Deposit Type cForeign Currency Non Resident FCNR(B) Please specify currency cNon Resident External (NRE) in INR cNon Resident Ordinary (NRO) in INR Amount cUSD cGBP cEURO cCAD cAUD cJPY ____ ____ _______ Funding Instructions cCheck / D.D. No : ____________ Drawn on:__________________ cDebit my NRE Rupee Checking Account: Debit my NRE Rupee Checking Account: __________________________________ Debit my NR0 Rupee Checking Account: __________________________________ Tenure (In days) ______________________________ (Minimum Tenure is 365 Days) ______________________________ (Minimum T enure is 365 Days ) _________________________________ (Minimum Tenure is 7 Days) Interest Mandate Only available as a compound interest deposit cCompound Interest cSimple Interest (Interest will be credited to the NRE Rupee Checking Account mentioned above) cCompound Interest cSimple Interest (Interest will be credited to the NRO Rupee Checking Account mentioned above) Maturity Instructions* cAutomatic Renewal cIssue a Demand Draft in the currency of the Deposit cAutomatic Renewal cCredit NRE Rupee Checking Account mentioned above cIssue an Demand Draft in INR cAutomatic Renewal cCredit NRO Rupee Checking Account mentioned above cIssue an Demand Draft in INR NRI DEPOSIT APPLICATION FORM EXISTING ACCOUNT INFORMATION 1 Please tell us about your existing relationship with Citibank,N.A., India 4ALL NEW DEPOSITS WILL BE OPENED IN THE SAME HOLDING PATTERN AS YOUR EXISTING DEPOSIT ACCOUNT OR RUPEE CHECKING ACCOUNT. 4YOUR NEW DEPOSITS WILL BE AUTOMA TICALL Y LINKED TO YOUR EXISTING ACCOUNTS. 4IF YOU DO NOT HAVE AN NRI ACCOUNT WITH CITIBANK NA, INDIA PLEASE COMPLETE THE NRI ACCOUNT OPENING FORM 2 DEPOSIT DETAILS 4Interest payments in for eign currency / credit to NRE Sa vings Account are as per RBI r egulations, amended from time to time. 4If you have requested for a Demand Draft to be issued to you on Maturity, this will be sent to your registered mailing address only. 3 PERMANENT ACCOUNT NUMBER (PAN) Please provide us with your PAN details PRIMARY APPLICANT’S PAN: JOINT APPLICANT’S PAN: 4If you do not have a P AN Card, we request you to complete the Form 60 overleaf. 4You will not recei ve T ax Deducted at Source (TDS) Cer ti ficates in Form 16 A to help file taxes in India if you do not provide your PAN details. 4The automatic renewal option is not available for NRO Deposits, if you do not provide your P AN details and the maturity proceeds will be credited to your NRO Rupee Checking Account Citibank NRI Rupee Checking Account: Citibank NRI Deposit Account Number: PRIMARY APPLICANT : JOINT APPLICANT (if any): Please use CAPITAL LETTERS only D D M M Y Y Y Y Date : D D M M Y Y Y Y Date : 4 DECLARATION. PLEASE READ THIS CAREFULLY AND SIGN AT THE SECTION INDICATED. Declaration prior to Signature 1. I/We hereb y declare that I/W e are a Non Resident Indian (NRI) or Person of Indian Origin (PIO) as defined under the Foreign Exchange Management Act, 1999 along with its regulations as amended from time to time and I/We agree to notify Citibank about my/ our return to India for permanent residence. 2. I/We will be bound b y the T erms and Conditions det ailed in this Deposit Application F orm and understand that the same are in addition to the Terms and Conditions provided to me/ us at the time of initial account opening. I/We also understand that the Terms and Conditions may be amended from time to time at the sole discretion of the bank and that the current Terms and Conditions are available at www.citinri.com. 3. I/We authorize Citibank to execute pre-m ature withdraw als on my deposits placed and/ or proposed to be placed, based on the instructions from any one of account holders on the deposit account subject to the terms and conditions stipulated for this product. I/w e further agree and accept that such premature withdrawal shall be subject to the terms and conditions of this product as may be amended from time to time including but not limited to the Deposit Application form, Account Opening Form. Please ensure that all the relevant details in the form, with the exception of the field “For Bank Use Only”, are completed or struck out before you sign this form Please complete the following forms overleaf 1.Nomination Form (Form DA 1), this form is mandatory 2.Form 60; please complete this in case you do not have a PAN PRIMARY APPLICANT’S SIGNATURE JOINT APPLICANT’S SIGNATURE (If any) P J 1 CV/NR/NA/ALL/DAF/1.0/26-09-13 *Not for the FCNR (B) Special Deposit scheme under leverage
