deposit appln form

8/12/2019 Deposit Appln Form

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DepositType

c Foreign Currency Non ResidentFCNR (B) Please specify currency

c Non Resident External (NRE) in INR c Non Resident Ordinary (NRO) in INR

Amountc USD c GBP c EURO c CAD c AUD c JPY

______________________________ __________________________________ __________________________________

FundingInstructions

c Check / D.D. No : ____________

Drawn on:__________________c Debit my NRE Rupee Checking

Account : __________________

Debit my NRE Rupee Checking Account:

__________________________________

Debit my NR0 Rupee Checking Account:

__________________________________

Tenure(In days)

______________________________(Minimum Tenure is 365 Days)

______________________________(Minimum Tenure is 365 Days)

_________________________________(Minimum Tenure is 7 Days)

InterestMandate

Only available as a compoundinterest deposit

c Compound Interestc Simple Interest

(Interest will be credited to the NRE RupeeChecking Account mentioned above)

c Compound Interestc Simple Interest

(Interest will be credited to the NRO RupeeChecking Account mentioned above)

MaturityInstructions*

c Automatic Renewalc Issue a Demand Draft in the

currency of the Deposit

c Automatic Renewalc Credit NRE Rupee Checking Account

mentioned abovec Issue an Demand Draft in INR

c Automatic Renewalc Credit NRO Rupee Checking

Account mentioned abovec Issue an Demand Draft in INR

NRI DEPOSIT APPLICATION FORM

EXISTING ACCOUNT INFORMATION1 Please tell us about your existing relationship with Citibank,N.A., India

4 ALL NEW DEPOSITS WILL BE OPENED IN THE SAME HOLDING PATTERN AS YOUR EXISTING DEPOSIT ACCOUNT OR RUPEECHECKING ACCOUNT.

4 YOUR NEW DEPOSITS WILL BE AUTOMATICALLY LINKED TO YOUR EXISTING ACCOUNTS.4 IF YOU DO NOT HAVE AN NRI ACCOUNT WITH CITIBANK NA, INDIA PLEASE COMPLETE THE NRI ACCOUNT OPENING FORM

2 DEPOSIT DETAILS

4 Interest payments in foreign currency / credit to NRE Savings Account are as per RBI regulations, amended from time to time.4 If you have requested for a Demand Draft to be issued to you on Maturity, this will be sent to your registered mailing address only.

3 PERMANENT ACCOUNT NUMBER (PAN) Please provide us with your PAN details

PRIMARY APPLICANT’S PAN: JOINT APPLICANT’S PAN:

4 If you do not have a PAN Card, we request you tocomplete the Form 60 overleaf.4 You will not receive Tax Deducted at Source (TDS) Certificates in Form 16 A to help file taxes in India if you do not provide your PAN details.4 The automatic renewal option is not available for NRO Deposits, if you do not provide your PAN details and the maturity proceeds will

be credited to your NRO Rupee Checking Account

Citibank NRI Rupee Checking Account:Citibank NRI Deposit Account Number:

PRIMARY APPLICANT :

JOINT APPLICANT (if any):

Please use CAPITAL LETTERS only

D D M M Y Y Y YDate : D D M M Y Y Y YDate :

4 DECLARATION. PLEASE READ THIS CAREFULLY AND SIGN AT THE SECTION INDICATED.

Declaration prior to Signature1. I/We hereby declare that I/We are a Non Resident Indian (NRI) or Person of Indian Origin (PIO) as defined under the Foreign ExchangeManagement Act, 1999 along with its regulations as amended from time to time and I/We agree to notify Citibank about my/our return toIndia for permanent residence.

2. I/We will be bound by the Terms and Conditions detailed in this Deposit Application Form and understand that the same are in addition to theTerms and Conditions provided to me/us at the time of initial account opening. I/We also understand that the Terms and Conditions may beamended from time to time at the sole discretion of the bank and that the current Terms and Conditions are available at www.citinri.com.

3. I/We authorize Citibank to execute pre-mature withdrawals on my deposits placed and/or proposed to be placed, based on theinstructions from any one of account holders on the deposit account subject to the terms and conditions stipulated for this product. I/wefurther agree and accept that such premature withdrawal shall be subject to the terms and conditions of this product as may beamended from time to time including but not limited to the Deposit Application form, Account Opening Form.

