Debit Card Application Form

This Form Is Processed Through Automated System. Please Ensure That All Mandatory Fields Have Been Filled Correctly Else The Form Is Liable To Be Rejected.

Declaraon/Debit Card Undertaking/in Case Minor

Only for Defence Accounts

Please paste

Passport Size colour

photograph here

Signature of First Holder

(Please Sign in BLACK)

Signature of POA / LOA Holder

(Please Sign in BLACK)

Name__________________________________

Signature and applicant/Guardian

Signature of Joint Holder

(Please Sign in BLACK)

First Holder

Please paste

Passport Size colour

photograph here

POA / LOA Holder

Only for Defence Accounts

Please paste

Passport Size colour

photograph here

Joint Holder

In case of more than two cards, please use on addional applicaon form, charges applicable.

Please visit www.axisbank.com to know about your debit card variant and charges. “The property that is situated in the communicaon address registered with the Bank Shall only considered for coverage

under the Fire & Burglary insurance. For updang the communicaon address the customer needs to apply for the same with the Bank with relevant address proof. The insurance shall be subject to the terms

and condions as prescribed by the insurance company from me to me. **Debit Card is provided only for accounts where Mode of Operaon is Self/Either or Survivor/Anyone or Survivor. For mode of

operaon - “All Jointly” debit cards will not be issued. PAN is mandatory for internaonal transacons. The nominee of the account will be considered for nominaon of debit cards also. The debit card by

default will have the contactless opon, however, basis your preference, the same can be enabled / disabled through various channels like Mobile App, Internet Banking, Call Centre or Axis Bank Branches.

The contactless opon is not applicable to Rupay Debit cards. Your card comes acvated with facility of using at domesc contact based ATMs and POS merchant outlets within India only. The card not present

(domesc and internaonal) and card present (internaonal ) transacons on your card can be enabled/disabled through various channels like Mobile App, Internet Banking, Call Centre or Axis Bank Branches.

The usage opons opted will have default limits set at the bin level and can be changed. The default limits will be a discreon of the bank or regulatory guidelines and are subject to change. The limits for

Online, POS, and Contactless will be a cumulave limit and not an individual limit.

l/We have read and understood the terms and condions governing the usage of the Internaonal Debit Card. l/We accept to be bound by the said terms and condions and to any changes made therein from

me to me by the Bank, as its sole discreon without any noce to me/us. l/We are the sole account holder(s) or have the required mandate to operate all the account linked to the Debit Card(s) Singly and

that l/We have completed 18 years of age. l/We understand that upon issue of a Debit Card to me/us, the exisng link to my/our account will be deacvated on ﬁrst me usage of new Card. I/we understand

and undertake that the usage of the Debit Card shall be strictly in accordance with the Exchange Control Regulaon and in the event of any failure to do so, l/We will be liable for acon under the Foreign

Exchange Management Act, 1999 and the amendments thereof spulated by the Reserve Bank of India.

l/We accept full responsibility for my/our Debit Card and agree not to make any claims against Axis Bank, in respect thereof. Apart from this, the current Schedule of Charges has been received by me and I

agree with the same.

I am we are aware of the addional charges for an Image Debit Card, and agree to abide by the same. I am/We are also aware of the fact that the Image Card will not be Photo Card. I have read all terms of

Debit Card & explained the same to minor account holder. I request & authorize Axis bank Ltd., to issue Axis bank Debit Card to minor. I acknowledge that the issue and usage of Debit Card is governed by

the terms and condions as in force from me to me and agree to be bound by the same. I acknowledge that this is my responsibility to obtain a copy of and read the same. I accept thot the terms and

condions are liable to be changed from me to me. I further uncondionally irrevocably authorize Axis Bank Ltd., to debit my account annually with the amount equivalent to the fee and the charges for

use of the Debit Card. I hereby conﬁrm that this account will be operated by me (the guardian & the minor account holder). I also undertake to indemnify the Bank against any transacons carried out by minors

using Debit Card or any other channel. I am aware of the importance of Personal Idenﬁcaon Number (PIN) & hove explained the same to the minor account holder.