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Drawn on:__________________c Debit my NRE Rupee Checking
Account : __________________
Debit my NRE Rupee Checking Account:
__________________________________
Debit my NR0 Rupee Checking Account:
__________________________________
Tenure(In days)
______________________________(Minimum Tenure is 365 Days)
______________________________(Minimum Tenure is 365 Days)
_________________________________(Minimum Tenure is 7 Days)
InterestMandate
Only available as a compoundinterest deposit
c Compound Interestc Simple Interest
(Interest will be credited to the NRE RupeeChecking Account mentioned above)
c Compound Interestc Simple Interest
(Interest will be credited to the NRO RupeeChecking Account mentioned above)
MaturityInstructions*
c Automatic Renewalc Issue a Demand Draft in the
currency of the Deposit
c Automatic Renewalc Credit NRE Rupee Checking Account
mentioned abovec Issue an Demand Draft in INR
c Automatic Renewalc Credit NRO Rupee Checking
Account mentioned abovec Issue an Demand Draft in INR
NRI DEPOSIT APPLICATION FORM
EXISTING ACCOUNT INFORMATION1 Please tell us about your existing relationship with Citibank,N.A., India
4 ALL NEW DEPOSITS WILL BE OPENED IN THE SAME HOLDING PATTERN AS YOUR EXISTING DEPOSIT ACCOUNT OR RUPEECHECKING ACCOUNT.
4 YOUR NEW DEPOSITS WILL BE AUTOMATICALLY LINKED TO YOUR EXISTING ACCOUNTS.4 IF YOU DO NOT HAVE AN NRI ACCOUNT WITH CITIBANK NA, INDIA PLEASE COMPLETE THE NRI ACCOUNT OPENING FORM
2 DEPOSIT DETAILS
4 Interest payments in foreign currency / credit to NRE Savings Account are as per RBI regulations, amended from time to time.4 If you have requested for a Demand Draft to be issued to you on Maturity, this will be sent to your registered mailing address only.
3 PERMANENT ACCOUNT NUMBER (PAN) Please provide us with your PAN details
PRIMARY APPLICANT’S PAN: JOINT APPLICANT’S PAN:
4 If you do not have a PAN Card, we request you tocomplete the Form 60 overleaf.4 You will not receive Tax Deducted at Source (TDS) Certificates in Form 16 A to help file taxes in India if you do not provide your PAN details.4 The automatic renewal option is not available for NRO Deposits, if you do not provide your PAN details and the maturity proceeds will
4 DECLARATION. PLEASE READ THIS CAREFULLY AND SIGN AT THE SECTION INDICATED.
Declaration prior to Signature1. I/We hereby declare that I/We are a Non Resident Indian (NRI) or Person of Indian Origin (PIO) as defined under the Foreign ExchangeManagement Act, 1999 along with its regulations as amended from time to time and I/We agree to notify Citibank about my/our return toIndia for permanent residence.
2. I/We will be bound by the Terms and Conditions detailed in this Deposit Application Form and understand that the same are in addition to theTerms and Conditions provided to me/us at the time of initial account opening. I/We also understand that the Terms and Conditions may beamended from time to time at the sole discretion of the bank and that the current Terms and Conditions are available at www.citinri.com.
3. I/We authorize Citibank to execute pre-mature withdrawals on my deposits placed and/or proposed to be placed, based on theinstructions from any one of account holders on the deposit account subject to the terms and conditions stipulated for this product. I/wefurther agree and accept that such premature withdrawal shall be subject to the terms and conditions of this product as may beamended from time to time including but not limited to the Deposit Application form, Account Opening Form.
Please ensure that all the relevant details in the form, with the exception of the field “For Bank Use Only”, are completed or struck outbefore you sign this form
Please complete the following forms overleaf1. Nomination Form (Form DA 1), this form is mandatory 2. Form 60; please complete this in case you do not have a PAN
6. Details of documents being produced in support of address above:
c Passport c Drivers License c Utility Bill c Other ______
Verification: I______________________do hereby declare that
what I stated above is true to the best of my knowledge and belief.Date: Place: _________________
SIGNATURE OFDECLARANT
DD M M Y Y Y Y
P J
5 NOMINATION FORM (Form DA1) Nomination under Section 45ZA of the Banking Regulation Act, 1949, and Rule 2(1) of the BankingCompanies (Nomination) Rule, 1985 in respect of bank accounts.