State Bank of India

Application for ATM Gold International Debit Card

Branch:
Visa
MasterCard
(Please tick one of the options)

I hold A/c No.

with the following customer number (IN CASE OF CORE BANKING BRANCH ONLY)

at your branch in my sole name/jointly with …………………………………………………………………

and to be operated on Self/E or S/F or S /Anyone or survivor basis. I have been issued a domestic Debit
Card No

I have not been issued any Debit Card (delete as applicable). I hereby apply for an ATM Gold
International Debit Card for my use I am aware that ATM Gold International Debit Card can be used in
India and abroad. I am aware that the ATM Gold International Debit Card can be used for all domestic
transactions and transaction involving foreign exchange permitted under the Foreign Exchange
Management Act and the Rules framed there under by Reserve Bank of India from time to time. I
undertake to use the card in strict compliance with the applicable Exchange Control/Foreign exchange
Management regulations and any violation thereof will result in cancellation of the card and make me liable
under relevant provision of the act/regulations. I also undertake to furnish all the details in respect of any
transaction entered into by me to facilitate any investigation. I hereby authorise you to recover from my
account the cost of the card and all other fees which may be payable by SBI to master card (other than
transaction fee) for extraordinary services rendered by them (example lost/stolen Card).

B. My name on the card should appear as under [This can be full name (not exceeding maximum 24
characters) or an abbreviated form of the name of the applicant for example. Bharat Kumar can appear as
Bharat Kumar, B.Kumar or K.Bharat].

C. I furnish the following particulars to be used for identification when I contact the Help Line through
telephone for reporting loss of SBI ATM Gold International Debit Card

Fathers First Name *

Mothers Maiden Name **

Date of Birth Passing SSC Marriage ***

D
D
D D
D
D M
M
M M
M
M Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y Y
Y
Y

* Do not furnish surname for example, if the name is S R Tendulkar, the name should be Sachin.
** In respect of Mother's maiden name, you may furnish Mother's name before marriage.
*** If not relevant it may be filled as XXXX.
I have read the terms & conditions detailed overleaf and agree to abide by them.

