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    Application Form For Interbank Giro For Payment of Credit / Charge Card Account

    Uploaded by

    Yei Yan
    This document is an application form for customers to enroll in Interbank GIRO payments to automatically deduct monthly credit or charge card payments from their bank account. It includes sections for the customer to provide their credit/charge card and bank account details, as well as authorization for the bank to process the GIRO instructions from DBS Bank. The form also has sections for DBS Bank and the receiving bank to complete for processing the GIRO setup.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form For Interbank Giro For Payment of Credit / Charge Card Account

    Uploaded by

    Yei Yan
    101 views1 page
    This document is an application form for customers to enroll in Interbank GIRO payments to automatically deduct monthly credit or charge card payments from their bank account. It includes sections for the customer to provide their credit/charge card and bank account details, as well as authorization for the bank to process the GIRO instructions from DBS Bank. The form also has sections for DBS Bank and the receiving bank to complete for processing the GIRO setup.

    Original Title

    Giro Cards Dbsv2.Doc

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    This document is an application form for customers to enroll in Interbank GIRO payments to automatically deduct monthly credit or charge card payments from their bank account. It includes sections for the customer to provide their credit/charge card and bank account details, as well as authorization for the bank to process the GIRO instructions from DBS Bank. The form also has sections for DBS Bank and the receiving bank to complete for processing the GIRO setup.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    101 views1 page

    Application Form For Interbank Giro For Payment of Credit / Charge Card Account

    Uploaded by

    Yei Yan
    This document is an application form for customers to enroll in Interbank GIRO payments to automatically deduct monthly credit or charge card payments from their bank account. It includes sections for the customer to provide their credit/charge card and bank account details, as well as authorization for the bank to process the GIRO instructions from DBS Bank. The form also has sections for DBS Bank and the receiving bank to complete for processing the GIRO setup.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    APPLICATION FORM FOR INTERBANK GIRO

    FOR PAYMENT OF CREDIT / CHARGE CARD ACCOUNT


    Complete Part 1 of this Form and return it to DBS Bank Ltd, GIRO Application, Cheque & GIRO, 2 Changi Business Park Crescent #07-05 DBS Asia Hub Singapore
    486029, to enable your monthly billing to be deducted from your bank Account. Please ensure that you sign the form in the usual way that you would sign for your bank Account.

    PART 1: FOR CUSTOMER’S USE


    To: DBS Bank Ltd

    To: Name of Bank

    Branch: Name of Billing Organisation (“BO”)


    DBS - CARDS

    CREDIT / CHARGE CARD ACCOUNT NUMBER (S) Name of Cardmember(s) Identity Card / Passport No

    I would like to make payment via Interbank GIRO as follows:

    Full Payment Min Payment (Option unavailable for charge card account)

    *Payment amount (as of statement) will be defaulted to full payment if there is no indication.

    (a) I /We hereby instruct you to process the instructions of DBS Bank Ltd (“DBS Bank”) to debit my/our account.
    (b) This payment instruction will be used to settle transactions incurred on both the Principal and Supplementary Card(s) of the Card account.
    (c) You are entitled to reject DBS Bank’s debit Instruction if my/ our account does not have sufficient funds and charge me/ us a fee for this. You
    may also at your discretion allow the debit even if this results in an overdraft on the account and imposes charges accordingly.
    (d) This authorisation will remain in force until terminated by your written notice sent to my/own address last known to you or upon receipt of my/
    our written revocation through DBS Bank.

    My/Our Name(s) as in Bank Account: My/Our Contact Number(s):

    √ (Mobile) √
    My/Our Bank Account Number:

    √ (Home) √
    My/Our Signature(s)/ Thumbprint(s) and Date

    (Office) √
    √
    (Signature as in Bank’s records. For Thumbprint, please go to the branch with your
    NRIC/passport to have your thumbprint taken/witnessed.)

    PART 2: FOR DBS BANK’S COMPLETION

    Bank Branch DBS Cards - Account No. CREDIT / CHARGE CARD ACCOUNT NUMBER (S)

    7 1 7 1 0 9 8 0 9 8 0 0 0 0 3 6 4

    Bank Branch Account No. to be debited


    Instruction to Receiving Banks/ Finance Companies: The Receiving bank is advised to create separate
    Interbank GIRO accounts bearing the same account to be credited for each of the Credit /Charge Card
    Account Nos. (DDA Reference Nos.) listed. *Please take last 12 digits as reference.

    PART 3: FOR BANK’S COMPLETION


    ┌ ┐
    To: DBS Bank Ltd For DBS BANK’S USE
    GIRO Application, Cheque & GIRO
    2 Changi Business Park Crescent
    Verified by & Date Approved by & Date
    #07-05 DBS Asia Hub
    Singapore 486029
    └ ┘
    This Application is hereby REJECTED (please tick) for the following reason(s):
    □ Signature/ Thumbprint# differs from Financial Institution’s records □ Wrong Account Number
    □ Signature/ Thumbprint# incomplete/unclear# □ Amendments not countersigned by customer
    □ Account operated by signature/thumbprint# □ Others:

    Name of Approving Officer Authorised Signature Date


    DBS Bank LTD psas-girosi-oh02003
    CO. REG. NO. 196800306E 06-02-006 (07/2018) SG005100

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