I authorize Axis Bank Ltd., to issue Axis Bank Debit Card to the minor account holder. I acknowledge that the issue and usage of the Card is governed by the terms and condions as in force from me to me

and agree to be bound by the same. I acknowledge that it is my/our responsibility to obtain a copy of and read the same. I accept the terms and condions are liable to be amended by Axis Bonk Ltd., from

me to me. I uncondionally and irrevocably authorize. Axis Bank Ltd., to debit the Account with any amount equivalent to the fee and charge for the use of the Debit Card. I indemnify Axis Bank Ltd., for

arty loss/damages caused to Axis Bank Ltd. for issuing Debit Card to the minor account holder,

Signature of Guardian

l/We have read and understood the rules and regulaons concerning and agree to abide by them. l/We also understand that the Bank

reserves the right to suspend services of to me/us unilaterally without any prior noce or assigning any reason.

“The Account” means the Savings account of the minor account holder with AXIS BANK Ltd., who is represented in all transacons by the Guardian unl aainment of majority. “Cardholder” means the minor,

to whom a Card is issued by AXIS BANK Ltd., at the request of the Guardian. “Guardian” means the guardian of the Cardholder at whose request AXIS BANK Ltd., issues the Card to the Cardholder. The Guardian

and AXIS BANK Ltd., are hereinaer collecvely referred to as the “Pares”. All indemnies / undertakings / representaons to be made by the Cardholder in respect of the Terms and Condions of Debit Cards

shall be deemed to have been made by the Guardian.

Undertakings / Representaons and Warranes:

The Guardian agrees, conﬁrms and undertakes that:

(i) AXIS BANK Ltd., issuing the Card to the minor account holder with AXIS BANK Ltd., solely at the request of and at the sole risk and liability of the guardian.

(ii) The Guardian is the legal and / or natural guardian of the cardholder on the speciﬁc understanding that all amounts paid to or the order of the Cardholder on the basis of the said Card and all commission /

fees, interest, costs, expenses in relaon thereto shall be debited to the account.

(iii) The Guardian is solely and exclusively bound by these terms and condions for issue of the Card to the Cardholder expenses / other monies incurred/ due and payable on the Card and debited by AXIS BANK

Ltd., from the Account.

(iv)All charge slips in respect of the Card singed by the Cardholder shall be deemed to have signed by the Guardian.

(v) The issue of the Card to the Cardholder by AXIS BANK Ltd., at the sole and exclusive request of the Guardian constutes supply by the Guardian of necessaries suitable to the condion in life of the Cardholder

in terms of secon 68 of the Indian Contract Act, 1872.

(vi)Subject to there being adequate credit balance in the Account (in accordance with AXIS BANK Ltd.'s applicable rules) the Cardholder will be permied to use the Card for cash withdrawals of an amount of

Rs.1500/- (Rupees One Thousand Five Hundred Only) and for expenses / purchases of goods by use of the Card of an amount of Rs.1000/- (Rupees One Thousand Only) daily (the daily limit) or such other further

amount as AXIS Bank Ltd., may specify.

(vii) AXIS BANK Ltd., shall be entled to refuse to authorize any intended withdrawal /expenses/ purchases if the amount of such withdrawal / expenses / purchases is wholly or in part in excess of such daily

limit, even though there may be adequate balance in the Account.

(viii) The Card issued to the Cardholder shall not be used for purchases if alcoholic beverages, tobacco product and / or similar goods or services by the Cardholder. The Guardian further agrees, conﬁrms and

undertakes that in the event that expenses are incurred on the Card issued by the Cardholder which pertain to the purchase of any or all of the aforestated goods and / or services, the Guardian shall be deemed

to have consented to the said expenses being incurred.

(ix) The connuance of the Card issued to the Cardholder being a special facility issued at the request of the Guardian will be solely dependent on the connuaon of the Account.

(x) The Guardian / Cardholder shall have no claim for damages or otherwise against AXIS BANK Ltd., or its Aﬃliates, in the event of refusal by any person to honour the Card, presented by the Cardholder, on

the ground of his minority or in the event that the daily limit has been exhausted or otherwise howsoever.

