Name of the Primary Cardmember:

First name Middle name

Please leave one box space between names and surname
Last name
Appl. No.:
If you are an existing Cardmember, please tick whichever is applicable
I hereby acknowledge the request made for Add-on Card and warrant that the above information is correct and hereby request and authorise that an Account be opened and Card(s) be issued as indicated
herein and renewed and replaced until I give notice to cease, and in connection herewith authorise the exchange and transfer of credit information from / with my Bank or any other source. I understand that
HDFC Bank Ltd., reserves the right decline the application without giving any reason whatsoever. The additional applicant (s) and I agree to be bound by the terms and conditions of The Cardmember
Agreement earlier executed by me. I declare and undertake that the Cards issued to me, if used overseas shall be utilised strictly in accordance with the relevant exchange control regulations issued and as
amended by the Reserve Bank of India (RBI) from time to time. In the event I exceed my entitlemants as per the exchange control guidelines of RBI, I undertake to bring the same immediately to the notice of
HDFC Bank Ltd., in writing. And in the event of any failure to comply with the prevailing exchange control guidelines issued by RBI, I shall be liable for action under the Foreign Exchange Management Act,
1999 as amended, and be debarred from the Card facility. The undersigned will be liable for all charges incurred with the Add-on Card(s) issued on the Account and each Add-on Applicant will be liable for all
charges incurred with the Add-on Card jointly and severally with the holder of the Primary Card.
Add-on applicant without HDFC Bank A/c & not staying with Primary cardholder will be required to submit valid photo ID, Pan Card or Form 60 & Address proof. If Add-on applicant
does not hold HDFC Bank a/c and is sibling of primary applicant valid photo ID, Pan Card or Form 60 & Address proof will be required. Please refer to the List of Acceptable valid photo ID
& address proof for Add on in the next Page.
Conditions Apply: Sub-limit on Add-on Card is per statement cycle. Sub-limit will hold good only for ATM and POS transactions but the same will not apply for online transactions.
For detailed terms & conditions visit www.hdfcbank.com.
By Signing here, I certify that I have read and agree to all applicable Terms & Conditions.
Primary Cardmembers Signature ........................................................................................................................ Date : ............................................................
Add - on Card (s) Application Form Cum MID
Version 1.11
Credit Card Number
AFFIX
YOUR
PHOTO
If neither option is chosen clearly, 100% will be set as default Add-on limit.
Add-on Card Regular - (Life Time Free)
ADD-ON SUB-LIMIT OPTION: Please indicate the limit to be set on the Add-on Card per statement cycle:
25% of Credit Limit 50% of Credit Limit Rs.1000 Rs.5000 Rs.10000
Add-on applicant's Email ID
Add-on applicant's Cust ID
Add-on applicant's Mobile no.
I confirm that the add-on applicant is my __________________________________________________ (relationship with Add-on)
and is staying/ not staying with me at the same residential address as provided to the Bank by me. I as primary card holder
take the full responsibility of the add-on card, including all transactions/usage and payments related to the add-on card. I will produce
the ID proof of the add-on card member, as and when requested by the Bank.
Add-on applicants HDFC Bank A/c No.
* Mandatory for Add on customer who have an account.
Sex M F Date of Birth
D D MM Y Y 1 9
Name to be embossed on the Card
Please restrict to 30 characters including Spaces
Title Mr Ms Mrs Dr
Please tick as applicable
Add-on
Applicant
Form of declaration to be mandatorily filled by a person who does not have a Permanent Account Number.
1. Full Name and Address
3. If Yes,
A. Details of ward/circle/range the last ITR was filed
B. Reason for not having PAN
Track your Credit Card application status at the HDFC Bank website through 16-digit unique application
reference number which you will receive on your mobile number.
www.hdfcbank,com->Cards->Credit Cards->Track your Credit Card.
2. Are you a Tax Assessee Yes No
4. Address Proof Attached
Signature of the Add-on Applicant Date
knowledge and belief.
VERIFICATION
I do hereby declare that what is stated above is true to the best of my
Voter ID Bank account statement/Passbook Lease deed/Rent agreement copy
Registration documents/Ownership proof copy Others (please specify)
Passport Driving Licence Utility bill (incl. mobile postpaid bill) Ration card
HDFC Bank customers need to sign as per Bank records.
FORM NO. 60 (SEE THIRD PROVISION TO RULE 114 B)
Place
Verified today the day of
Solitaire Titanium Edge Platinum Plus Card Superia Gold Titanium Regalia Business Platinum Credit Card
Visa Signature Chip Card JetPrivilege Titanium JetPrivilege World JetPrivilege Platinum World MasterCard
List of acceptable Address Proof for Add on Card holder.
1. Passport
2. Driving licence(Customer having Driving License Issued from Uttar Pradesh can be accepted with out the Signature on the
same.)
3. Telephone bill - MTNL / BSNL & all WLL lines' bills can be accepted
4. Electricity bill - Ebil and Physical Bill
5. Bank account statement - Bank statement or Pass book can be accepted - In both the address should be mentioned
6. Ration card
7. Voters ID (if it has address)
8. Letter from the society (only Registered societies) - on the letterhead which carries the society's Registration No. The letter
should carry the applicant's name & full address as well as the signatories full name, designation (Secretary, President) and
address.
9. Monthly outgoings bill from Registered Housing society - on the letterhead which carries the society's Registration No.
(Maintenance charges receipt issued by the society NOT acceptable)
10. Registration documents/Ownership proof copy
11. Senior citizens card from Indian Railways/Indian Airlines (if it has address)
12. Mobile post paid bill
13. Letter from any recognized public authority (In original)
14. Company ID card (For CAT AB companies only)
15. LIC Premium receipt
16. Address confirmation by the corporate on company letter head as valid address proof (For CAT AB companies only)
17. Gas Bill
18. Water Bill
19. Society Maintenance Bill
20. Property Tax Receipt
List of acceptable Photo ID for Add on Card holder. (Expired ID proof will not be consider as valid proof)
ANY ONE OF THE BELOW
ANY ONE OF THE BELOW
1. PAN Card
2. Passport
3. DL / LL (DL from Uttar Pradesh alone can be accepted without Signature)
4. Voters ID
5. Ration Card (In Customer Name)
6. Company/Institution photo ID card
7. Student ID card
8. Club membership card (which carries customer photo)
9. OBC Photo Card
10. Insurance / Mediclaim Photo Card
11. Passbook with Photo
12. Railway station pass ID - Government recognised
13. Senior citizen ID - wherever applicable
14. Government organisation ID card with signature and photo.
20.5cm x 29cm
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Name of TSE : ________________________________________________________
TSE Code : __________________________________________________________
Name of Doc-Ex : _____________________________________________________
Doc-Ex Code : ________________________________________________________
Channel : ____________________________________________________________
Source Code / Activity : _________________________________________________
Team Supervisors Code : _______________________________________________
Signature of Team Supervisor : ___________________________________________
PB/RM
BRANCH CODE :
BDR Code / LC Code :
(Mandatory Field) :
__________________________________________________
City : _______________________________________________________________