SBI ATMDebit Card Application Form
SBI ATMDebit Card Application Form
Thank you for applying for the State Bank ATM / Debit Card. To help us process your request quickly please
fill this form as per the instructions overleaf if you have any questions, please check with your Branch Official.
We are committed to making your life simpler with the State Bank CARDs.
Application No:
New Renewal Replacement
Name
Name as you would like it on the card (max. 25 Letters (including spaces)
Address
Town / City
State Pin
Telephone Mobile
Email
Account Type:
Savings Current Overdraft Male Female
Date of Birth / /
A/C No.
TYPE OF ATM CARD APPLIED FOR: (Read Overleaf before selecting Card Type)
ATM-cum-Debit Card Yuva Card International Debit Card
SBI Gold International Debit Cards 1.VISA 2.MASTERCARD
DECLARATION: I am aware of the Terms and Conditions governing the use of the ATM Card and agree to
abide by them. The bank may call me at my residence / office in connection with my ATM transactions.
Place:
Date: / / Applicant's Signature
Ticket No.
Old ATM card No. to be mentioned for a replacement or renewal of the card. Ticket No. in case of Lost ATM card.
INSTRUCTIONS:
• The card is the property of the Bank and shall be returned unconditionally and immediately to the
Bank upon request by the Bank.
• The Bank reserves the right to cancel the card and stop its operations unilaterally without assigning
any reason.
• The Card is non-transferable.
• The Card Holder is initially allotted a computer generated 4 digit PIN (Personal Identification Number)
which will be in a secured and sealed PIN Mailer. It is mandatory for the card holder to carryout a
successful transaction using the PIN at SBI in order to activate the card.
• Any financial loss due to misuse of Card will be to the Card Holder's account.
• Loss of card should be reported at Bank's all India Helpline No.1800112211 and ticket no should be
obtained in order to apply for replacement card. And also notify the Branch from where he/she has
obtained the card in writing.
• Fresh card will be issued in replacement of lost/damaged card at a charge of Rs.200/- plus taxes, if
any, at present.
• The cardholder can request for regeneration of PIN in case he has lost / forgotten the same. The
Bank provides the customer with a new PIN at a charge of Rs.55/- which will be debited to the
customer’s account.
• The Card holder wishing to close the designated account or surrender the card facility will give the
Bank 10 working days notice in writing and surrender the Card along with the notice.