(xi) AXIS BANK Ltd., shall be entled to refuse authorizaon for any withdrawal/ expenses / purchases in excess of the daily limits or in the event of AXIS Bank Ltd., being under a reasonable apprehension that

a fraud is sought to be perpetrated or there exist circumstances which in the reasonable opinion of AXIS BANK Ltd., merit that authorizaon should be refused.

(xii) The Card is a discreonary facility granted by AXIS BANK Ltd., at the request of the Guardian and may be withdrawn by AXIS BANK Ltd., at any me at its sole discreon.

(xiii) The death or insolvency of the Guardian or the fact that the Minor has aained the age of majority shall not aﬀect the liability of the Guardian here under.

(xiv) The liability of the Guardian will be binding on his/hers/its heirs, executors and administrators and his/hers/ its estate and eﬀects.

(xv) The Guardian shall do, perform and execute and cause to be done, performed and executed any act, deed, maer or thing which AXIS BANK Ltd., may require for AXIS BANK Ltd's further security.

(xvi) Any noce from AXIS BANK Ltd., in respect of the Account / Card may be given by AXIS BANK Ltd., by delivering it to the Guardian personally or by posng it to the latest address recorded with AXIS BANK

Ltd. The Guardian must nofy AXIS BANK Ltd., of any change to his/her address. Proof of posng to such last noﬁed address shall be conclusive proof of the noﬁcaon at the me when it ought to be delivered

in due course by post even if the noﬁcaon may be returned through the post undelivered. AXIS BANK Ltd., may also give noce of variaon of these addional terms and condions by displaying a noce on

or within the immediate vicinity of the site of an ATM/branch of AXIS BANK Ltd. or by press adversement or by message in the Account Statement.

Indemniﬁcaon: The Guardian hereby agrees, undertakes to indemnify, defend and hold harmless AXIS BANK Ltd., and its respecve directors, oﬃcers, employees, representaves, agents and assigns from and

against any and all liability including but not limited to liabilies to third pares, judgment, damages, losses, claims, cost and expenses, including aorney's fees and expenses arising from or related to: (i) a

breach by the Guardian of its obligaons under these Addional Terms (ii) the acts, errors, representaons, misrepresentaons, wilful misconduct or negligence of Guardian in performance of the Guardian's

obligaons under these Addional Terms (iii) the issuance of the Card to the Card holder. (iv)mishandling/wrong handling of Debit Card/PIN number by minor/myself.

The Guardian hereby declares that this indemnity is in addion to and not by way of limitaon of or in substuon for, any other indemnity or security that the AXIS BANK Ltd., may hold or any other indemnity

which the Guardian may have previously given to AXIS BANK Ltd., or may hereaer give to AXIS BANK Ltd., and that this indemnity will not evoke or limit to any such other indemnity.

I /We have read and understood the terms and condions governing the usage of debit card. I / We accept to be bound by the said terms and condions and to any changes made here in from me to me by

the bank at the sole discreon without any noce to me/us. I /We conﬁrm that we are the sole account holder(s) and have issued the required mandate to the above person to operate all accounts linked to

debit card(s) singlely. I /We understand that upon issuance of the debit card to the above POA/LOA holder, I/We undertake to rafy all transacons put through the above account using the said debit card,and

hold the bank indemniﬁed against any claim arising out of such transacons. Please mail this chip debit card and PIN to the POA/LOA holders communicaon address

Signature of Account Holder (s) Signature of Account Holder (s)

Name _____________________________ Name _____________________________

In conﬁrm that I am the Power of Aonery / Leer of Authority holder to the above NRE account who is authorised to operate the domesc debit card. I shall hold the bank indemniﬁed against all the claims

that may arise out of my using the Debit Card.

Terms And Condions (Indemnity) for Issuance of Debit Card to Minor

Declaraon / Debit Card Undertaking

ATM Card Applicaion Form-DCAF(B2B)/Aug 20/V1 14/08/20

Date:________________________________