I.

PERSONAL DETAILS

Application Form No: Application Number: 2711008003528

First Name: VANDANA Last Name: SHARMA

Middle Name: Father's Name: VIJAY SHARMA

Mother's Maiden Name: RAJKUMARI Gender: FEMALE

Date Of Birth: 06/09/1994

Official Email ID:

Personal Email ID: VANDNA05071994@GMAIL.COM

Embossing Name: VANDANA SHARMA

Card Type: BPCL SBI Card Rupay Card Category: PLATINUM CARD

Marital Status: MARRIED

Mobile: 7223930456

Account Type: Loyalty No:

Education: GRADUATE

Form 60: NO PAN: IPIPS0479N

Aadhar No:

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
Nationality: INDIAN Address Proof Type: OTHERS

Id Proof No:

Easy Pay Consent: YES Easy Pay Date: 2024-04-

19T18:30:00.000Z
Enable Marketing: YES Statement Type: E-STATEMENT

Preferred Mail Address: RESIDENCE ADDRESS

Signature Declaration : NO

International txn sign GIVEN / Disable int txn check box NOT selected:

Contactless Domestic:

Contactless International:

Domestic Online:

International Online:

POS-International:

Consent Given:

II. RESIDENTIAL DETAILS

House No: QUATER NO 1 JAWAHAR

Phone: 7223930456 Phone 2:

Locality: COLONY POLICE LINE

Address Line 2: KAMPU GWALIOR

Address Line 3:

Landmark: KAMPOO LASHKAR GIRD City: GWALIOR

GWALIOR
State: MADHYA PRADESH Pincode: 474001

Same As Permanant: NO Extension No:

Years At Current Residence: 5

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
International Contact No. NA International Contact No. :
Given :
Status: RESIDENT

III. PERMANANT RESIDENTIAL

Address Line 1: WARD NO 15 KILA ROAD GOHAD

GOHDI BHIND
Address Line 2:

Address Line 3:

Landmark:

City: GWALIOR State: MADHYA PRADESH

Phone: Pincode: 477116

IV.OFFICE DETAILS

Company Name: GOVT OF MADHYA PRADESH

Occupation Type: SALARIED Designation: ASSISTANT SUB

INSPECTOR
Department: Employee ID:

Income PA: 400000 Years At Current Employer: 3

Landmark: NEAR CHOUHAN PIYAU

Address Line 1: GOVT OF MP,THATIPUR POLICE

STATION
Address Line 2: NEAR AMAR BHARTI VIDHYA
PEETH
Address Line 3:

Extension No: Fax:

City: GWALIOR State: MADHYA PRADESH

Pincode: 474011 Phone:

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
V. OTHER DETAILS

Mid No: 800448496

2711008003528 SE BRE Code:

ASM OHR ID: Aadhar Consent: NO

Form Sign Date: GSTN: NA

VI. BANK DETAILS

Bank Name:

Type of A/c: Account No:

Year Of Opening CIF No:

Credit Card No: Account No:

Alternate Card No: Amount To 0.0

Transfer:
Other Bank Credit Primary Applicant NO
card No:
Card Issuing Bank:

Amount In Words:

Authorised Person Authorised Person

Name: Email:
Authorised Person
DOB:
Authorised Person
Phone:
Authorised Person Mother
Maiden Name:

VII. PENNY DROP DETAILS

Account Number:

Bank Name:

IFSC Code:

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
 VIII. UTILITY BILL DETAILS

ELECTRICITY BILL

Consumer ID:

Service Provider:

PNG

Consumer ID:

BP Number: null

Service Provider:

LPG

Consumer ID:

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
IX. ADDON CARDS

ADDON 1
Addon Relationship

Addon Embossing

Addon Dob

Addon Gender

Addon Primary Applicant Signature NA

Addon Mob No

Addon Email Id

Addon Stay with NA

ADDON 2
Addon Relationship

Addon Embossing

Addon Dob

Addon Gender

Addon Primary Applicant Signature NA

Addon Mob No

Addon Email Id

Addon Stay with null

ADDON 3
Addon Relationship

Addon Embossing

Addon Dob

Addon Gender

Addon Primary Applicant Signature NA

Addon Mob No

Addon Email Id

Addon Stay with NA

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
ADDON 4
Addon Relationship

Addon Embossing

Addon Dob

Addon Gender

Addon Primary Applicant Signature NA

Addon Mob No

Addon Email Id

Addon Stay with NA

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
 MOST IMPORTANT DOCUMENT
Subject : Confirmation of application for SBI Card and Card fees acceptance.

DECLARATION
This is to confirm that I am submitting my SBI Card application form along with the
required document for processing.

I, Mr. / Ms. _______________________________________,

VANDANA SHARMA hereby acknowledge that I
have applied for the card ticked below and agree to pay the annual fee mentioned in the
corresponding column

SBI Card Year 1 Annual Fee* Year 2 Onwards Maximum Limit Minimum
Offering Annual Fee* Limit

BPCL SBI Card Rupay 499 499 500000 15000

Rs. Rs. Rs. Rs.

*All applicable taxes on above

I am agreeable to
1. Any Variation in credit limits assigned to multiple credit cards issued to me. 2. Any
Alternate Card being issued to me 3. Any Transfer of existing card to the new card
applied for by me whether

I am aware that the joining and the annual fee will reflect in my first card statement
issued to me and I need to pay the same before the payment due date of the 1st
statement. I am also aware that this declaration does not necessarily guarantee card
approval.

I further state and declare that while sourcing the application of SBI Credit Card: No
Cash has been collected from me; No Credit limits have been promised to me. I shall
contact the SBI Credit Card Customer helpline in case I have any doubts/clarifications

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
I hereby confirm and declare that :

1. I/We declare that the information provided by me in this form is true, correct and complete in all respects and authorize SBI Cards
& Payment Services Limited (formerly known as SBI Cards & Payment Services Private Limited) / or its affiliates & associates to
verify any information at my office / residence, with my employer, financial institution, credit bureau or any third party engaged by
SBICPSL. I have read and understood the contents of the SBI Credit Card Application form, Card Member Agreement and the
attached Most Important Terms and Conditions and agree and give my consent to all its content. 2. I/We accept that SBICPSL is
entitled in its absolute discretion to accept or reject this application. 3. I confirm that I have no insolvency proceedings pending
against me nor have I ever been adjudicated insolvent by a court of competent jurisdiction. 4. I and the additional cardholder(s) agree
unconditionally to be bound by the terms and conditions of the card holder agreement accompanying each SBI Credit card unless the
card is cut in half and pieces returned to SBICPSL. 5. I will be liable for all charges incurred on the primary credit card and all
Additional cards issued and each additional Card holder will be liable for all charges incurred on all such credit cards jointly and
severally with me. 6. I agree that charge slip or a payment requisition or requisition or an electronic record resulting from or generated
by the use of the card will amount to an unconditional undertaking by me to pay SBICPSL the amount stated therein and agree that a
copy of my periodic billing statement sent to me by post or e-mail, at the e-mail address provided by me will be final and conclusive
evidence of my liability for the charges stated therein. 7. I authorize SBICPSL, at its sole discretion to transfer my outstanding
balances on other credit cards and credit facilities availed by me from other companies and financial institutions as provided in the
application. 8. I authorize SBICPSL to disclose any information relating to my / our card(s) as mentioned by me in the application form
or any information reflected in the documents submitted including any default in payments to a credit bureau, financial institutions,
any parent, subsidiary, affiliate or associate of SBICPSL, my employer, co brand partner, third parties engaged by SBICPSL for
proper operation of card accounts, verifications and other administrative services. 9. I authorize sharing of any of my information for
purposes such as marketing and offering of various products and services of SBICPSL or any of the product(s) of its Group
Companies, subsidiaries, affiliated, associates of co brand partner. 10. I also authorize SBICPSL to send me SMS Alerts on
marketing / account related information on my mobile phone number. All documents submitted in support of the application shall
become the sole and absolute property of SBICPSL and shall be treated in accordance with all applicable Laws and Rules
established in India. 11. I am fully aware and understand the regulations governing the use the Card outside India and my obligations
under the applicable exchange control / management regulations and guidelines issued by Reserve Bank of India / applicable
authority from time to time. 12. I undertake that my and Additional Card members use of the card shall be in strict compliance with
applicable exchange control / management regulations, otherwise the card may be cancelled at the instance of RBI and / or SBICPSL
in the event the I or the additional card member(s) are not in compliance with the usage restriction, foreign exchange entitlements
