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Flexi
Benefit
Solution

HDFC Bank
Prepaid Card Solutions

Enjoy easy issuance, load & reload

and assured secure transactions.

Petty Cash
Expense
Management
Solution

Payroll
Solution

Fleet Xpress Management Solution

W e understand your world

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PREPAID CARD SOLUTION APPLICATION FORM

Corporate ID
LC 1 Code

LC 2 Code

LG Code

Branch Code

(For office Use only)

Corporate Information

Corporate Name (M/S):

Current Address:

City: Pin:

Phone No.(s) Mobile No:

Date of Incorporation: Corporate PAN No.:

Type of Business Entity: Public Ltd., Pvt. Ltd., Other (Pls Specify):

Existing relationship with HDFC Bank: Corporate Salary Account Cash Management Services

Corporate Banking Other (Pls Specify):

Existing HDFC Bank Current A/c No.

Corporate GSTIN

Expected Business Volume

No. of Employees:

No. of Reload Request (annually): Average Business Volume Committed:

Corporate’s Business Profile

Variants of Prepaid Cards: Please click on the product you wish to avail and sign across.

(Please
Product Signature
Tick)

 Flexi Benefit Solution Purpose of request:

 Fleet Xpress Management Solution Purpose of request:

 Petty Cash Xpense Solution Purpose of request:

 Payroll Solution Purpose of request:

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Schedule I – Variants of the Prepaid Cards and Features

As on the date hereof, the following variants of Prepaid Cards are issued by the Bank & their usage :-

a. Fleet Xpress Solution POS, ATM & E- Comm

b. Flexi Benefit Solution POS & E-Comm

c. Petty Cash Expense Solution POS, ATM & E-comm

d. Payroll Solution POS, ATM & E-Comm

Schedule of Fees and Charges

Product Features and Benefits Charges & Fees

Fleet Xpress Solution - Card Validity 5 Years

a) Joining Fee – Rs. 600/- (Rupees Six Hundred only) per
Prepaid Card plus taxes as applicable
i. Type of card – Open system payment instrument
b) Annual Fee – Rs. 600/- (Rupees Six Hundred only) per
ii. Reloadable
Prepaid Card plus taxes as applicable
iii. Purpose – To manage Fleet Business
c) Card Replacement Charges – Rs 135/-( Rupees
iv. Maximum value outstanding – Rs. 200,000/-
Hundred and Thirty Five only)

Flexi Benefit Solution – Card Validity 5 Years
i. Type of card – Open system payment instrument
ii. Reloadable
iii. Purpose – To provide tax benefits to their employees
iv. Maximum value outstanding – Rs. 200,000/-
a) Joining Fee – Rs. 135/- (Rupees Hundred and Thirty
Five only) per Prepaid Card plus taxes as applicable
b) Annual Fee – Rs. 135/- (Rupees Hundred and Thirty
Five only) per Prepaid Card plus taxes as applicable
c) Card Replacement Charges – Rs 135/-( Rupees
Hundred and Thirty Five only) per Prepaid Card plus
taxes as applicable

Petty Cash Expense Solution - Card Validity 5 Years
i. Type of card – Open system payment instrument
ii. Reloadable
iii. Purpose – Petty cash solution to the Corporate
iv. Maximum value outstanding – Rs. 200,000/-
a) Joining Fee – Rs. 600/- (Rupees Six Hundred only) per
Prepaid Card plus taxes as applicable
b) Annual Fee – Rs. 600/- (Rupees Six Hundred only) per
Prepaid Card plus taxes as applicable
c) Card Replacement Charges – Rs 135/-( Rupees
Hundred and Thirty Five only) per Prepaid Card plus
taxes as applicable

a) Joining Fee – Rs. 250/- (Rupees Two Hundred Fifty

only) per Prepaid Card plus taxes as applicable
b) Annual Fee – NIL
Payroll Solution - Card Validity 5 Years c) Wallet to Bank Account Transfer Charges
Amount Slab (Rs) Per Transaction (Rs)
i. Type of card – Open system payment instrument
ii. Reloadable Up to Rs 2000 10 +GST
iii. Purpose – Payroll solution to the Corporate >2000 20+ GST
iv. Maximum value outstanding – Rs. 200,000/-
d) Card Replacement Charges – Rs 135/- (Rupees Hundred
and Thirty Five only) per Prepaid Card plus taxes as
applicable

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ATM Use
ATM cash withdrawal Fees -
HDFC Bank ATM
ATM cash withdrawal
Fees (Other Bank ATM)
Balance enquiry from any ATM
(HDFC Bank & others)
Fund reversal
(Virtual account to company
2nd transaction onwards- Rs 1000 +
account)
Annual
Charges Withdrawal Prepaid Products
Limit
Free 1. Fleet Express Solution
Rs.21 + GST Rs. 15,00,000/- 2. Petty Cash Expense Solution
3. Payroll Solution
(Cash withdrawal per transaction)
1. Fleet Express Solution
2. Petty Cash Expense Solution
Rs.10 + GST per transaction NA
3. Payroll Solution
4. Flexi Benefit Solution
1st Reversal- Rs 500 + GST 1. Fleet Express Solution
2. Petty Cash Expense Solution
NA
3. Payroll Solution
GST 4. Flexi Benefit Solution

Sr.
Details
No.

Place and Date of

1
Execution

having read and/or being explained, verified, understood, irrevocably agreed to, accepted, confirmed and
declared all the clauses viz._______ to________ on all the page nos._______,______,_______,_____
Signed and Delivered by/for and on behalf of the Corporate in token of and in witness of the Corporate
Signature of Authorised
Name of Corporate :

Constitution :

Signatory
Registered Office :
2
Corporate Office:

Authorised Signatory &

Designation :

(a) Corporate : and_______ of the terms and conditions.

Attn:
Name of Authorised Signatory

Address :

Facsimile No. :

Email :
3 Notices

(b) Bank :

Attn:

Address :

Facsimile No. :

Email :

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Corporate and HDFC Bank has mutually agreed on above commercials, which will be applicable for HDFC
Bank INR Prepaid Card Issuance, Loading and Reloading of existing HDFC Bank INR Prepaid Cards.

The above commercials is accepted by both the parties i.e, HDFC bank and the Corporate

DECLARATION

1. I / We have read and understood the Terms and Conditions (T&C of Corporate application form for prepaid
cards) governing Prepaid card as hosted on HDFC Bank’s website https://www.hdfcbank.com/personal/useful-
links/terms-and-conditions and agree to abide by the same.

2. I / We hereby declare that the information given by me/us in this Application Form is true and correct.
Documents submitted to HDFC Bank under the digital signature of the aforesaid officials are binding on me /
us.

3. I / We agree to indemnify HDFC Bank for any loss or damage which HDFC Bank may suffer or incur by it as
a result of reliance on documents submitted by or instructions given by the aforesaid officials.

4. I / We understand that RBI/FEMA guidelines will be applicable from time to time.

5. I / We agree and declare that HDFC Bank Relationship Manager for Prepaid Card has given detailed brief of
terms and conditions of issuance, usage and associated fee of Prepaid Cards.

Name of the Authorized Signatory:

Email ID:

Date : Signature of Authorized Signatory

Name of the Authorized Signatory:

Email ID:

Date : Signature of Authorized Signatory

Name of the Authorized Signatory:

Email ID:

Date : Signature of Authorized Signatory

Name of the Authorized Signatory:

Email ID:

Date : Signature of Authorized Signatory

Name of the Zonal Head / Regional Head(HDFC Bank):

Email ID:

Date : Signature of Zonal Head / Regional Head

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