Rca Form Ver 2.4
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Rca Form Ver 2.4 Rca Form Ver 2.4 Document Transcript

  • OFFSHORE VERSION 2.4 : Effective From 25/08/2007 RUPEE CHECKING SAVINGS ACCOUNT FORM
  • Dear Applicant/s, Thank you for your interest in Citibank Rupee Checking Account. Please follow these easy steps, fill in the form and ensure the following requirements are met for Account Opening: 1. Complete all fields of the form in block capitals and countersign any corrections/overwritings on the form. 2. Please make sure you strike out all the blank sections of the form prior to submission. 3. Attach one passport-sized photograph for each applicant. 4. Attach photocopies of your passport with pages showing photograph, personal details and work permit/visa details. 5. Submit Secondary Identification Proofs as per the details given overleaf. 6. Submit address proof (Original Utility bill not more than 3 months' old or bank Statement not more than 30 days' old with your address). 7. Attach a check favouring Citibank, N.A., India Account - Your first name and complete last name. 8. For customers residing in Singapore/Australia/Canada and for special cases, please submit additional documents as mentioned below. Also, please note: 1. All sections except section 3 is mandatory. 2. Kindly ensure that all proofs being submitted are clear and visible photocopies. 3. If you are submitting a form to a Relationship Manager in person, please ensure that you carry the originals of the documents for verification and please sign the form in the presence of the Relationship Manager. Important information about Account Opening: As you would be aware Citibank Rupee Checking Account is offered under Reserve Bank of India programs for Non-Resident Indians and guided by the "Know Your Customer" (KYC) norms. Under KYC norms, we are required to verify the identity of the applicants who wish to open the account with Citibank, N.A., India. In case you have not met a Citibank Officer and therefore your identity documents have not been certified, Citibank, N.A., India will carry out verification of the information provided in the application form using information from government/local authorities/credit bureaus/ agencies, etc. In the event where we are unable to complete such verification, we will get back to you and request you to meet a Citibank Officer to complete the verification process or get your identity documents certified by the Indian Embassy/Consulate in your country of residence. We will be able to process your application form post verification only. Citibank, N.A., India reserves the right to reject the application form at its sole discretion. We thank you for your cooperation in this regard and look forward to your patronage of Citibank, N.A., India NRI business. Acceptable Secondary Identification Proofs For each account holder, please attach a copy of any ONE of the following: For all regions • Local Driver's License * • National Identity Card * • Birth Certificate * • Photo Credit Card (issued by Visa/ Master or Diners only and non- Photocard is acceptable for the U.S.) • Utility Bill (to be submitted in original, not more than 3 months' old & address should match the address given on the form)* • Bank Statement not more than 30 days' old & address should match the address given on the form* • Vehicle Registration Document * • U.S. Green Card (for U.S. Resident Alien) * This document may not be applicable for all regions, please check with your Relationship Manager or call our toll-free lines to confirm. Additional Country-specific Requirements For Singapore Residents Only: • Along with passport, please attach a copy of NRIC/ Employment Pass/Dependent Pass/ Work Permit issued by Singapore government. • Rupee Checking Account check clearing letter as provided by the Citibank Representative. For Australian Residents Only: • Online Cash Manager (OCM) Account Number • 100 point check verification from Australian Post/NRI Service Center or S-21 Form completed by an acceptable referee. For your 100 point check verification, you would require the following documents: • Photocopy of your Australian Driving License • Photocopies for any TWO of the following documents: - Foreign Driver's License - Person of Indian Origin (PIO) Card - Bank Account Statement of debit or credit card - Medicare Card - Student Identity Card (mandatory for students) • Rupee Checking Account check clearing letter as provided by the Citibank Representative. For German Residents Only: You are requested to visit nearest branch of Deutsche Post (DP) to submit all the documents. Kindly carry all the original documents along with for the identity verification process. The Deutsche Post