Please ensure that all the relevant details in the form, with the exception of the field “For Bank Use Only”, are completed or struck outbefore you sign this form

Please complete the following forms overleaf1. Nomination Form (Form DA 1), this form is mandatory 2. Form 60; please complete this in case you do not have a PAN

PRIMARY APPLICANT’S SIGNATURE JOINT APPLICANT’S SIGNATURE (If any)

P J

1CV/NR/NA/ALL/DAF/1.0/26-09-13

*Not for the FCNR (B) Special Deposit scheme under leverage



4 The Nominee or Guardian (if applicable), should not be either of the Account Holders (Primary or Joint).

6 FORM 60 Please complete this section if you do not have a Permanent Account Number (PAN)

2

PRIMARY APPLICANT JOINT APPLICANT (if any)

c Yes, I want to nominate the following person c No, I do not want to nominate any one on my behalf because____________________

I/We nominate the following person to whom in the event of my/our/minor’s death the amount of deposit in the account may be returnedby Citibank, N.A.

Nominee Name:

Address: City: Pin:

Relationship with Depositor (if any) : Age: Date of Birth:

As the nominee is a minor * on this date, I/We appoint:

Name:

Address:

City: Pin:

to receive the amount of the deposit in the account on behalf of the nominee in the event of my/our/minor’s death during the minority ofthe nominee.

In case you have specified the nominee above, please indicate if you wish to include the nominee name on the statement issued of your

account? c Yes c NoI/We do hereby declare what is stated above is true to the best of my knowledge and belief

*Strike out if nominee is not minor. ** Where deposit/ account is in the name of the minor, the nomination should be signed by a person

lawfully entitled to act on behalf of the minor.# Required only if the applicants use thumb impressions.

DD M M Y Y Y Y

P J

Signature Signature Signature Signature

Primary Applicant** Joint Applicant** (if any)#

Witness1#

Witness2

DD M M Y Y Y YDate: DD M M Y Y Y YDate: DD M M Y Y Y YDate: DD M M Y Y Y YDate:

Place: Place: Place: Place:

FORM NO. 60 - Form of declaration to be filed by a person who

does not have a permanent account number and who enters

into any transaction specified in rule 114B

1. Name & Address of declarant: __________________________

______________________________________________________

2. Particulars of transaction: _____________________________

3. Amount of the transaction: _____________________________

4. Are you assessed to Income Tax in India: c Yes c No

5. If answer to Q 4 is ‘Yes’,

Details of Ward/Circle/Range where last return of income was filed:

______________________________________________________

Reason for not having a Permanent Account Number:

______________________________________________________

6. Details of documents being produced in support of address above:

c Passport c Drivers License c Utility Bill c Other ______

Verification: I______________________do hereby declare that

what I stated above is true to the best of my knowledge and belief.Date: Place: _________________

SIGNATURE OFDECLARANT

DD M M Y Y Y Y

FORM NO. 60 - Form of declaration to be filed by a person who

does not have a permanent account number and who enters

into any transaction specified in rule 114B

1. Name & Address of declarant: __________________________

______________________________________________________

2. Particulars of transaction: _____________________________

3. Amount of the transaction: _____________________________

4. Are you assessed to Income Tax in India: c Yes c No

5. If answer to Q 4 is ‘Yes’,

Details of Ward/Circle/Range where last return of income was filed:

______________________________________________________

Reason for not having a Permanent Account Number:

______________________________________________________

6. Details of documents being produced in support of address above:

c Passport c Drivers License c Utility Bill c Other ______

Verification: I______________________do hereby declare that

what I stated above is true to the best of my knowledge and belief.Date: Place: _________________

SIGNATURE OFDECLARANT

DD M M Y Y Y Y

P J

5 NOMINATION FORM (Form DA1) Nomination under Section 45ZA of the Banking Regulation Act, 1949, and Rule 2(1) of the BankingCompanies (Nomination) Rule, 1985 in respect of bank accounts.

CV/NR/NA/ALL/DAF/1.0/26-09-13



1. Account(s) will be opened on the basis of the statements

/declarations made by depositor(s). If any of the

statements/declarations made therein is found to be incorrect

in material particulars then Citibank, N.A. (“Citibank”) shall

not be responsible nor liable for the same. In such event,

Citibank shall be entitled to withdraw/terminate forthwith the

facility granted to me and Citibank shall not be required to pay

any interest on the deposit(s).

