Action by Account Services (CP no: CT0008). Authorised by: Keyed in by: Report
checked by: DBS BANK LTD. Co. Reg. No. 196800306E. SSB-03(12/2012)
SSB3: PHONE BANKING/ ATM CARD UPDATES (includes POSB GO! Debit MasterCard and DBS Visa Debit Card) Send to: DBS Bank – Channel Services, 2 Changi Business Park Crescent, #07-05, DBS Asia Hub, Singapore (486 029) *
Name _______________________________ IC/Passport No. _____________________ *
Existing ATM / Debit Card (“Card”) No.: ___________________________ ATM card holders between 12 and 15 years old are not eligible to change withdrawal limit or include accounts without parental/guardian/joint holder consent.
PART A: REPLACEMENTS AND UPDATES
Replace Card due to:
Lost Card/ PIN* (Please call Lost Card No. at 1800-1111111 immediately to report loss of your Card.)
Forgotten PIN A $5 ATM/Debit Card replacement fee is applicable for:
Non-receipt of Card/ PIN*
Damaged/ Faulty Card* - Lost Card/ PIN - Forgotten PIN - Damaged Card
Retained at ATM. Location: ______________________
Change of Language Choice (available only for DBS ATM Cards)
English
Selection at ATM Cancel Card. Do not replace Card. (You are not required to return the Card to DBS Bank. Please cut up your Card for security reasons.) Allow overseas withdrawal access on my Card
Yes
No Daily ATM Cash Withdrawal Limit
$500
$1,000
$2,000
$3,000
$5,000 rd Daily ATM 3 Party Funds Transfer Limit
$3,000
$5,000 Daily NETS limit
$500
$1,000
$2,000
$3,000
$5,000 (Default $200 for age < 16, NETS limit change not allowed for age < 16)
Change my Debit Card spending limit (applicable to POSB GO! Debit MasterCard and DBS Visa Debit Card only):
$500
$1,000
$2,000
$5,000
Others ________
Permanent
Temporary from (ddmmyy) ______ / ______/ ______ until ______ / ______/ ______ Change Primary Account No. _____________________ For ATM Card transactions without account selection, e.g. ATM Fast Cash / NETS and where applicable, Bill Payment service and debiting of fees. The Card and the PIN’s mailing address will follow the address of the Primary account.
I wish to designate other secondary account(s): _____________________, _____________________, _____________________ Please delete my following secondary account(s): _____________________, _____________________, _____________________ Refund of Balance in CashCard Chip on ATM Card (Cashcard balance not refundable for lost card) IMPT: Please send the Card to T&O – Account Services – Channel Application. Refund will be based on the chip balance or DBS Bank’s host balance whichever is lower. Others: _______________________________________________________________________________________________ PART B: PHONEBANKING (PB) UPDATES / ACKNOWLEDGEMENT FOR INSTANT ISSUANCE OF PB AT THE BRANCH
Lost/Forgotten/Non-receipt* of:
PIN (new PIN will be issued)
PIN and User ID (New PIN and User ID will be issued)
I acknowledge that I have selected my Phone Banking PIN at DBS Bank. PART C: ATM/DEBIT CARD ACTIVATION
*
*
I authorise DBS Bank to activate my ATM/Debit Card . I acknowledge that I have received my ATM/Debit Card and PIN via mail.
Declaration:
PART D: DECLARATION (Important: Please read before signing):
1. I agree to be bound by the applicable terms and conditions governing the use of my ATM/Debit Card*. For details, please visit www.dbs.com.sg. 2. I agree that the primary account as stated in Part A will be linked to my ATM/Debit Card* account as specified by me. 3. I agree that the secondary account(s) as stated in Part A are in order of priority. 4. I agree that if my primary account is terminated for whatever reason, DBS Bank is entitled to link the secondary account as stated herein as the primary account for my ATM/Debit Card*, subject to DBS Bank's approval.
___________________________________
______________________________
_
#
Signature/ Thumbprint Account Holder
Date
Parental/ Guardian/ Joint holder consent: *
*
I, parent/guardian _______________________________, IC/Passport No. : ___________________ & joint holder __________________________________,
*
IC/ Passport No. : _______________________ am giving my consent to DBS Bank to *
*
change the daily withdrawal limit / create the ATM link to my account for ________________________________ , IC/Passport No. : _______________________.
___________________________ #
Signature/Thumbprint of Parent/ Guardian
#
_____________________________ #
*
Signature/ Thumbprint of Joint Holder Thumbprint must be taken and witnessed at Branch. Please sign as per your DBS/ POSB account records. * Delete where applicable.
Action by Branch
FOR BANK’S USE ONLY Action by Branch
For SSB Applications
For ATM PIN / Phone Banking PIN Acknowledgement
Action by Account Services (CP no: CT0008)
Signature/Thumbprint Verified by:
____________________
Attended by:
____________________
Authorised by:
____________________
Authorised by: Branch Name/ Branch Code:
____________________
Authorised by: Branch Name/ Branch Code:
____________________
Keyed in by:
____________________
____________________
Report checked by: ____________________
____________________
DBS BANK LTD Co. Reg. No. 196800306E
SSB-03(12/2012)