coordinators would cross-check your documents with the originals and hand over your original back to you there itself and then they themselves would forward your application forms to the London NRI Service Center free of cost. For Canadian Residents Only: If you are submitting an Indian passport, please attach a copy of your Permanent Resident Card. For UAE Residents Only: P.O. Box address may be provided, as long as the alternate address mentioned on the form is the street address in UAE. Documentary proof may be provided for either address. For Oman/Bahrain/Kuwait/Qatar Residents Only: P.O. Box address may be provided, as long as the alternate address mentioned on the form is the street address in country of residence (i.e. Oman, etc). Documentary proof for the street address must be provided. Additional Requirements for Special Cases Minor Accounts: Guardian's photograph if the Account Holder is a minor. Existing Citibank Account Holders: Account closure letter in case you have a Citibank Suvidha/Savings Account for domestic resident Indians. In case of you are opening an NRO account, you can instruct us to credit the balance of your Account into the Rupee Checking Account. For US/Canada, Singapore, Australia & UK Residents: Please send the completed form with the required documentation to your nearest Citibank NRI Business Center. (Please refer brochure or visit www.citinri.com for the addresses.) For Residents in any other country: PLEASE DO NOT MAIL YOUR APPLICATION FORM. KINDLY VISIT THE NEAREST CITIBANK NRI CENTER WITH YOUR ORIGINAL IDENTITY DOCUMENTS AND SUBMIT YOUR APPLICATION FORM TO A CITIBANK OFFICER. ALTERNATELY, YOU CAN GET THE DOCUMENTS FOR ALL APPLICANT/S CERTIFIED BY THE INDIA EMBASSY/CONSULATE IN YOUR COUNTRY OF RESIDENCE AND THEN SEND THE FORMS TO THE NEAREST CITIBANK NRI CENTER.
  • RUPEE CHECKING SAVINGS ACCOUNT FORM Please mention your specific offer code below Section 1: Information about you OFFER CODE: Name: Mr./Ms. First Name Middle Name (Initial) Last Name Please complete as given on supporting identity documents/SSN Card(for USA only) Name as on ATM Card First Name Middle Name (Initial) Last Name (In case your name exceeds 21 characters, please use initials so that the name can appear as above on your ATM Card.) Please provide your residential address as one of the addresses. Also, one of the addresses you mention must be outside India. Mailing Address First Applicant State PIN/Zip Code Country Telephone (Office) Telephone (Residence) Mobile Number OFFSHORE VERSION 2.4 : Effective From 25/08/2007 E-mail ID For Telephone and Mobile numbers, please indicate Country Code, Area Code and the Phone number. For example , for U.S. : +1-212-XXX XXXX Permanent Address State Country PIN/Zip Code Telephone (Office) (Residence) Nationality Country of Residence Date of Birth Passport Details: e.g. 01 FEB 07 D D M O N Y Y Passport No. Passport Issuing Country Are you a Senior Public Figure or related to one?* Yes No Place of Issue Date of Issue Date of Expiry D D M O N Y Y D D M O N Y Y * Please refer to clause 8 in section 9. Section 2: Information about your employment Check the relevant box in each of the sections A, B, C, D and E below. Kindly select only one box in each section. A. Employment Details: Self-employed: Occupation: Chartered Accountant Law/Secretarial Firm Doctor Engineer Management Consultant Other: ______________________ Business:- Name of Business ___________________________________________________________________ Nature of Business: Automobile Business Offshore Companies Bar/Casino/Night Club Remittance Services Export/Import Broker/Forex Dealer Lottery Bank/Finance/Personal Investment Company Dot Com Company Jewellery Dealer Restaurant & Hotels Other: __________________________________________________________________________________________________________ Salaried: Name of Current employer: _______________________________________ Designation: ___________________________________ Other: Occupation Charitable/Family Trust/NPO/Society Intermediary Trustee/Nominee Trade Unions Agents (incl. money manager) Other (Please specify the details): ____________________________________________________________________________________ B. Number of years in above employment: Up to 2 years 2-5 years Over 5 years C. Annual Income (USD): Up to 50,000 50,000 – 100,000 100,000 – 200,000 200,000 – 500,000 Over 500,000 D. Source of wealth (Please select the option representative for all applicants) Business Income Inheritance Investments Personal Savings Other: ___________________________ E. Number of years in a Foreign Country: Up to 2 years 2-5 years Over 5 years Page 1 of 6 View slide
