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Date of Birth
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Residence Address 2
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Residence Address 3
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By submitting this eligibility application, I provide my consent and agreed to
I hereby give an explicit consent to AEBC for collecting/downloading and verifying my details with/form CKYCR registry basis information/details provided. In the case the details provided does not match with CKYCR registry, I shall provide the revised correct information/details with AEBC.
I / We confirm that I / supplementary card applicant/s is a Resident Indian as defined under the Income Tax Act of India and hereby declare that I/We will notify American Express Banking Corp. if there is a change in the residential status.
I authorize American Express Banking Corp. (AEBC) to verify information in this application and to receive and exchange information about me including requesting reports from my bank, consumer credit, social media, reference schemes or credit information companies/bureaus and Credit Information Companies (CIC) as authorised by Reserve Bank of India. I authorize AEBC and its affiliates/representatives/agents to contact the aforesaid sources for information pertaining to me at any time, to use information from this application and information obtained from aforesaid sources for operational, administrative and marketing purposes and to service the card account(s) and to share such information with each other. I declare and undertake that the card(s) issued to me, if used overseas shall be used strictly in accordance with the extant Exchange Control Regulations issued by the Reserve Bank of India (RBI).
In the event that I exceed my entitlements as per the Exchange Control Guidelines of the RBI, I undertake to bring the same immediately to the notice of AEBC, in writing. Obtaining any approval from RBI for excess foreign exchange spending shall be my responsibility.
I understand that the basic cardmember will be liable for all charges incurred on the basic card, any additional card and any supplementary card. The Supplementary Cardmember accepts joint and several responsibility for all charges incurred on the supplementary card issued to him/her.
I agree to be bound by the cardmember terms and conditions of use which will accompany the card. I confirm that American Express® has shared the Most Important Terms and Conditions (MITC) for the American Express Membership Rewards® Credit Card with me in compliance of the RBI master circular on credit card operations of banks and I have read understood and accept the MITC and agree to sign this undertaking.
I accept that the additional factor of authentication is mandated by RBI vide letter DPSS.PDCONO223/02.14.003/2011-12 dates August 4, 2011 and use such cards for travel and related CNP Transactions without such additional factor of authentication carries security risk and such cards are vulnerable to frauds.
I understand that in the event of changes in correspondence address due to relocation or any other reason, I will intimate my new address to the bank within two weeks of such a change. I understand that in the event of change in the address mentioned as per proof of address, I will submit fresh proof of address to the bank within a period of three months of such a change.
I Authorize American Express® Banking Corp. to use the information/details provided earlier for the purpose of processing my card application. I Confirm that the information/details provided earlier are true and correct as of date. This Application form is intended only for card members who were in receipt of the original solicitation email.
I understand and agree that the first payment made on my Amex card will be made via a Know Your Customer (KYC)-complied account as maintained by me with another Scheduled Commercial Bank in India. I also understand that in the event I make the first payment via cash towards my Amex Card, my card account will be permanently cancelled without any further notice and will not be eligible for reinstatement.
Terms and Conditions