Name
Address

City PIN
Telephone Mobile
E-mail

Place Date Applicant Signature

The Terms and Conditions under which the SBI ATM Gold International Debit Card has been issued are
mentioned below for your guidance.
Bank issues International SBI ATM Gold International Debit
Card which are affiliated to Master Card International/VISA
International Programmes. These cards can also be used
outside the country.
Objectives :
¾ To provide the valuable customers with higher daily
cash withdrawal limits at ATMs in India
¾ To offer the customers with the VMT & VbV facilities
available on VISA card programmes
¾ To enable customers travelling overseas to meet
expenses without carrying foreign currency or
travellers cheques
¾ To use Internationally/ domestically with higher
withdrawal limits,
Transactions as per FEMA
There is no monetary ceiling on spends through ATM Gold
International Debit Card while on a visit outside India except that
it should not exceed exchange entitlements of the person under
extant FEMA guidelines. The other condition is that the total
amount of transactions on the card will be limited to the extent of
the balance available in the account maintained by the
cardholder.
The daily cash withdrawal limit at ATMs has been set at Rs.
50000/- or US$ 1000/- when used domestically or Internationally
respectively. The daily transaction limit at Point of Sales (PoS)
has been set at Rs. 200000/ US$4000 for domestic or
Internationally respectively.
Accounting Procedure and Settlement
On a daily basis, ASC obtains the TT selling rate for US $ from
Foreign Department, Kolkata and this is loaded to the ATM
Switch. While the cardholder can transact in any currency, the
amount is converted into equivalent US$ by MasteCard
International (MCI)/ VISA International and authorisaction is
sought for amount in US$. ASC converts US$ into Indian
Rupees at the TT selling rate and debits the account of the
cardholder before authorizing the transaction.
Issue of separate series of SBI ATM Gold International
Debit Card.
The SBI ATM Gold International Debit Cards are issued with a
different design and distinct card series to the select customers
of the Bank. Although Bank has offered to issue ATM Gold
International Debit Card free of cost to the identified customers,
Bank may at any time levy a charge on providing ATM Gold
International Debit Card and this will be binding on the applicant.
(a) Terms Used here :
Bank means State Bank of India
Cards means SBI ATM Gold International Debit Card issued to
customer either in association with MasterCard International or
VISA International
Cardholder means customer who has been issued SBI ATM
Gold International Debit Card
(b) The Card
ƒ The card is the property of the Bank and shall be returned
unconditionally and immediately to the Bank upon request by
the Bank.
ƒ The Bank reserves the right to cancel the card and stop its
operations unilaterally without assigning any reason.
ƒ The Card is non-transferable.
(c) The PIN
The Card Holder is initially allotted a computer generated 4 digit
PIN (Personal Identification Number) which will be in a secured
and sealed PIN Mailer. It is mandatory for the card holder to
carryout a successful transaction using the PIN at SBI
Office Use
Account particulars and Signature of Applicant and Mode of operation Verified.
Request for issue of ATM Gold International Debit Card approved/declined for the reasons ………………………… (delete as
applicable)
Date
Forwarded for processing for issue of SBI ATM Gold International Debit Card
Date
ATMs in order to activate the card for usage at Pos / MEs.
The Card holder is advised in his own interest to change this PIN
to any other four digit number of his/her choice. Change option is
available at SBI-ATMs. While selecting a PIN, the card holder is
advised to avoid a PIN which can be easily associated with
his/her personal details viz, Telephone no. Date of Birth etc..
Besides, the selected PIN value should not comprise.
• A sequence from the associated account numbers
• string of the same number
• Historically significant dates
• The Cardholder should change the PIN immediately if it is
accidentally divulged.
Please remember that an unauthorised person can access the
ATM services on cardholder's account if he gains the card and
the PIN. The Card, therefore, should remain in Card Holder's
possession and should not be handed over to anyone else. The
Card is issued on the condition that the Bank bears no liability for
the unauthorised use of the Card. This responsibility lies with the
Card Holder. Further the Bank will not be responsible for any
loss either direct of indirect on account of ATM
failure/malfunctioning.
(d) Loss of card
The Card holder should immediately notify the Branch from
where he/she has obtained the card in writing, if the card is
lost/stolen.
Any financial loss due to misuse of Card will be to the Card
Holder's account. Loss of card can also be reported at Bank's all
India Helpline No.1800112211 from MTNL / BSNL connection or
080-25608470 from other service providers.. Fresh card will be
issued in replacement of lost/damaged card at a charge of
Rs.200/- plus taxes, if any, at present.
e) Loss of PIN: The cardholder can request for regeneration of
PIN in case he has lost / forgotten the same. The Bank provides
the customer with a new PIN at a charge of Rs.50/- which will be
debited to the customer’s account
(f) Debit to customers account
The Bank has the express authority to debit the designated
account of the cardholder for all withdrawals/transfer effected
using the Card as evidenced by Bank's records, which will be
conclusive and binding on the Card Holder.
The Card Holder expressly authorises the Bank to debit the
designated account with service charges from time to time.
(g) Transactions
The transaction record generated by the ATM will be conclusive
and binding unless found to be otherwise on verification and
corrected by the Bank. The verified and corrected amount will be
binding on the Card Holder.
(h) Closing of Account
The Card holder wishing to close the designated account or
surrender the card facility will give the Bank 10 working days
notice in writing and surrender the Card along with the notice.
(i) Validity of Card - SBI ATM Gold International Debit Card is
valid for 5 years and the expiry date is pre-printed on the card.
Note: The Bank reserves the right to introduce new facilities or
remove existing facilities as and when warranted without
assigning any reason for the same. However cardholder will be
duly advised.
OTHER BENEFITS:
a) The card carries a complimentary accidental death
insurance of upto Rs. 2 lacs
b) The card also carries complimentary purchase
protection of Goods at Merchant Establishments upto
Rs.5000/- for theft and damage of goods upto 90 days
from the date of purchase
c) The ATM Gold International Debit Cards issued in
association with VISA International carry the following
additional facilities: i)Visa Money transfer (VMT)
whereby the card holder can transfer funds from his
VISA Gold Debit Card to another VISA Gold Debit /
Credit card issued either by SBI or any other Bank
subject to certain terms and conditions and charges
ii) Verified by Visa (VbV) By registering
for the facility Card holders can carry out transactions
more securely over the Internet
Authorised official
Authorised official