  • Section 3: Information about the joint applicant Name: Mr./Ms. First Name Middle Name (Initial) Last Name Relationship with you Nationality Date of Birth D D M O N Y Y E-mail ID Country of Residence Joint Applicant Passport Details: Passport No. Passport Issuing Country Place of Issue Date of Issuing Date of Expiry D D M O N Y Y D D M O N Y Y Are you a Senior Public Figure or related to one? * Yes No * Please refer to clause 8 in section 9. A. Employment Details: Self-employed: Occupation: Chartered Accountant Law/Secretarial Firm Doctor Engineer Management Consultant Other: ____________________ Business: Name of Business: ___________________________________________________________ Nature of Business Automobile Business Offshore Companies Bar/Casino/Night Club Remittance Services Export/Import Broker/Forex Dealer Lottery Bank/Finance/Personal Investment Company Dot Com Company Jewellery Dealer Restaurant & Hotels Other: _________________________________ Salaried: Name of Current employer: ___________________________________________ Designation: _______________________________________________ Other: Occupation Charitable/Family Trust/NPO/Society Intermediary Trustee/Nominee Trade Unions Agents (incl. money manager) Other (Please specify the details): ______________________________________________________________________________ B. Number of years in above employment: Up to 2 years 2-5 years Over 5 years Section 4: Information required for customers who have a U.S. address or are a U.S. person. First Applicant: I am a U.S. Person Yes No** ** Please refer to clause 9 in section 9 if you are not U.S. person. Social Security Number/Tax Identification Number: U.S. Driver's License No. Issued by: Date of Issue: Second Applicant: I am a U.S. Person Yes No** D D M O N Y Y Social Security Number/Tax Identification Number: U.S. Driver's License No. Issued by: Date of Issue: If you have been residing at the current address (as mentioned above) for less than 24 months, please provide your previous residential address: D D M O N Y Y Address: State: Zip Code: Section 5: Information on account type Check the relevant box and provide required information. A. Type of Account NRE (Non-Resident External) NRO (Non-Resident Ordinary) Fully-repatriable and funded by earnings overseas Non-repatriable and funded by income source in India (e.g. Shares, pension, receipts, rentals on property, etc.) B. City in which you want to hold the Account (Tick only one) Ahmedabad Bhubaneshwar Faridabad Jaipur Lucknow New Delhi Surat Aurangabad Chandigarh Gurgaon Jalandhar Ludhiana Noida Vadodara Bangalore Chennai Hyderabad Kochi Mumbai Pondicherry Vapi Bhopal Coimbatore Indore Kolkata Nasik Pune C. Existing Relationship with Citibank, N.A., India, if any In case you have a Citibank Suvidha/Savings Account for Citibank NRI Business Relationship Account No. domestic resident Indians, please attach a closure letter. In case you are opening an NRO-type of account, you can Please link this Relationship Account Number with my new RCA Account instruct us to credit the balance in your Account into the Rupee Checking Account. Citibank Suvidha/Savings Account No. Page 2 of 6 View slide
  • Section 6: Information on first credit to the account Check the relevant box and provide required information. (Kindly select only one box) A. Source of funds to open the account (Please select the option representative for all applicants) Salary Investments Savings Inheritance Business Income Sale of Property Other B. Mode of first credit Cheque/Draft Number ______________ Bank Name ____________________________________ Amount ________________________________ Wire Transfer Date ______________________ Bank Name & Branch ______________________________ Amount________________________ Other: ________________________________________________________________________________________________________________ Section 7: Information on account usage Check the relevant box and provide required information. A. Purpose of opening the account: Basic Household Expenses Investments Other (Please specify): ______________________________________________________________ B. Transactions you expect to perform: Expected Number of Amount of Expected Transactions Per Month Transaction Type Transactions Per Month INR INR INR INR 0-10 11-25 26-50 51+ (0 - 450,000) (450,001 - 1,000,000) (1,000,001 - 5,000,000) (5,000,001 +) Cash Deposits Cheques/ Drafts Funds Transfer Cash Withdrawals Cheques/ Drafts Funds Transfer C. Expected average balance to be maintained in an year INR 0 - INR 450,000 INR 450,001 - INR 1,000,000 INR 1,000,001 - INR 5,000,000 INR 5,000,001 + Section 8: Please provide Nomination Details Nomination under Section 45ZA of the Banking Regulation Act, 1949, and Rule 2(1) of the Banking Companies (Nomination) Rule, 1985 in respect of bank accounts. I would not like to assign a nominee and have read clause 6 of section 9 regarding the same. Yes, I want to nominate the following person. I/We (Name(s) and address(es) of Account Holder(s)) nominate the following person to whom in the event of my/our/minor's death, the amount of the money in the Account, particulars whereof are given below, may be returned by Citibank, N.A., India. Name Age (years) Address Date of Birth (if nominee is a minor) Relationship with Account Holder (if any) D D M O N Y Y As the nominee is a minor on this date, I/we appoint (Strike out if nominee is not a minor.) Name Age (years) Address to receive the amount of money in the Account on behalf of the nominee in the event of my/our/minor's death (if the nominee is still a minor). I/We, am/are nominating the person mentioned above for the Account. Section 9: Declarations 1. I/We certify that the information provided in this application form is accurate to the best of my/our knowledge, information and belief. I/We agree to inform Citibank of any changes to the information provided during my/our account opening process. I/We have obtained, read and understood the Citibank, N.A., India (“Bank”) Account Terms and Conditions (as may be in force from time to time) and hereby agree to be bound by the said terms and conditions including those excluding/limiting your liability. I/We have also read, understood and hereby agree to abide by the terms and conditions governing Citibank Online Internet Banking, CitiAlert and Statement on E-mail. I/We authorise the Bank to give me/us notice of availability/readiness of my monthly/quarterly statement(s) of Account(s)via e-mail to the e-mail ID specified by me/us. I/We hereby agree to receive Alert messages/advices with respect to events/transactions relating to my/our Account/Linked Accounts through e-mail/over my mobile phone to the e-mail ID/mobile phone number specified by me/us in the application form. I/We hereby agree that it shall be my/our sole responsibility to advise the Bank in the event I/we do not wish to avail of Statement-on-the-Net or receive Alerts/advices through e-mail/over mobile phone. 2. It shall be my/our responsibility to educate myself/ourselves and to comply at all times with all relevant laws, regulations and rules applicable to my/our use of Offshore Wealth Services, including any tax, foreign exchange or capital controls, and for reporting or filing requirements that may apply as a result of my/our country of citizenship, domicile or residence or the location where Offshore Wealth Services activities may be conducted. “Offshore Wealth Services” means any products or services provided to individual consumers who reside in countries other than the country in which the providing Business is located. 3. In the event I/Joint Applicant are applying for an NRE account, I/Joint Applicant hereby declare that I/Joint Applicant are Non-Resident Indian(s) of Indian origin as defined under the Foreign Exchange Management Act, 1999 along with its Regulations as amended from time to time. In the event I/Joint Applicant are applying for an NRO account, I hereby declare that I am a Non-Resident Indian(s) of Indian origin as defined under the Foreign Exchange Management Act, 1999 along with its Regulations as amended from time to time. I/Joint Applicant understand that the Rupee Checking Account is a Savings Bank Account and will be opened with Citibank, N.A., India (the Bank) on the basis of the statements/declarations made by me/us. I/Joint Applicant also agree that if any of the statements/declarations made therein is/are found to be incorrect in material particulars, the Bank is not bound to pay any interest and is also entitled to, at its sole discretion, close the said Account. I/Joint Applicant also undertake to notify the Bank about my/our return to India for permanent residence. I/Joint Applicant understand that the services herein offered by you are in accordance with the schemes made GCG-MK/SG/RCA-Saving/08-07 Page 3 of 6