and other applicable regulations. I/We shall bring the same to the notice of SBICPSL in writing forthwith. 13. I accord the above
consent notwithstanding the issuance / non issuance maturity of the card(s) or its discontinuance by me. 14. I accept the fee structure
mentioned below. I understand that the Joining & Annual fee mentioned below shall be required to be paid by me on receiving the
first statement of account. Paid insurance is OPTIONAL and has been clearly communicated to me at the time of selling the credit
card. 15. I/We hereby unconditionally agree that SBICPSL may in its discretion consider to use the information supplied by me/us on
the application form and sell insurance to me/us at their sole discretion, even in the event of me/us not having been issued the card.
Finance charges @ 3.35% per month. GST extra, as applicable. 16. I further state and declare that while sourcing the application of
SBI Credit Card : No Cash has been collected from me. No credit limits / gifts etc. have been promised to me. I shall contact the SBI
Credit Card Customer Helpline in case I have any doubts / clarifications. 17. I authorize SBICPSL to use my KYC/PAN number to
verify KYC details submitted by me in the Application form. Any such verification will be from an authorized forum only. The
application form will not be processed pending completion of KYC verification. Further, if SBICPSL requires any information on
account of compliance with the KYC and AML Guidelines, I will provide the same. 18. I am agreeable to any variation in credit limits
assigned to multiple credit cards issued to me whether on notice or otherwise and done at the sole option and discretion of SBICPSL
based on its internal policy. 19. I further give specific consent to the blocking and deactivation of any of my credit cards and its
aligned accounts in all circumstances where at any instance I commit default in timely payments of my outstanding on any of such
credit cards issued by SBICPSL to me. 20. In the event of my application getting approved, I/We agree to receive my card statement
through email on the email id mentioned in this application form and the said email id will be considered as my Registered email ID
for the purpose of transactions alerts and One Time Password (OTP). 21. I understand that I may be issued a SBI Card from SBI
Card portfolio at the absolute and sole discretion of SBI Card to which I, hereby give my full and free consent and I further undertake
that subsequently I shall not raise any demure, protest and/or contest with regard to any matter connected therewith. I confirm that I
have been duly communicated and I have fully understood all accompanying terms and conditions of SBI credit cards. 22. In all
events of payments not being paid by the due date, SBI Card reserves the right to carry out follow ups by means of personal visits,
post, fax, telephone, e-mail, SMS and/or engaging third party to remind, follow-up and collect due payments in any manner deem fit
by SBI Card keeping the intent in view. 23. In all events where SBI Card or its authorized representatives are unable to contact me,
SBI Card shall be at liberty to leave payment due messages with any third parties which may include without restriction your spouse,
parents, other family members, secretary, accountant etc who may be available at your residence, office, mobile number, registered
Landline number, address. 24. This is without prejudice to other rights of SBI Card to collect outstanding dues to be exercised in
accordance to law.

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024
I hereby undertake to comply with all directives from SBICPSL in my capacity of the beneficial owner of the SBI Credit card if
and when such credit card is issued by SBICPSL to me based upon approval of my SBI credit card application form. 25. I have
read and understood all SBICPSL policies regarding data privacy and security procedures published on its web site
www.sbicard.com and acknowledge all its content.

I have submitted the following document

a) KYC Document(s)

Digitally Signed By : VANDANA SHARMA

Date and Time: 2024-04-20 10:51:33

Place : GWALIOR

Customer Authorization Given: YES

Notwithstanding any earlier instructions given by me, I hereby authorize and consent sharing of any of my
information (details mentioned in the application form and/ or any other document, transaction details) and
sending me SMS/email alerts or / calling on my Registered mobile number for the purposes of operation of the
card, marketing and offering of various products and services of SBICPSL through agent(s) and/or any third
party(ies) or any of the product(s) of its group companies, subsidiaries, affiliates, cobrand partners.

WHATSAPP CONSENT GIVEN: Y

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VANDANA
Date: Sat Apr 20 14:33:43 IST
2024

To view detailed information on schedule of charges, please download the Key Fact
Statement from https://sbicard.com/KeyFactStatement