DECLARATION FOR

Signature Variation / Dual Name / Vernacular declaration

To be filled by applicant only

Application # Date

The Manager,
YES BANK Ltd.,

Dear Sir / Madam,

Ref: Name ___________________________________________________________________________

SIGNATURE VARIATION (tick if applicable)

I have submitted My _______________________________________________________ as a KYC document

for opening Credit card account with YES BANK.
My signature in the above referred document differs from the signature on the Credit Card Application
form. I wish to record the signature affixed in the Credit card application form for operating my YES
BANK Credit Card Account.

DUAL NAME (tick if applicable)

I wish to open a Credit Card account with YES BANK LTD. as ___________________________________
however the Identity document submitted by me are bearing the name as
_____________________________________________________________________________________ (name
as per KYC document). Kindly consider the name mentioned on the Credit card application form.

VERNACULAR DECALARATION (tick if applicable)

The details of the Credit Card application form, underlined terms and conditions and all declaration
have been read and explained to me in ________________________________(language in which the form
has been explained )by ________________________________________________(name of the bank official).
I confirm to have understood the contents thereof. I am accepting the terms & conditions for opening
credit card account by signing in ____________________________ (the language in which the signatory is
Signing),

 I hereby confirm that my details and signature provided above shall be constructed to be latest
and final and Bank shall use the same to accept and honour all instruments and instructions.
 I hereby agree and undertake to hold YES BANK and its officers and directors harmless for any
loss or damage caused due to acceptance of my above request.

Sincerely,

Name ___________________________________________Signature _____________________________

Place ____________________________________________

For OFFICE USE ONLY

GURJEET SINGH
Document Executive / DST / AM / ASM Name: _____________________________________________________
5415026
Document Executive / DST / AM / ASM Emp code: __________________________________________________

Document Executive / DST / AM / ASM Signature: ___________________________________________________

 ADDRESS DECLARATION
Date:

To,
The Manager – APU,
YES BANK Cards Division,
P.O. Box 2, Ambattur Industrial Estate,
Ambattur, Chennai – 600058.

Subject: Minor difference between KYC Address Proof and Mailing Address

Ref: Application Number (Bar Code or Reference Number):

I wish to apply for a credit card with “YES BANK Ltd” and submitted ____________________ as
address proof (KYC document). My address in the KYC document as minor variation as below.

Address as per KYC Document, Correct Address

I request you to consider the ‘Correct Address” as my address. I hereby agree and undertake to
hold YES BANK and its officers and directors harmless for any loss or damage caused to it due
to acceptance of my above request.

Sincerely,

Signature: __________________________________

Name: ___________________________________