)
Internal
