Visa Debit Card Application Form (PDF, 260KB) - Peoples Bank

1.
cd;sl ye÷kqïm;aZßhÿre n,m;%ZúfoaY .uka n,m;% wxlh
Nj.m.ml;il/rhujp mDkjp gj;jpuk;/flTr; rPl;L ,y. NIC/Driving License/Passport No.
ks

03' uf.aZwmf.a fm!oa.,sl y÷kd.ekSfï wxlh ^PIN& udZwm úiska w;sYhskau
ryiHj ;nd.kq ,nk w;r" tu wxlh lsisu ;eke;af;l=g" lsisu wjia:djl"
lsisu wjia:d.; lreKla hgf;a t Fiwepug;Gjy;
m;y;yJ NtWgLj;Jif vd;id/vk;ikg; nghWg;ghf;Fk;.
11. gPgs;]; tPrh ,yj;jpud; ml;il mg;Nghijf;F tYtpYs;s tpjpfSf;Fk;
xOq;FtpjpfSf;Fk; gPgs;]; tPrh ,yj;jpud; ml;ilahy; Nktg;gl;l vy;yhr;
NritfisAk; trjpfisAk; nfhLf;fy; thq;fy;fisAk; my;yJ
NtWtifapy; gpd;tUtdtw;iw MSif nra;Ak; vitNaDk; epajp
epge;jidfSf;Fk; fl;Lg;gl Ntz;Lk;.
� kpFjp gw;wpa tprhuiz � PIN khw;wk;
� gzk; kPsg;ngWjy; � POS Clhf nfhLf;fy; thq;fy; nra;jy;
12. vdf;F/vkf;F vNjDk; Kd;dwptpj;jypd;wp my;yJ vitNaDk; fhuzq;fs;
fhl;lhky; gPgs;]; tPrh ,yj;jpud; ml;ilia uj;Jr;nra;tjw;fhd>
kPsg;ngWtjw;fhd my;yJ GJg;gpg;gjw;fhd KO chpikAk; tq;fpf;F ,Uj;jy;
Ntz;Lk;. ehd;/ehk; gPgs;]; tPrh ,yj;jpud; ml;ilapd; ghtidia
KbTWj;jj; jPh;khdpf;Fk;gl;rj;jpy; ehd;/ehk; tq;fpf;F 7 ehl;fSf;Ff; Fiwahj
vOj;jpyhd Kd;dwptpj;jy; nfhLj;J gPgs;]; tPrh ml;iliaj; jpUg;gpf;nfhLf;f
cld;gLfpNwd;/Nwhk;
13. gPgs;]; tPrh ,yj;jpud; ml;ilapd; vy;yh khw;wPLfSk; GJg;gpj;jy;fSk;
tYtpYs;s epajp epge;jidfSf;F mike;jdthjy; Ntz;Lk;.
14. v j jd; ikaJkhd VNjDk; fhuzq; fSf; fhf ml; il
15.
nry;Ygbaw;wjhf;fg;gl;likf;F tq;fp nghWg;ghspahfkhl;lhJ.
kPsg;ngWjiy my;yJ ifkhw;wj;ij Nrkpg;G my;yJ NtW VNjDk; fzf;if MSif nra;Ak;
vy;yh tpjpfSk; xOq;FtpjpfSk; mj;jifa fzf;Ffs; njhlh;gpyhd ml;ilf;
nfhLf;fy; thq;fy;fSf;F Vw;Gladthjy; Ntz;Lk;.
19. ehd;/ehk; gPgs;]; tPrh fldl;ilia ntspehnlhd;wpy; cgNahfpf;Fk;NghJ>
tq;fpapdhy; toq;fg;gl;Ls;s fld; vy;iyf;Fl;gl;l njhiff;F khj;jpuNk
nfhs;tdT nra;tnjd;gij cWjpg;gLj;JtNjhL> gpuahzr;nryT> N`hl;ly;
nryT> $Ljyhf Vw;gl;lnryT> itj;jpa nryT kw;Wk; jdpg;gl;l ghtidf;fhf
nghUl;fisf; nfhs;tdT nra;tjw;fhd nryT Nghd;wtw;wpw;F khj;jpuk;
ntspehLfspy; fldl;ilia cgNahfg;gLj;Jtij cWjpg;gLj;Jfpd;Nwd;/
cWjpg;gLj;Jfpd;Nwhk;. ghhpa mstpyhd gzf;nfhLf;fy; thq;fy;fs;> tpahghu
Nehf;Fldhd nfhs;tdTfs; kw;Wk; ,wf;FkjpfSf;fhd nfhLg;gdTfs;
Nghd;wtw;wpw;fhf ehd;/ehk; fldl;ilia cgNahfpf;f khl;Nld;/khl;Nlhk;. NkYk;
vdf;fhf/vkf;fhf my;yJ %d;whtJ fl;rpf;fhuUf;fhf fldl;ilia
cgNahfpj;J tpahghu mstpy; nghUl;fisf; nfhs;tdT nra;a my;yJ
,yq;iff;F mg;ghy; ntspehLfspy; KjyPLfis Nkw;nfhs;s/%yjd khw;wq;fis
Nkw;nfhs;s khl;Nld;/khl;Nlhk; vd;gij cWjpg;gLj;Jfpd;Nwd;/gLj;Jfpd;Nwhk;.
20. ehzakhw;Wf; fl;Lg;ghl;Lr; rl;lj;jpd; fPo; 2005.09.19 ,y; 1411/15 Mk; ,yf;f
mjptpN\l th;j;jkhdpapy; cs;s mwptpj;jypd; epge;jidfs; kw;Wk; mtw;wpw;fpzq;f
ntspehl;L ehzakhw;Wf; nfhLf;fy; thq;fy;fSf;fhf fldl;iliag;
ghtpf;fyhnkd;w xU Ghpe;Jzh;T cs;snjd;gij ehd;/ehk; cWjpg;gLj;JtNjhL
me;j tpjpKiwfSf;Ff; fl;Lg;gl rk;kjk; toq;Ffpd;Nwd;/toq;Ffpd;Nwhk;.
vdf;F/vkf;F toq;fg;gl;Ls;s fldl;ilia cgNahfpj;J> nra;ag;gLk; ntspehl;L
ehzakhw;W eltbf;iffs; gw;wp ehzakhw;Wr; rl;lj;jpd; Nehf;f mbg;gilapy;
kf;fs; tq;fpf;F Njitahd re;jh;g;gq;fspy; mJ njhlh;ghd ve;jnthU jftiyAk;
toq;Ftjw;Ff; flikg;gl;Ls;snjd;gij Vw;Wf;nfhs;fpd;Nwhk;.
21. ehd;/ehk; ntspehnlhd;wpy; njhopy; nra;tjw;F ,yq;ifia tpl;L ntspNaWtjw;F
Kd; vdf;F/vkf;F toq;fg;gl;Ls;s fldl;ilia kf;fs; tq;fpf;F xg;gilg;gjw;F
,zf;fk; njhptpg;gij cWjpg;gLj;Jfpd;Nwd;/gLj;Jfpd;Nwhk;. vdJ/vkJ
fldl;ilia cgNahfpj;J mDkjpf;fg;glhj ntspehl;L ehzakhw;Wf; nfhLf;fy;
thq;fy;fs; eilngWtjhf re;Njfg;glf;$ba ntspehl;L ehzaq;fis jilnra;a
KbAnkd;gij ehd; mwpNtd;/ehk; mwpNthk;.
22. ,yj;jpudpay; gzkhw;w ml;ilfs; njhlh;ghf ,yq;if kj;jpa tq;fpapdhy;
ntspaplg;gl;Ls;s kw;Wk; ntspaplg;glTs;s tpjpKiwfSf;Ff; fl;Lg;gl ehd;/
ehk; ,zf;fk; njhptpf;fpd;Nwd;/njhptpf;fpd;Nwhk;.
23. ,t; ml;il fhzhky; NghFkplj;Jk; kw;Wk; nfhLf;fy; thq;fy;fspy; Vw;gLk;
rh;r;irfs; rk;ge;jkhf vOk; fl;lzq;fs; kw;Wk; mwtPLfis tq;fpapdhy;
fhyj;jpw;F fhyk; jPh;khdpf;fg;gLk; tPjq;fspd; gb nrYj;Jtjw;F rk;kjpf;fpd;Nwd;/
rk;kjpf;fpd;Nwhk;.
24. ehd;/ehk; ntspehL nry;Yk;NghJ mq;F ml;iliag; ghtpf;f vz;Ztjhapd;
mJ gw;wp tq;fpf;F mwptpf;f rk;kjpf;fpd;Nwd;/Nwhk;.
03. I/We shall keep my/our Personal Identification Number (PIN)
strictly confidential and undertake not to reveal such number to
any person at any time or under any circumstances. In respect
of the card PIN shall mean the original Personal Identification
Number confidentially generated for me/us by the Bank and any
substitution effected by me/us.
04. I/We shall accept full responsibility for all transactions
proceeded or effected by the use of the card however effected.
05. I/We hereby authorize you to debit my/our account with the amount
of any withdrawal/transfer payment made by the use of the card.
06. I/We further authorize you to debit my/our account with all charges
relating to transactions made internationally through the card or
through any other Local Networks, wherever applicable and also
with any other liabilities inclusive of legal fee or other statutory
charges if any, relating to the use of card.
07. If my/our account is a joint account, I/we shall be jointly and
severally liable for all transactions arising from the use of the card.
