admission Registration

1. To,
HDFC LTD,
Manager
Sub : Request for Registration of bank account for web enabled online payment facility with HDFC LTD
Housing Loan Account no.
Customer Name (Applicants
Name / Co-applicant's Name)
Customer name as per Bank
account.
Bank Account No
Bank Name
Bank Account type
(SB / CA / CC / NRE / NRO / if
others specify)
Account Type Salary Account Main Business Account Others(Specify ________________ )
Bank Branch
Account operated since ____________ years / months
MICR Code
Registration of bank account for web enabled online payment facility for Housing loan Customers
I/We, the undersigned, hereby request you to kindly register my bank account with you for web enabled online payment facility. The
details are as follows :
Mobile no
email ID
I, hereby declare that the particulars given above are correct and complete.
I have also attached following self attested documents along with originals for verification purpose to HDFC LTD.
I/We am/are aware that the existing facility is avaialble for selected banks only.
I/We undertake not to close this bank account without HDFC LTD's written consent.
Required documents : (All Originals for Verification purpose only)
For Identification proof : Driving License / Passport copy / PAN card/Voter ID / Identity card issued by employer/Letter
issued by the Unique Identification Authority of India containing details of name,address and
Aadhaar number/Letter from recognized public authority or public servant verifying the identity
and residence,subject to the satisfaction of HDFC (please tick any one)
For Address proof : Driving License / Voter ID/Passport copy / Ration Card / Electricity Bill / Telephone Bill/Ration
Card/ Letter from employer subject to the satisfaction of HDFC/ Letter from recognized public
authority or public servant verifying the identity and residence or rent receipt or Lease agreement
,subject to the satisfaction of HDFC/Bank account statement (please tick any one)
Bank Statement : Original & Photocopy of last 3 month Bank account Statement (all Originals for Verification
purpose only)
Date: __________________
Signature of the Account Holder (s)
For official purpose only :
I/We understand, as per the condition of the offer letter, I've to make the repayment of the loan by Electronic Clearing Scheme /
Standing Instructions from HDFC Bank / Salary Deductions / Post Dated Cheques (either one). The Online payment facility extended
would be for one-off payment transaction only.
For official purpose only :
Date of Receiving form : Officers ID :
Officer Name :
Service Center : Signature :