2. These deposits are payable solely at the branch of Citibank,

N.A. in India subject to the laws of India (including anygovernmental actions, orders, decrees and regulations).

Payment on these deposits are subject to any Government

Acts, Orders, Decrees, Regulations, Political Disputes, Civil

Commotion, War, Expropriation or other causes beyond the

control of the Bank where the deposits are made. No recourse

will be available for any amounts due and payable to the

depositor(s) in connection with the said deposits made by the

depositor(s) against the Head Office or against any other

branch of Citibank, N.A. These deposits made by the

depositor(s) in India are not insured by the Federal Deposit

Insurance Corporation (FDIC) of the USA, or CDIC nor by any

other insurance company or corporation outside India. Thesedeposits are not covered by the Deposit Protection Scheme

under Financial Services Compensation Scheme. There is also

no coverage against sovereign risks including risks arising

from any changes in the laws of India. All deposits on

placement and their payments are governed by, and all

accounts in respect of such deposits shall be subject to the

applicable terms and conditions issued by Citibank, N.A. in

India.

3. If you do not hold any deposit accounts, we will open a new

deposit (Non Resident Indian Base) account in the same

holding pattern and details as your Rupee Checking Account

and your deposit account will be automatically linked to your

Rupee Checking Account. If you wish to open a deposit

account in a different holding pattern, you will be required to

complete a new NRI Account Opening Form.

4. All bank deposits are insured up to maximum of ` 1,00,000

(Rupees One Lakh Only) at an aggregate level subject to Terms

& Conditions specified by the Deposit Insurance & Credit

Guarantee Corporation of India (DICGC). For more details

please log on to www.dicgc.org.in.

5. The customer also undertakes that he/she shall not make

available to any person in India any foreign currency against

reimbursement in Rupees or any other manner in India. The

customer also understands and acknowledges that incasehe/she instructs the Bank for conversion of his/ their

remittance from one currency to another, either for booking of

a deposit or upon receiving the deposit amount from the Bank,

the currency conversion risk shall solely be borne by the

Customer(s). The customer(s) understands that the Bank shall

endeavour, on a best effort basis, to hedge the exchange risk

of the deposit in the Indian market and its re-payment

obligations are subject to Indian market constraints. In

addition to the events mentioned above the Customer(s) also

acknowledges that the concerned branch of the Bank books

contracts for the availability of foreign exchange based on the

contracted terms of the deposit so that such exchange is

available on the contracted date of repayment and if the

deposit is terminated prematurely, that branch may have to

bear additional costs in procuring foreign exchange foraffecting premature repayment. With respect to the above,

the customer understands the following:

• The Customer(s) accordingly agree that in case the

Customer(s) seek premature repayment of the deposit

before the contracted term all costs, incurred by the bank,

including, but not limited to costs in procuring foreign

exchange for effecting premature repayment, shall be

borne solely by the Customer and will be debited to the

Customer(s) account without prior notice.

• The Customer agrees that the decision of the Bank shall be

final in this regard.

• The Customer further understands that this shall be in

addition to the usual penalty in interest rates on account of

premature termination, as per prevailing rules.

• Minimum Tenure for FCNR & NRE Deposits is 1 year.

• In case an FCNR or an NRE Deposit is withdrawn within 1

year, no interest will be payable on the withdrawn amount

and such withdrawal shall be subject to the penalty and

costs as above irrespective of the withdrawal being

requested by the Depositor or arising out of any

Government Acts, Court Orders, Decrees, Regulatory

Notices, Regulations

• Minimum Tenure for NRO Deposits is 7 days.• On premature withdrawal of a deposit, the original deposit,

if partially withdrawn, will be treated as two deposits; one

equal to the withdrawn amount, and the other equal to the

amount remaining in the deposit.

• The interest rate applicable on the above withdrawn

amount shall be either the original interest rate or the

interest rate corresponding to the period for which the

withdrawn amount has been maintained, whichever is

lower, less penal rate of 1%.

• The interest rate applicable on the amount surviving in the

deposit shall be the interest rate corresponding to the

original period and the surviving amount.

