MOBILE BANKING APPLICATION FORM

KVB@MobilE ====We Travel with You=====

____________________Branch Date:

I / We wish to apply for the SMS banking and subscribe for the Mobile alerts facility offered by KVB. I am herewith furnishing the details of my / our account for which this facility shall be enabled. Customer Details Customer ID Customer Name Customer Address

Account Number Mobile Number (Only one) E-Mail Address

( Please tick appropriate box. Optionally you can subscribe for any one or all of these services )

Type of Alert Debit Alert Credit Alert Balance Alert Over Draft Alert

Alerted when

Debit Amount is greater than Credit Amount is greater than Daily Balance Alert Limit Exceeding / Over Draft

Alert Limit Rs. Rs. Available Balance Net Outstanding

SMS

Email

Declaration : I/We have read and agree to abide by the terms and conditions governing KVB @ Mobile made available to me / us by THE KARUR VYSYA BANK LTD.

Name of the Account Holder

Signature of the Account Holder

Joint /A or S Accounts:
I/ We hereby agree and authorize the above account holder as Primary Account Holder to send and/or receive email / SMS Alerts / Send SMS Banking Requests to the Bank for the above account to the e-mail id / mobile number specified.

Name of the Account Holder(s) 1. 2. 3. 4.

Signature of the Account Holder

Note: 1. Use separate application forms for each account 2. Re-submit the application form in case of change of Mobile Number and/or E-mail Address. 3. For assistance call ________ (or) visit our nearest branch (or) visit our website www.kvb.co.in

----------------------------------------------------------------------------------------------------------------------------------------For Bank Use Only Application Verified by Application Entered by Date