Deposit

Type
c Foreign Currency Non Resident
FCNR (B) Please specify currency
c Non Resident External (NRE) in INR c Non Resident Ordinary (NRO) in INR
Amount
c USD c GBP c EURO c CAD c AUD c JPY
______________________________ __________________________________ __________________________________
Funding
Instructions
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)
Interest
Mandate
Only available as a compound
interest deposit
c Compound Interest
c Simple Interest
(Interest will be credited to the NRE Rupee
Checking Account mentioned above)
c Compound Interest
c Simple Interest
(Interest will be credited to the NRO Rupee
Checking Account mentioned above)
Maturity
Instructions*
c Automatic Renewal
c Issue a Demand Draft in the
currency of the Deposit
c Automatic Renewal
c Credit NRE Rupee Checking Account
mentioned above
c Issue an Demand Draft in INR
c Automatic Renewal
c Credit NRO Rupee Checking
Account mentioned above
c Issue an Demand Draft in INR
NRI DEPOSIT APPLICATION FORM
EXISTING ACCOUNT INFORMATION 1
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 RUPEE
CHECKING 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 APPLICANTS PAN: JOINT APPLICANTS PAN:
4 If you do not have a PAN Card, we request you to complete the Form 60 overleaf.
4 You will not receive Tax Deducted at Source (TDS) Certicates in Form 16 A to help le 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 Y Date : D D M M Y Y Y Y Date :
4
DECLARATION. PLEASE READ THIS CAREFULLY AND SIGN AT THE SECTION INDICATED.
Declaration prior to Signature
1. I/We hereby declare that I/We are a Non Resident Indian (NRI) or Person of Indian Origin (PIO) as dened under the Foreign Exchange
Management Act, 1999 along with its regulations as amended from time to time and I/We agree to notify Citibank about my/our return to
India 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 the
Terms and Conditions provided to me/us at the time of initial account opening. I/We also understand that the Terms and Conditions may be
amended 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 the
instructions from any one of account holders on the deposit account subject to the terms and conditions stipulated for this product. I/we
further agree and accept that such premature withdrawal shall be subject to the terms and conditions of this product as may be
amended 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 eld For Bank Use Only, are completed or struck out
before you sign this form
Please complete the following forms overleaf
1. Nomination Form (Form DA 1), this form is mandatory 2. Form 60; please complete this in case you do not have a PAN
PRIMARY APPLICANTS SIGNATURE JOINT APPLICANTS SIGNATURE (If any)
P J
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CV/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).
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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/minors death the amount of deposit in the account may be returned
by 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/minors death during the minority of
the nominee.
In case you have specied the nominee above, please indicate if you wish to include the nominee name on the statement issued of your
account? c Yes c No
I/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.
D D M M Y Y Y Y
P J
Signature Signature Signature Signature
Primary Applicant** Joint Applicant** (if any)
#
Witness1
#
Witness2
D D M M Y Y Y Y Date: D D M M Y Y Y Y Date: D D M M Y Y Y Y Date: D D M M Y Y Y Y Date:
Place: Place: Place: Place:
FORM NO. 60 - Form of declaration to be led by a person who
does not have a permanent account number and who enters
into any transaction specied 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 led:
______________________________________________________
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 ______
Verication: I______________________do hereby declare that
what I stated above is true to the best of my knowledge and belief.
Date: Place: _________________
SIGNATURE OF
DECLARANT
D D M M Y Y Y Y
FORM NO. 60 - Form of declaration to be led by a person who
does not have a permanent account number and who enters
into any transaction specied 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 led:
______________________________________________________
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 ______
Verication: I______________________do hereby declare that
what I stated above is true to the best of my knowledge and belief.
Date: Place: _________________
SIGNATURE OF
DECLARANT
D D M M Y Y Y Y
P J
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NOMINATION FORM (Form DA1)
Nomination under Section 45ZA of the Banking Regulation Act, 1949, and Rule 2(1) of the Banking
Companies (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
/decl arati ons made by deposi tor(s). I f 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 any
governmental 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 Ofce 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. These
deposits 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 specied 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 incase
he/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 for
affecting 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
nal 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
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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 and
amount 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:
Authori sed deal ers/authori sed banks may al l ow
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 the
Government 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 sufcient 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 specied by the Bank. Please speak to your Tax
Consultant 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,
notication, 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 Customer
refuses 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 t.
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 proceeding
required 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
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