6. Renewal of Deposits: In the event you choose to opt for the

automatic renewal of your deposit, and then decide to

prematurely close the same, or renew it for a period shorter

than the remaining period of the deposit, a penal rate of 1% will

be charged. The interest rate applicable at the time of

3

TERMS AND CONDITIONS

FOR BANK USE ONLY

CV/NR/NA/ALL/DAF/1.0/26-09-13



renewing your deposit will be as per the interest rate for the

corresponding tenor of the new deposit

• Auto renewal of your term deposit can only be for the same

duration as the original deposit

• In case you seek to make a renewal of your deposit after it

has matured in accordance with applicable terms, a fresh

deposit booking instruction is required. The deposit when

rebooked shall be treated as a new deposit and will be

subject to the then prevailing applicable terms and such

interest rate as may apply depending on the tenure andamount of the deposit.

7. Death of depositor: In the event of the death of the

depositor/holder of the deposit, a premature withdrawal made

by the claimants would not attract any penal charge. All other

costs on account of premature withdrawal would continue to

apply. For details please refer to the “Deceased Depositors

Policy” available at www.citinri.com

8. Repatriation of funds to non-resident nominee:

• Authorised dealers/authorised banks may allow

remittance of funds lying in the NRE/ FCNR(B) account of

the deceased account holder to his non-resident nominee.

• The amount due/payable to non-resident nominee from

the account of a deceased account holder shall be credited

to NRO account of the nominee with an authorised

dealer/authorised bank in India.

9. Repatriation of funds to resident nominee:

• Application from a resident nominee for remittance of funds

outside India for meeting the liabilities, if any, of the deceased

account holder or for similar other purposes, should be

forwarded to the Reserve Bank of India for approval.

10. Tax Deduction at Source: Tax Deduction at Source (TDS) shall

be applied on every interest application on a Deposit

(presently applicable to NRO deposits only) and paid to theGovernment of India. TDS once applied shall not be reversed

or adjusted on any pre-closure/part closure of deposits. In

case of cumulative interest deposits, the interest reinvested is

after TDS recovery and hence the maturity amount for re-

investment deposits would vary to the extent of tax and

compounding effect on tax for the period subsequent of

deduction till maturity. In cases where the interest amount is

not sufficient to recover TDS, the same is recovered from the

principal of the deposit. In addition to the interest taxed in

India, the interest earned on NRO deposits may also be subject

to tax in your country of residence.

11. Interest: The Bank will pay interest on all deposits maintained

by a customer with the Bank at such rate as determined, from

time to time, by the Bank, in accordance with applicable laws in

India. The Bank will inform the customer of the said rates of

interest on a periodic basis as determined by the Bank. The

customer understands and acknowledges that in the event of

any premature withdrawal of the deposit by him, the Bank has

the right to levy a penal interest on the customer at a rate that

will be specified by the Bank. Please speak to your TaxConsultant for tax obligations in your country of residence

12. FEMA DECLARATION: The Customer hereby declares that

any transaction involving foreign exchange hereunder will not

involve, and will not be designed for the purpose of any

contravention or evasion of the provisions of the Foreign

Exchange Management Act, 1999 or any rule, regulation,

notification, direction or order made thereunder.

• The Customer also hereby agrees and undertakes to give

such information/documents as will satisfy the Bank with

regard to any foreign exchange transaction in terms of the

above declaration.

• The Customer also understands that if the Customerrefuses to comply with any such requirement or makes

only unsatisfactory compliance therewith, the Bank shall

refuse in writing to undertake any transaction on the

Account and shall, if it has reason to believe that any

contravention is contemplated by the Customer, report the

matter to Reserve Bank of India and/or such other

authority as the Bank deems fit.

13. The laws of India will govern these Terms and Conditions and

the same shall be subject to the exclusive jurisdiction of the

courts at the location in India at which the relevant branch of

the Bank, which maintains the Account, is located. The

Customer agrees that for any suit, action or other proceedingrequired to be taken in respect of these, the same shall be

instituted by it and tried in the courts at the location in India at

which the relevant branch of the Bank, which maintains the

Account and/or the relationship, it being the intention of

parties to select the courts in such location in India, exclusively

by exercising their right of forum selection.

14. These Terms & Conditions shall be in addition to your Account

Terms and conditions and/or all agreements executed by you

and shall bind the customer upon submission of duly executed

form.

CV/NR/NA/ALL/DAF/1.0/26-09-13 4

deposit appln form

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