CUSTOMER ACKNOWLEDGEMENT FORM (MID)
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APPLICANT INFORMATION
Primary Holder Name:
(As per Aadhaar)
Mobile Number: Account Number:
Joint Holder/
Guardian Name:
(As per Aadhaar)
DECLARATION FOR DIGITAL ACCOUNT OPENING
I/We confirm that I/We have read and understood the detailed terms and conditions on www.indusind.com/tabdeclaration.html and that the contact details provided on
the form/during digital account opening process are correct. I/We hereby confirm that all the information entered by Bank’s official on my/our behalf through Bank’s digital
platform is accurate & the same has been provided by me/us for the purpose of banking services. I/We do not have any objection that this information has been filled in as a
part of digital account opening process. Further, I/We agree that all the information submitted by me/us to the Bank shall be deemed and remain property of the Bank and the
Bank will be free to use this information for the purpose of providing banking services to me/us from time to time.
Consent to Use, Share and Disclose Registered Communication Contact Details
I/We hereby ACCEPT, AUTHORISE, CONFIRM AND PERMIT IndusInd Bank Limited (“Bank”) to USE, SHARE AND DISCLOSE any/all of my/our registered communication
contact addresses/details (postal, e-mail, mobile number, social media platforms/channels etc.), that I/we have willingly registered/shared with the Bank for the purpose of
(A) receiving information, either from the Bank, Central KYC Registry and/or through any of the Bank’s authorised Service Providers/Agency(ies)/Professional Advisors related
to the operations of my/our account(s)/services availed by me/us from the Bank; and/or (B) API based authentication where my/our details are being auto fetched/populated to
process my banking requests/applications on/throughthe Bank’s Web Applications/Systems; and/or (C) any kind of promotional/research/feedback based exercise about the
Bank’s products/services that I/we must/may be made aware for general consumption or to provide feedback as an existing customer of the Bank; until such time I request/notify
the Bank to stop sending communication to any/all of my/our registered communication addresses/details as per the Bank’s defined process and knowing that the Bank will
ensure security and confidentiality to all my communication contact details provided by me/us. If I am /we are or become a Non Resident Indian (NRI)/foreign national, I confirm
that the following consent is well within my capacity as a Non-Resident Indian and by doing so I do not violate or breach in any manner the regulations or statutes of the country of
my residence as are applicable to me. Notwithstanding anything contained herein above, in case I/we opt out from the aboveand tick ‘NO’ below, the Bank shall be entitled to
use/share/disclose my communication contact addresses/details to send me/us all communication either through select/mandated communication channels, those that are
deemed necessary for the (A) smooth processing of my/our account operations/service request(s) (B) for general awareness and/or (C) any statutory action required to be undertaken
by me/us as per the applicable laws and guidelines/regulations/directions/notifications prescribed by the Reserve Bank of India, Ministry of Finance India, government/quasi-
government authorities and any other authorities governing the financial and banking operations whether in India or outside India.
ü Yes No
DISCLAIMER: This material is for general informational purposes only and is not investment advice nor does it constitute an offer, recommendation or solicitation to buy or sell a
particular financial instrument. It does not have regard to the specific investment objectives, financial situation, risk profile or the particular needs of any specific person who may receive
this material. No representation is made that the information contained herein is accurate in all material respects, complete or up to date. Recipients of this document are to contact the
representative in their local jurisdiction or contact details given in this document with regard to any matters or questions arising from, or in connection with, the document. The
information contained herein is not intended for distribution to, or use by, any person in any jurisdiction where such distribution or use would be contrary to applicable law or regulation
or which would subject IndusInd Bank to additional licensing or registration requirements. It may not be copied, reproduced, posted, transmitted or redistributed in any form without the
prior written consent of the Bank. This publication is for general information only, without addressing any particular needs of any individual or entity, and should not be relied upon
without obtaining specific advice in the context of specific circumstances.
FOR SALARY ACCOUNT
In case there is no salary credits in my/our account, the Bank at its own discretion may withdraw all the benefits provided for salary account holders without any further notice. I
understand that any benefits under Salary Account will stand true till the time the account is eligible under this category. I also authorise IndusInd Bank to convert my Salary Account to
Savings Account, basis confirmation received from my employer. Also, the Bank has the discretion to convert my Salary Account to a Regular Savings Account and Terms & Conditions and
Schedule of Charges of the same will be applicable, as updated on Bank's website www.indusind.com in case there are no salary credits in my account for 3 consecutive months or the
Salary Account proposition is withdrawn at the employer level with due notice. I confirm that I will not dispute and raise any legal action against IndusInd Bank towards such remittance/
conversion of account status.
TATKAL KIT (If Applicable)
Tatkal CIF Number
VERNACULAR DECLARATION (If Applicable)
I confirm that Bank executive has explained me all the product features, charges and important T&C in my prefered language and all the same has been understood
and agreed by me.
SIGNATURE DECLARATION
Please treat the signature signed as below in presence of Bank official as my current signature and valid for all future banking transactions.
Primary Holder Signature Joint Holder/Guardian Signature
Date: D D M M Y Y Y Y
BANK USE SECTION
VER02/CAF/11-2023
I hereby confirm that I have seen the original document/s and verified customer's details. All relevant documents have been signed in my presence.
Signature
Sourcing Executive ECN:
