iB 6: DBS iBANKING

Multi-purpose Form (DBS d2pay INDIVIDUAL)

DBS Bank Ltd

Simpang Bedok Post Office

PO Box 216
Singapore (914 808)
(Submit by mail only)
Tel: 1800 111 1111
From overseas, please call (+65) 6327 2265

PERSONAL PARTICULARS

Mr

Mrs

Miss

Mdm

Dr

Full name as in NRIC / Passport

*NRIC / Passport Number

Mobile Phone

Account No. (Please Include hyphens)

(Mobile no. supplied may be used in SMS communication)

A/C Type: *DBS Autosave/Current/Savings or POSBank Current/Savings

SERVICE PARTICULARS
Please

where applicable:

1.

I wish to *apply / reactivate for DBS d2pay Service. (Please complete 2 and 3)

2.

I wish to *set / revise my DBS d2pay Daily E-Commerce Limit. I acknowledge that the limit will be applicable
to E-commerce sites and electronic channels that accept DBS d2pay.
My Daily E-Commerce Limit: *$100 / $200 / $300 / $400 / $500 / $1,000 / $1,500 / $2,000 / Above $3,000, please specify:
(Maximum $25,000)

I wish to *set / change my designated debiting account for DBS d2pay:

3.

Account No. (Please include hyphens):

A/C Type: *DBS Autosave/Current/Savings or POSBank Current/Savings

4.

I wish to deactivate my DBS d2pay

Note:

Upon activation of service(s), notification (if applicable) will be sent to your designated Primary Account address
* Delete accordingly

I agree to abide by the Terms and Conditions Governing Electronic Services (copies available at www.dbs.com/sg and all Branches)

Applicants Signature / Thumbprint

Date

Please sign according to bank records

(For thumbprint, call at any branch with proof of identification to have your thumbprint verified by a branch staff.)

For Bank Use

Verified by / Date:

Issuance Authorised by:

Approved by:

Keyed by:

Checked by:

DBS Bank Ltd

Aug13
Co. Reg. No. 196800306E