APPLICATION FORM FOR FUNDS TRANSFER FACILITY (FTF)THROUGH AXIS BANK INTERNET BANKING

Name:

AZHARUDDIN
First Name

RAUF
Middle Name

MUNSHI
Last Name

Axis Bank Internet Banking User ID: Account Number: Email ID:

029050541 0 0 4 2 1 0 1

Branch: 1 0

GHATKOPAR-E 0 0 0

azhar.mitashi@gmail.com

I/ We have read and understood the Terms & Conditions applicable to Axis Bank Internet Banking and hereby wish to be registered for the Axis Bank Internet Banking Service of the Bank. I/we have read and understood the Terms and Conditions relating to opening of an account and various services including but not limited to Funds Transfer through Axis Bank Internet Banking. I accept and agree to be bound by these Terms and Conditions. I/We understand that the Bank may, at its absolute discretion, discontinue any of the services completely or partially without any notice to me / us. I/We agree that I/ We have no objection in the Bank debiting my account for the service charges applicable from time to time. I understand and agree that, once my request for FTP is accepted and my User ID is activated by the bank, all my linked accounts will be covered under FTP as per rules in force time to time. I understand and agree that the Bank is free to change the terms and conditions of Axis Bank Internet Banking, FTF and all related products and service charges.

Signature:

Date:

FOR BANK USE ONLY

Branch: Customer ID No. Signature Verified by: (Name and Specimen Signature Number of the Authorised Signatory)