TERM DEPOSIT APPLICATION FOR EXISTING CUSTOMER

* Fields are mandatory.

Br. Code: Branch: Date: D D M M Y Y Y Y Value Date: D D M M Y Y Y Y

st
1 APPLICANT INFORMATION
Cust. ID* (For existing customers)

First Name*

Middle Name
Last Name*

PAN#

E-mail ID
nd
2 APPLICANT INFORMATION
Cust. ID* (For existing customers)

First Name*

Middle Name
Last Name*

PAN#
#Please submit Form 60 in absence of the PAN.

FIXED DEPOSIT (FD)/RECURRING DEPOSIT (RD)

FD RD Incase of FD, Premature withdrawal required Yes No
For Non-Resident customers, please check against the respective account types.: NRE NRO FCNR
FCNR currencies to be chosen: USD EURO CAD AUD JPY GBP
FD Payment Instruction RD Payment Instruction
Cheque No.: Debit My Existing Account:
Debit My Existing Account: Amount: .
Amount: . Tenure: Months Currency:
Tenure: Months Days Currency: Rate of Interest: %
Rate of Interest: % Monthly debit shall be done on the date mentioned in the value date field.

OPTION 1 OPTION 2
Interest Payment
Frequency$ (Please fill Reinvestment Payout Quarterly Payout Monthly
only for deposits > 180 days):
Renew Principal and Interest Renew Automatically
Maturity Instructions:
Renew Principal and Pay Back Interest Do not Renew Do not Renew
Interest Payment and Credit to linked IndusInd Bank account#
Maturity Payment
Instructions: For NEFT IFSC: Account No.:

Sweep-in Facility#: Yes No (Linking of Fixed Deposits with Current/Savings Account for fulfillment of any shortfall(s) in the Current/Savings Account)
$ Interest (simple) on Fixed Deposits with tenure less than or equal to 180 days will be only paid on the maturity date of such deposit.
# Linked Current/Savings Account will be applicable for initial payment, interest/maturity payment, and sweep-in facility, if selected. This facility is not available on NRE deposits. Monthly/Quarterly
interest payment options are not available on FCNR Deposits.
For deposits booked under ‘Premature Withdrawal Not Allowed' scheme - in case of renewal, these deposits will be rolled over to ‘Premature Withdrawal Allowed' scheme at the prevailing rate of interest.
If TDS is not to be deducted, please submit Income Tax Exemption letter along with this Form.
In absence of specific request, existing Mode of Operations set up for your Non-Individual/Individual Account stands applicable for all Term Deposit operations.

MODE OF OPERATION
Single Either or Survivor** Anyone or Survivor** Former or Survivor** Jointly please specify
Others________________________
For Term Deposits: The above mandate will be applicable to premature withdrawal at any point of time , including death of any one but not all holders.
**In case of joint Term Deposits having operating instructions as ‘Either or Survivor’, ‘Anyone or Survivor’ or ‘Former or Survivor’, the Bank shall repay the deposit(s) before maturity of
the deposit(s) in case such a request is received in accordance with the operating instructions of the respective deposit(s), along with relevant documents as may be specified by the
Bank from time to time. The same would be applicable even in the event of death of the joint depositors prior to maturity of the deposit. Any such repayment before maturity shall
constitute a valid discharge of the Bank’s obligations against all concerned including, but not limited to, the nominee/legal heirs of the depositors or anyone claiming under them.
For bulk deposits, please refer to the deposit policy at our website for T&C on your Fixed Deposits.
 NOMINATION FORM DA1* (Please choose one of the available options)
I/We hereby confirm that I/We do not require any nomination facility. Nomination under Section 45ZA of the Banking Regulation Act 1949, and Rule 2(1)
of the Banking Companies (Nomination) Rules 1985 in respect of Bank deposits.
I/We require nomination facility.
I/We _______________________________________________________________nominate the following person(s) to whom in the event of my/our minor’s death. the
amount of deposit in the account may be returned by IndusInd Bank Ltd.
I/We agree/ do not agree for the name of my/our nominee to be displayed on Fixed Deposit Advice/Statement of Account and/or other documents/letters.
Details of Deposit Nominee***
Nature of Deposit & Additional Relationship with If Nominee is a minor,
Name Address Age
Distinguishing No. Details, if any Depositor, if any his/her date of birth

As the nominee is a minor on this date, I/We appoint ________________________________________________________

to receive the amount of the deposit in the account on behalf of the nominee in the event of my/our minor's death during Signature/Thumb impression
the minority of nominee.** of the depositor *#
Details are mandatory.***
Witness(es) - Required only if the depositor is giving thumb impression and not signature.