  • available by the Reserve Bank of India (RBI) for Non-Resident Indian(s). I/Joint Applicant will abide by the provisions of the NRE/NRO or any other applicable scheme laid down by RBI from time to time and any other regulations as prescribed by the Government of India and/or Foreign Exchange Management Act, 1999 and agree to keep myself/ourselves updated about the same. I/We hereby declare that any transaction involving foreign exchange hereunder will not involve, and will not be designed for the purpose of any contravention or evasion of the provisions of the Foreign Exchange Management Act, 1999 or any rule, regulation, notification, direction or order made thereunder. I/We also hereby agree and undertake to give such information/documents as will satisfy the Bank with regard to any foreign exchange transaction in terms of the above declaration. I/We also understand that if I/we refuse to comply with any such requirement or make any unsatisfactory compliance therewith, the Bank shall refuse in writing to undertake any transaction on the Account and shall, if it has reason to believe that any contravention is contemplated by me/us, report the matter to RBI and/or such other authority as the Bank deems fit. 4. I/We hereby accept and acknowledge that the Bank shall have the right and authority to carry out investigations and seek information from the government/local authorities/credit bureaus/agencies, etc. for confirming the information provided by me/us to the Bank. The Bank may use my/our information to administer my/our account and for other business purposes including credit, address verification or anti-money laundering purposes. The Bank shall have the sole discretion to reject my/our application form and I/we hereby undertake not to hold the Bank liable for the same. I/We further understand that in the event of the Bank accepting an application, an intimation confirming the placement of a Deposit and its particulars shall be sent to me/us. The rejection or cancellation of my/our application shall be communicated by the Bank by any means, whether oral or otherwise and the intimation of acceptance or rejection shall be served on me/us in accordance with the Bank's usual practice and I/we agree and undertake to be bound by the same. I/We hereby expressly authorize the Bank and/or its affiliates, to disclose at any time and for any purpose, any information whatsoever relating to my/our personal data and sensitive personal data, accounts, transactions or dealings with the Bank, to any of the Bank's offices, branches, representative offices, affiliates, subsidiaries, agents and/or service providers of Citibank and third parties selected by any of them, wherever located, for the purposes of administration of my/our Account and the facilities extended to me/us hereunder or otherwise as also to any national or local governmental or regulatory or statutory or judicial or quasi-judicial authorities and any agent or contractor engaged to perform services for the Bank's benefit. Such disclosure includes, but is not limited to, providing information to U.S. and/or other tax authorities in India or any other applicable jurisdiction relating to my/our Account (s), when required and/or withholding of such taxes when mandated by law. 5. I/We hereby indemnify the Bank against any losses, claims, costs, charges and expenses arising from or suffered by the Bank by reason of mailing for us on our mailing instructions to the Bank. I/We undertake that in case of debits to NRO/NRE Accounts for the purpose of investments in India and credits representing sale proceeds of investments, I/we will ensure that such investments/disinvestments would be covered either by the general or specific permission of RBI. 6. Advantages of Nomination: The Bank recommends that all Customers avail nomination facility. The nominee, in the event of death of the Customer/s, would receive the balance outstanding in the account. Nomination facility is intended only for individuals including a sole proprietary concern. There cannot be more than one nominee in respect of single/joint account. This is also applicable to deposits having operating instructions “Either or Survivor”. It may be noted that in the case of a joint account, the nominee’s right arises only after the death of all the holders. 7. Important for residents of countries other than India: I/We understand that these Accounts/deposits are with, and payable solely at and by, the specific branch of Citibank, N.A., India, where such account/deposit is held, in accordance with Reserve Bank of India rules, and in accordance with and exclusively subject to the laws of India, including any governmental actions, orders, decrees and regulations. No other branch or office of Citibank, N.A. or its affiliates will be liable for payment in respect of the account/deposit, and there is no recourse whatsoever against Citibank, N.A. or any of its affiliates. Deposits at any branch in India are not insured by any government or private scheme, company or corporation outside India. Interests accrued on credit balances shall be at such rate as determined, from time to time, by Citibank, N.A., India in accordance with applicable Indian laws. All interests will be paid gross (unless the Bank or the relevant deposit taker or paying agent is required by law to make any deduction or withholding tax and I/we be accordingly responsible for declaring and paying any tax on these. 