CREDIT CARD APPLICATION FORM

For quick processing of your application, please complete all sections in BLOCK LETTERS
Please fill in CLEAR BLOCK Letters, without touching the boxes e.g.

SIGNATURE

I / We wish to apply
for BOBCARD

Domestic use

PLATINUM (VISA)

International use

c.

Recommended by

Permanent

BOB Br. BCL Br.

Office

Both

APPLICANTS INFORMATION
Mr./Mrs./Ms./Dr.

Present
Preferred Mailing
Address

ASSURE
b.

Boxes where appropriate and write N. A. if not applicable.

& use BLACK INK only

PLATINUM (MASTER)

TITANIUM

CARD Required for a.

A B

DSA

Others

# Denotes Mandatory fields

First Name

Middle Name

Last Name

Your Full Name

Your name, As you would like to have on Card

Mothers Maiden
Name #

Applying for :

Fathers Name

Mobile No.
of Spouse

Spouse Name
Date of Birth

DD

Marital Status

MM

Single

Educational Qualifications :

YY

Married
Under Graduate

Age

Sex

DOM

DD

Graduate

Male

Female

Nationality :

No. of
Dependents

MM

Post Graduate

Indian

Add-on

Professional

Your Present residential Address

Non Resident Indian

Passport
No.
Voter Id
No.

Others

Permanent Residential Address

City#

Pin#

City#

Pin#

Land Mark

Tel. (with STD code)

Tel. (with STD code)

Resi. is

Mobile#

Owned

Rented

Financed
Vehicle :

#
e-mail ID

2 Wheeler

Parental

Company Provided

Others
4 Wheeler

Ownership :

Self

Driving License No.

Alternate
Mobile No.

Residence changed

Once in
Last 3 Years

More than Once

in Last 3 Years

Not
Changed

OCCUPATION

( For Verification )
Employment Status

Business
Govt.

NGO

Professional
Private

Self Employed

Salaried

Others

Public

Name of Organisation / Employer

Your Designation :
Current Position

Emp.Code
Top Management

Middle Management

Junior Management

Department

Junior / Clerical

Self Employed

No. of Years in Current Org.

Months

Your present office address

City
PIN

Extn.

Tel. (with STD code)

Profession

Mobile

Annual Income (In Rs.)

Spouse Working Yes No

Both

PAN No.

University /
Institution

Employer Type

Principal

Other Income (IN. Rs.)

Spouse Income

#
e-mail ID

Income Per Month :

Company

ADD-ON CARDS

(Photo Identity Proof Required)

I Would like to apply for Add-on Cards for

1
Spouse

Father

Mother

Son

Daughter

Father

Mother

Son

Daughter

Father

Mother

Son

Date of Birth

Date of Birth

Date of Birth

DD

MM

YY

DD

MM

YY

DD

MM

YY

Occupation

3
Spouse

Occupation

2
Spouse

Daughter

Occupation

BANK OF BARODA A/C DETAILS

CBS A/c No.

Type of A/c

Demat A/c No.

Branch

Customer ID :

Savings A/c

Current A/c

Other
No. of Yrs
with Bank
Valid Upto

Debit Card No.

OTHER CARD DETAILS

In case already holding other Credit Cards, Last bill Statement to be Attached

Banks Name

Card No.

Valid up to

Credit Limit

1)
2)

OTHER BANK A/C DETAILS

Bank name
A/c No.

Type of A/c

Savings A/c

Branch

Current A/c

Other

Address
City

TYPE OF LOAN
Type of Loan :

Housing Loan

Car Loan

Consumer Loan

Aggregate Loan Amount

Business Loan

others (please specify)

Current Outstanding

Name of the Institution from where Loan taken

Duration of Loan

Months

Branch

( For Verification )

RELATIVE / REFERENCE NAME

(Not Mandatory)

Name
Address:

Tel :

Pin Code

NOMINATION FOR PRIMARY APPLICANT

I

(Name in full)do hereby assign the moneys payable by the Insurance Co, in the event of my death to my
(mention relationship with the insured) Mr/Mrs/Miss

and I further declare that his/her receipt shall be sufficient discharge to the Company.

(Name in full)

Signature

Date

Witness Name

Signature

Date

Place

Statement by :

Email

Mobile

COLOUR PHOTOGRAPH

Primary Applicant

Add-on 1

Add-on 2

Add-on 3

Please Paste
Photograph here
(colour)

Please Paste
Photograph here
(colour)

Please Paste
Photograph here
(colour)

Please Paste
Photograph here
(colour)

DECLARATION ( Will provide the same within 1 hr. )