08. I/We shall accept the Bank’s record and statements of all
transactions processed by the card as conclusive and binding on
me/us for all purposes.
09. If the card obtained by me/us is stolen or lost I/we shall notify
the Bank immediately and shall also give a written confirmation
to the Bank. I/we shall not hold the Bank liable for any loss
incurred by the use of the card that is lost, stolen or used without
my/ our authority.
10. The Bank shall at any time be entitled to amend, supplement,
or vary any of these terms and conditions at its absolute
discretion with or without notice to me/us and such amendment,
supplement or variation shall be binding on me/us
11. The use of the card shall be subject to the Bank’s prevailing
rules, regulations, and any terms and conditions governing all
services, facilities and transactions covered by the card or otherwise
as follows :-
� Balance Inquiry � PIN Change
� Cash withdrawal � Transactions through POS Machines
12. The Bank shall have the full discretion to cancel, withdraw or
renew the card without any prior notice or any reasons given to
me/us In the event that I/we decide to terminate the use of the
card, I/we shall give the Bank not less than 7 days prior notice
in writing and agree to return the card.
13. All replacements and renewals of the card shall be subject to
the terms and conditions which are in force.
14. The Bank will not be responsible for the card not being honoured
for any reason whatsoever.
15. I/We shall at no time use or attempt to use the Card unless there are
sufficient funds in my/our account to cover the withdrawal or transfer.
16. I/We acknowledge that the amount stated on the ATM Screen or
a printed inquiry slip or receipt advice shall not for any purpose
whatsoever be taken as conclusive of the state or my/our account
with the Bank.
17. I/We do not hold the Bank liable, responsible or accountable in
any way whatsoever for any loss or damage howsoever arising
caused by any malfunction or failure of the Card or the ATM or the
insufficiency of funds in the ATM.
18. All rules and regulations governing the operation of Current, Savings
or any other Account shall be applicable to Card transaction relating
to such accounts.
19. I/We undertake to use my card abroad solely within the limit
authorized by the bank and affirm that the card will only be used
overseas for personal expenses such as travel expenses, hotel
charges, incidental expenses, medical expenses and purchase
of goods/services for my/our personal use, and affirm that it will
not be used to purchase goods in commercial quantities, for
capital transactions and purchase goods/services on behalf of
third parties.
20. I/We hereby confirm that I/We am/are aware of the conditions
imposed under the Exchange Control Act in the Notice published
in the Extraordinary Gazette No. 1411/5 of 19th September 2005
subject to which the card may be used for transactions in foreign
exchange and I/We hereby undertake to abide by the said
conditions. I/We further agree to provide any information on
transactions carried out by me /us in foreign exchange on the
card issued to me/us by the Bank may require for the purpose of
Exchange Control Act.
21. I/We also affirm that I/We undertake to surrender the card to the
Bank, if I/We migrate or leave Sri Lanka for employment abroad.
I/We am/are aware that the Bank is required to suspend the
availability of foreign exchange on card if reasonable ground
exists to suspect that unauthorized foreign exchange
transactions are being carried out on the card issued to me/us.
22. I/We undertake to abide by the existing and future regulations
and directives of the CBSL issued to govern the EFT Card industry
and their usability.
23. I/We agree to pay the Bank where applicable, charges and fees in
respect of the operations of the card, loss of the card and the
charges in respect of dispute resolution of card transactions imposed
by the Bank at rates determined by Bank from time to time.
24. I/We undertake to notify the Bank whenever I/We travel
abroad and intend to use the card.
by; i|yka lreKq udZwm úiska lshjd f;areï .kakd ,o w;r uyck nexl=fõ mSm,aia ùid yr ldâm;a myiqlu md,kh jk by; i|yka Í;s iy fldkafoaisj,ska ne£ isàug uuZwms tlÕfjñZfjuq'
Kw;Nghe;jtw;iw ehd;/ehk; thrpj;J tpsq;fpf;nfhz;Ls;sJld; gPgs;]; tPrh nlgpl; fhl; trjpia MSif nra;Ak; Nkw;gb tpjpfSlDk; epge;jidfSlDk; ,ire;njhOFtjw;F cld;gLfpd;Nwd;/Nwhk;. I /
We have read and understood the foregoing and agree to abide by above rules and conditions governing People’s Bank Visa Debit Card Facility.
Èkh
jpfjp
Date
kshuhka iy fldkafoais epajp epge;jidfs;; TERMS AND CONDITIONS
b,ä ïlref.a w;aik
tpz;zg;gjhuhpd; ifnahg;gk;
Applicant Signature
noaO whq֕lref.a w;aik
$l;L tpz;zg;gjhhpapd; ifnahg;gk;
Joint Applicant's Signature
Designed & Printed at People’s Bank Printing Section