8. Senior Public Figure Declaration: I/We declare that I/we have read the terms and conditions governing Public Figure and declare that I/we, am/are not Senior Public Figure(s) which is defined as a senior official in the executive, legislative, administrative, military or judicial branches of a government, whether or not elected, a senior official of a major political party, or a senior executive of a government-owned or government-funded corporation, institution or charity. A "Senior Public Figure" also includes any entity that has been formed by or on behalf of a Senior Public Figure, in which the Senior Public Figure is a beneficial owner of at least twenty-five per cent of the entity. In addition, a "Senior Public Figure" includes the immediate family of a Senior Public Figure and any close associate or relative of a Senior Public Figure. A close associate is a person who is widely and publicly known to maintain an unusually close relationship with and able to conduct financial transactions on behalf of a Senior Public Figure. 9. For Non-U.S. Persons only: By opening this account and signing below, you represent and warrant that you are not a U.S. person for purposes of U.S. Federal income tax and that you are not acting for, or on behalf of, a U.S. person. A false statement or misrepresentation of tax status by a U.S. person could lead to penalties under U.S. law. If your tax status changes and you become a U.S. citizen or a resident, you must notify us within 30 days. A U.S. person is defined as U.S. citizen, U.S. Green Card holder or U.S. Resident Alien. 10. Data Protection and Privacy Notice: Citibank, N.A. India, is a member of the Citibank group of companies and is the data controller in the meaning of EU Directive on Data Protection (For EU customers - Please telephone us on 0800-032-2484 if you want to have details of agencies from whom we obtain and with whom we record information about you. You have a legal right to these details). Citibank values your privacy and has a policy to hold in confidence information about you and your account. We will use your information to open and administer your account and for other business purposes, including the following: making any enquiries that we consider necessary to confirm your identity when considering your application, managing your account(s) (You have a right to make representations against any adverse decisions which have been taken on a solely automated basis); making searches against your name at licensed reference agencies. This may be for address verification or money laundering prevention purposes. It is important that you give us accurate information. We will check your details with a fraud prevention agency/agencies and if you give us false information and we suspect fraud we will record this. Law enforcement agencies may access and use this information. We and other organisations may access and use from other countries the information recorded by fraud prevention agencies. Citibank may disclose details of your relationship with Citibank NRI to other Citibank organisations for their confidential and internal use. Citibank NRI may also disclose such details to Citibank organisations or other third parties where it is reasonably necessary to do so for processing your dealings with us or to enable them to provide services to you. In certain circumstances, Citibank may disclose information, if required to do so by any court order, regulatory body or similar process and to countries outside the European Economic Area including the Head Office of Citibank in the United States of America and India for account management and other business purposes. You understand that this information may then become subject to the laws of other countries. Declaration This must be signed by each applicant. Note: When two or more people sign this Declaration, then the following applies to each of them and to accounts which they or either of them open. I am over 18 years of age. I confirm that I have read this form carefully and that the information in it about me is accurate. I confirm that I will be liable to compensate Citibank for any loss that Citibank may suffer as a result of any inaccuracy in this information. I have been given adequate opportunity to read and understand, and agree to be bound by the Citibank Rupee Checking Account Terms and Conditions. I understand that Citibank has the right to alter any Terms and Conditions. If you do not wish to be contacted by post or telephone regarding relevant products or services and offers, that we believe will be of interest to you, please tick this box. Please note that the telephone calls you make to