In consideration of BOBcards Ltd/Bank of Baroda granting/reviewing facility to use the credit card, I do hereby declare and confirm that I have personally read and understood
and interpreted aim vernacular, in full, before execution of all terms & conditions that have been received by myself. It is my responsibility to obtain the terms and conditions
applying to the Bobcards International credit card separately and read the same. I will be bound by the terms and conditions as may be in force from time to time. I agree to be
charged the joining card fee in my first statement. In case of application for add-on(s), I will be billed for such add-on cards in the monthly statement. I undertake that the usage
of the credit card shall be strictly as per the exchange control regulations of the Regulatory authorities as applicable from time to time which I undertake to keep myself updated
with and in any event of any failure to do so, shall be liable for action under the Foreign Exchange Management Act 1999, or its statutory modification or re-enactment thereof.
Credit limit on my card account may be reviewed as per the bank policies specified from time to time and the bank will be entitled to cancel my application/cards/alter the credit/
cash limit/product upgrade at any time without assigning any reasons.
I hereby authorize Bobcards Ltd./ Bank of Baroda to provide information about the applicant and /or the card account to the financial credit bureaus / regulatory authorities.
I confirm that the attached photograph is present true identity of myself and that of my additional card application, which authorizes Bobcards Ltd to apply to our credit cards
and for which is accepted full responsibility and agree to make claims against Bobcards Ltd, in respect thereto. And that this condition applies in addition to the terms of the
card member Agreement which governs the use of my card. I also confirm that I am not a defaulter of any Credit Institution/Bank and my repayments are regular.
By signing this application, I understand that all the transactions effected through my card account, I including my successor, legal heirs, assignees shall be lawfully responsible
for making payments of the same, as per the payment schedule in force time to time. I further understand that mere disputing the transactions shall not absolve my prime
liability to defer/delay the payment of my credit card dues and I along with my successor, legal heirs, assignees will be fully responsible for making payments of the same, as
per the payment schedule in force in time to time.
I understand that Bobcard Ltd/Bank of Baroda will provide the credit card as per Banks internal guidelines and I give my consent for issuance of different card in case I am
not applicable to the product applied for.
I am maintaining individual/ joint accounts in Bank of Baroda and I/we have irrevocably authorised to debit any of my accounts maintained with you against the
demand raised by Bobcards Ltd. Signature of Joint account Holder if applicable __X_____________________
I have applied for Bobcard (type) ________________ card, I irrevocably authorise Bobcards Ltd. to debit my A/c No. _______________________ maintained with Bank of
Baroda ___________________ branch, against monthly/any dues in credit card issued to me
Yes No.
Total Amount Due
Minimum Amount Due
Customer Specific
%(If not specified total amount due will be debited)
In case application is not considered favorably Bobcards Ltd reserves right to retain documents
I agree to abide by the terms and conditions as may be amended by the bank from time to time, without giving notice to me.
The most important terms & conditions as available on the website www.bobcards.com has been read by me and I agree to abide by them.
I understand that bank/company reserves right to introduce/withdraw any of the existing features/conditions including personal Accident cover, nomination details obtained
stand null & void in such a case, if arise.
I further understand that in event of settlement of claim by the insurance agency against Personal death accident cover, Bobcards dues, if any shall be appropriated first and
balance shall be paid to the nominee.
Incase of default in payment of the card outstanding, company may refer the matter to the sole arbitrator to be appointed by the Company. The Arbitration shall take
place at Mumbai and I undertake to abide by the terms and conditions what so ever of the award, if any passed by such arbitrator.
I hereby authorize Bobcards Ltd./ Bank of Baroda to provide information exclusively for marketing purpose about the applicant and /or the card account to any of the third
parties associated with Bobcards Ltd. / Bank of Baroda (Yes ____ No ____).
Signature of
Primary Applicant

Signature of
Add-on 1

Signature of
Add-on 2

Signature of
Add-on 3

(Please sign within the box in black ink)

(Please sign within the box in black ink)

(Please sign within the box in black ink)

x
(Please sign within the box in black ink)

Please Note : (1) Please attach the relevant income related documents. (2) The bank reserves the right to provide the applicant with card on the information available to the bank and the Bank /Bobcards Ltd.
assessment of credit rating (3) Mere fulfilment of eligibility criteria, does not constitute an offer for the card. (4) The bank reserve right to accept or reject this application without any reason and issue cards with lower
limits.

Required Documents

Residence Proof :

Copy of Passport

Income Proof :

Salary Slip/ certificate (Only for Govt./PSU employees)

Identity Proof :

PAN card Copy

Ration Card / Election card

Electricity/Telephone bill
Latest IT Return / Form 16

UID card Copy

Others :

Latest 3 months Bank Statement

( All documents to be self-attested by the applicant)
FOR CORPORATE OFFICE USE
Primary Card No.
Add - on 1 Card No.

Date of Issue :

Verified by :

Add - on 2 Card No.

Add - on 3 Card No.

Sanctioned by :

VERIFICATION REPORT FROM BANK OF BARODA BRANCH

BoB Branch Name :

Bob Branch Code :

BoB Branch Phone No.:

BoB Branch email id.:
Name of the Applicant :
Account Type :

Savings A/c

Current A/c

Fixed Deposit

A/c. No. :
If Fixed Deposit,
Please Specify :

Loan A/c

Others
Dealing with
Bank since

Avg. Qly. Bal. :

FD A/c No.

Amount
For Amount

Lien Noting Date

If against Fixed Deposit
If Loan A/c, Please Specify :

Asset Classification

FB:

Account Opening Date :

NFB:

Total Limit Sanctioned :

Conduct of A/c :
Address in BoB Records :

Phone No. :
Card Type :

Mobile No. :
Normal

VIP

Staff (BCL/BOB)

Documents Verified with the Originals :

Any A/c maintained by other Family Members :

Yes

Limit Recommended :

No
Yes

No

If yes, A/c Type & No.:

Remarks, If any :

Declaration : We confirm, The details furnished above are correct, address, signature and other particulars mentioned in the application are verified
form our records.

Information Verified by & Date :

Sign & Seal; Branch Head :

Signature Code

Note: Requisite information is mandatory. Incomplete deatails may lead to rejection of the application

For further details visit : www.bobcards.com or call at Toll Free No. 1800 225 110

Regd. & Corporate Office :BARODA HOUSE, 2nd floor, Behind Dewan Shopping Centre, S.V. Road, Jogeshwari (W.), Mumbai - 400 102. INDIA. Phone : 91 22 4206 8502; Fax : 91 22 2677 7560