User name
Password (Minimum of 8 characters)
Confirm Password (Minimum of 8 characters)
First Name
Middle Name
Last Name
Date of Birth
Gender
Address
Country
Email
Phone
   
By signing below, I hereby apply for the this bank - internet and electronic banking service (collectively the electronic banking services) as may be made available to me by the Bank from time to time. Further, I acknowledge that my use of the Electronic Banking Services shall be governed by the Bank’s prevailing Electronic Banking Terms and Conditions, available on the Bank’s web-site and I declare that I have read and fully understand the said Terms and Conditions and accept the same. I hereby instruct and authorize the Bank to mail/send by courier my Electronic Banking ID and Electronic Banking Password (collectively Security codes) relating to my access to the Electronic Banking Services, to my address, as per the Bank’s records, and, I agree that the risk of non-receipt and / or disclosure of the Security Codes to an unauthorized third party shall be fully borne by me. Subject to the Bank’s prevailing terms governing the use of the Services, I hereby authorize and instruct the Bank to act on any instructions received through the use of my Security Codes, including, but not limited to the transfer of funds (subject to limits as may be imposed by the Bank from time to time) from my account(s) with the Bank (which I am entitled to operate on a single signatory basis) to the third party accounts named under the heading Beneficiary Accounts, above, and, to any account which I may designate from time to time,for this purpose under the Bank’s prevailing procedures. I warrant that all the information provided by me, in this application form is true, accurate and complete in all respects.