Citibank may be recorded and/or monitored for training and quality purposes. Stop waiting for snail mail to deliver your Account Statement. Get your statement delivered in your mailbox in an all-new format that comes with these features: Fast, Easy, Secure, Archiveable and FREE! Yes ! Please send me Monthly Statement & Advices on the e-mail Id provided by me on the form. First Applicant (Please sign in black within the box) Joint Applicant (Please sign in black within the box) X X Signature Date ____________ Signature Date ____________ In the event of a joint signatories, your account will be operated in “Single or Survivor” status only. Please ensure that the account holder’s signature on the form matches with at least one of the identification documents or with the first party check being submitted. Page 4 of 6 GCG-MK/SG/RCA-Saving/08-07
  • Section 10: Important and useful information Citibank NRI Business Value Added Products 1. Charges/Fees on your Account: Details of First Applicant I. Service Charges: In the absence of a special offer, the average minimum balance required to maintain a Citibank Rupee Checking Account is Rs. 40,000 or its equivalent. A nominal service charge equivalent to Rs. Name: Mr./Ms. 400* would be charged for that month in case the average monthly balance First Name Middle Name (Initial) Last Name is not maintained. The Service Charges as mentioned herein are subject to change at the sole discretion of the Bank. Telephone (Office) ii. Conversion Commission: Any conversion from one currency to another shall be at the rate of conversion as applicable and determined by the bank as on the transaction date. Citibank's conversion rate for both incoming and outgoing transfers denominated in a foreign currency includes a Mobile Number commission for the conversion service. 2. Interest Rates: The Interest rate offered on Rupee Checking Savings Account is 3.5% per annum, as per RBI regulations. The interest is paid on the minimum E-mail ID balance in the account between the 11th to the last day of the month. The interest is applied half-yearly in March and September. 3. Change of Address: In case you need to change mailing address of your Details of Joint Applicant account, please send a written request to your nearest NRI Service Center. 4. Designate a family member to operate your account in India: You will receive the Mandatee application form in your Rupee Checking Account Name: Mr./Ms. Welcome Pack or you can download it from www.citinri.com. Please fill the form, First Name Middle Name (Initial) Last Name sign and send it to your Mandatee in India for signing. Your Mandatee should hand it over to the nearest Citibank Branch in India. Telephone (Office) 5. Service Access Channels: I. Call CitiPhone: Our 24-hour phone banking service. Please visit www.citinri.com for toll-free numbers in your region. Mobile Number II. Walk into our Citibank Branches in India and NRI service centers around the world. III. Manage your Account easily and securely at your fingertips through Citibank E-mail ID Online Internet Banking. IV. E-mail us at indiaservice@citicorp.com for any service-related issue. * Service tax and an education cess will be leived on the service charge, in accordance with I/We hereby voluntarily requisition, accept and expressly authorise Citibank, N.A. the latest notification from Government of India. and/or all the companies/entities/subsidiaries /affiliates thereof under Citigroup and their agents to exchange, share, disclose or use in any manner whatsoever, the information voluntarily provided by me/us herein or any change in my/our information including, but not limited to, e-mail ID, Telephone number, Mobile number and Address that Citibank, N.A. may be informed of or be available with Citibank, N.A. and/or any of its subsidiaries/affiliates/associates and/or all the companies/entities/ subsidiaries/ affiliates thereof under Citigroup to offer and/or market and/or sell to me/us any of the products or services or any enhancements/upgradation/revisions thereof offered from time to time by Citibank, N.A. and/or all/any of the companies/entities/ subsidiaries/ affiliates thereof under Citigroup. First Applicant X Signature Joint Applicant X Signature Page 5 of 6
  • Section 11: To be filled in by the Bank The customers have been met in person and their documents have been verified against the originals. The customers have not been met in person. The ID Verification has been carried out using: The address has been verified through: Customer Details Verified by: Name of Relationship Manager Signature Source of Account opening: Customer Referral New Product Seminar Branch Walk-in Telecalling Internet Lead Staff Referral Other Page 6 of 6