Name:
Address: Signature***

Name:
Address: Signature***

*Where deposit is made in the name of minor, the nomination must be signed by a person lawfully entitled to act on behalf of the minor. **Strike out if nominee is not a minor.
***Thumb impression(s) shall be attested by two witnesses. #Right thumb impression required in case the depositor is female and left in case it is male.

DECLARATION
In the event of the death of the depositor(s), premature termination will be allowed without levy of penal charges as under:
1. With Nomination: In the event of the death of all depositors, the nominee will have the right to seek premature withdrawal of Term Deposit account; 2. Without Nomination:
In the event of the death of all depositors, premature withdrawal will be permitted on joint request by all legal heirs (or any of them as mandated by all the legal heirs) and
upon verification of the authority of the legal heirs; 3. Term Deposit with survivorship clause: Bank may permit withdrawal of Fixed/ Term Deposits in accordance with the
mandate of ‘Either or Survivor’, ‘Former/Latter or Survivor’, ‘Anyone of Survivors or Survivor’, etc. as the case may be; 4. Term Deposit with Mandate Jointly: Premature withdrawal
will be permitted on joint request by the Survivor and legal heirs of the deceased depositor (or any of them as mandated by all the legal heirs) and upon verification of the
authority of the legal heirs.

1st Applicant 2nd Applicant

Signature/Thumb impression of the depositor Signature/Thumb impression of the depositor

Consent to Use, Share and Disclose Registered Communication Contact Details

I/We hereby ACCEPT, AUTHORISE, CONFIRM AND PERMIT IndusInd Bank Limited (“Bank”) to USE, SHARE AND DISCLOSE any/all of my/our registered communication
contact addresses/details (postal, e-mail, mobile number, social media platforms/channels etc.), that I/we have willingly registered/shared with the Bank for the purpose of
(A) receiving information, either from the Bank, Central KYC Registry and/or through any of the Bank’s authorised Service Providers / Agency(ies)/Professional Advisors related
to the operations of my/our account(s)/services availed by me /us from the Bank; and/or (B) API based authentication where my/our details are being auto fetched/ populated
to process my banking requests/applications on/throughthe Bank’s Web Applications/Systems; and/or (C) any kind of promotional/research/feedback based exercise about
the Bank’s products/services that I/we must/may be made aware for general consumption or to provide feedback as an existing customer of the Bank; until such time I
request/notify the Bank to stop sending communication to any/all of my/our registered communication addresses/details as per the Bank’s defined process and knowing that
the Bank will ensure security and confidentiality to all my communication contact details provided by me/us. If I am /we are or become a Non Resident Indian (NRI) / foreign
national, I confirm that the following consent is well within my capacity as a Non-Resident Indian and by doing so I do not violate or breach in any manner the regulations or
statutes of the country of my residence as are applicable to me.
Notwithstanding anything contained herein above, in case I/we opt out from the aboveand tick ‘NO’ below, the Bank shall be entitled to use/share/disclose my communication
contact addresses/details to send me/us all communication either through select/mandated communication channels, those that are deemed necessary for the (A) smooth
processing of my/our account operations/service request(s) (B) for general awareness and/or (C) any statutory action required to be undertaken by me/us as per the applicable
laws and guidelines/ regulations/directions/notifications prescribed by the Reserve Bank of India, Ministry of Finance India, government/quasi-government authorities and any
other authorities governing the financial and banking operations whether in India or outside India.

ü Yes No
DISCLAIMER: This material is for general informational purposes only and is not investment advice nor does it constitute an offer, recommendation or solicitation to buy or sell a particular financial
instrument. It does not have regard to the specific investment objectives, financial situation, risk profile or the particular needs of any specific person who may receive this material. No representation is
made that the information contained herein is accurate in all material respects, complete or up to date. Recipients of this document are to contact the representative in their local jurisdiction or contact
details given in this document with regard to any matters or questions arising from, or in connection with, the document. The information contained herein is not intended for distribution to, or use by,
any person in any jurisdiction where such distribution or use would be contrary to applicable law or regulation or which would subject IndusInd Bank to additional licensing or registration requirements.
VER01/TD/07-2021

It may not be copied, reproduced, posted, transmitted or redistributed in any form without the prior written consent of the Bank. This publication is for general information only, without addressing any
particular needs of any individual or entity, and should not be relied upon without obtaining specific advice in the context of specific circumstances.

BANK USE ONLY

I confirm having met the customer in person at the Residence/ Office address and
I hereby confirm that I have verified the copies with the original documents and the AOF has
been filled up in my presence. Sourcing Executive Signature
ECN

ACKNOWLEDGEMENT FOR NOMINATION

We acknowledge your nomination in form DA1 relating to Account Number___________________________________________________________in the name
of_______________________________________________________________________________________________________________________held with us.
Ref. No. ___________________________ Date of Registration________________________________DBM_____________________________________________

Branch Round Stamp/Seal