IndianOil Citi Platinum Card Fuel Citibank Rewards Card Shopping Citibank Cash Back Card Cashback Citibank PremierMiles Card Travel IndianOil Citi Platinum Card Save over 5% on fuel at IOC outlets. 4 Turbo Points on Rs.150 spent on fuel at authorized IndianOil outlets(1 Turbo Point = Re 1 Free Fuel) Complete waiver of 2.5% fuel surcharge at authorized IndianOil outlets. 2 Turbo Points on Rs.150 at grocery stores and supermarkets. Zero Annual Fee on spend of Rs.30000 or more in a membership year, else Rs.1000 will be charged as Annual Fee. Citibank Rewards Card Earn 10 Reward Points for every Rs 125 spent at Apparel & Department Stores and when you shop at our wide & exclusive range of 10X partners. Pay with your Reward Points when you shop at over 700 outlets and e-shopping sites. Enjoy over 3,600 offers across Dining, Shopping, Movies & EMI. No Joining Fees. No fee shall be charged if Rs. 30,000 or more is spent on the card during the year (a year from the date of issuance of the card), else a fee of Rs. 1,000 will be charged at the end of the said year. Citibank Cash Back Card 5% Cash Back on movie ticket purchases. 5% Cash Back on all your telephone bill payments. 5% Cash Back on all your utility bill payments made online through Citibank Online Bill Pay. The Citibank Cash Back Card comes at an annual card fee of Rs 500. Citibank PremierMiles Card Earn 10 Miles for every Rs 100 spent on all airline transactions. Earn 10 Miles for every Rs 100 spent on travel & stay booked on exclusive website www.premiermiles.co.in and with our select partners. Redeem the Miles across over a 100 domestic and international airlines. The PremierMiles Card comes at an annual card fee of Rs 3000. IndianOil Citibank Platinum Card Fuel Card Citibank Rewards Card Shopping Card Citibank Cash Back Card Travel Card Citibank PremierMiles Card Shopping Card Back IndianOil Citibank Platinum Card Citibank Rewards Card Citibank Cash Back Card Citibank PremierMiles Card Earn 10 Reward Points for every Rs 125 spent at Apparel & Department Stores and when you shop at our wide & exclusive range of 10X partners. Pay with your Reward Points when you shop at over 700 outlets and e-shopping sites. Enjoy over 3,600 offers across Dining, Shopping, Movies & EMI. No Joining Fees. No fee shall be charged if Rs. 30,000 or more is spent on the card during the year (a year from the date of issuance of the card), else a fee of Rs. 1,000 will be charged at the end of the said year. 5% Cash Back on movie ticket purchases. 5% Cash Back on all your telephone bill payments. 5% Cash Back on all your utility bill payments made online through Citibank Online Bill Pay. The Citibank Cash Back Card comes at an annual card fee of Rs. 500. Earn 10 Miles for every Rs 100 spent on all airline transactions. Earn 10 Miles for every Rs 100 spent on travel & stay booked on exclusive website www.premiermiles.co.in and with our select partners. Redeem the Miles across over a 100 domestic and international airlines. The PremierMiles Card comes at an annual card fee of Rs 3000. Save over 5% on fuel at IOC outlets. 4 Turbo Points on Rs150 spent on fuel at authorized IndianOil outlets (1 Turbo Point = Re 1 Free Fuel). Complete waiver of 2.5% fuel surcharge at authorized IndianOil outlets. 2 Turbo Points on Rs150 at grocery stores and supermarkets. Zero Annual Fee on spend of Rs30000 or more in a membership year, else Rs.1000 will be charged as Annual Fee. CONTACT DETAILS Email, Mobile Number 123456 20 203040506070 *Do you have a Citibank Savings Account? Yes No *Savings Account No.: *My salary gets credited to the above mentioned bank account: Yes No *I currently reside in the address updated in my bank account: Yes No Personal Data Name, DOB, PAN, Nationality YOUR NAME Mr. Ms. Mrs. Mx. MAIDEN NAME Ms. Mrs. Mx. FATHER'S NAME SPOUSE NAME Mr. Ms. Mrs. Mx. Mother's Name Ms. Mrs. Date of Birth / / *Nationality India Others PAN Card Fill all the above details as it appears on the PAN Card. PROFESSIONAL DETAILS Profession, Company Name, Designation *Profession Salaried Self-employed *Designation Accountant Assistant Manager Assistant Vice President Consultant Engineer Executive / Officer Teacher / Professor Manager Software Engineer Team leader / Supervisor Vice president *Designation Sole Proprietor Partner Director I confirm the annual income entered above is it appears in my latest ITR. Address Address for Communication Please fill in your residence address which matches exactly with the address proof you would be required to submit. 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Passport Driving licence UID (Aadhaar) Voter Identity Card NREGA Job Card Others Simplified Measures Account-Document Type Code Document CodeDescription 01Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water bill). 02Property or Municipal Tax receipt. 03Bank account or Post Office savings bank account statement. 04Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if they contain the address. 05Letter of allotment of accommodation from employer issued by State or Central Government departments, statutory or regulatory bodies, public sector undertakings, scheduled commercial banks, financial institutions and listed companies. Similarly, leave and license agreements with such employers allotting official accommodation. 06Documents issued by Government departments of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India. Permanent Address: *City Ahmedabad Bengaluru Chennai Delhi Gurgaon Hyderabad Kolkata Mumbai Noida Pune Secunderabad Ghaziabad Faridabad Please fill in your residence address which matches exactly with the address proof you would be required to submit. Proof of Address* Passport Driving licence UID (Aadhaar) Voter Identity Card NREGA Job Card Others Simplified Measures Account-Document Type Code Document CodeDescription 01Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water bill). 02Property or Municipal Tax receipt. 03Bank account or Post Office savings bank account statement. 04Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if they contain the address. 05Letter of allotment of accommodation from employer issued by State or Central Government departments, statutory or regulatory bodies, public sector undertakings, scheduled commercial banks, financial institutions and listed companies. Similarly, leave and license agreements with such employers allotting official accommodation. 06Documents issued by Government departments of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India. Please note that your office and residence addresses cannot be the same. Kindly enter a valid office address which is different from your residence address. Office: Locate Me Reset *City Ahmedabad Bengaluru Chennai Delhi Gurgaon Hyderabad Kolkata Mumbai Noida Pune Secunderabad Ghaziabad Faridabad *Preferred mailing address: Office Residence I Hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/Email address. *I have read the Authorization Statement, Know Your Credit Card, Card Member Terms and conditions and Most Important Terms and conditions and fully accept it and agree to be issued the Credit Card opted for by me. ^^From time to time, Citibank brings great products, offers & value addition to its customers. I authorize Citibank & its affiliates and/or partners to communicate these products and offers to me. *I agree for placing a standing instruction to debit my bank account against the card outstanding. *Standing Instruction Mode: Total Amount Due Minimum Amount Due *Are you a director/senior officer of Citibank and/or their Relative AND / OR director of other banks and/or their Relative? Yes No *Name of the Director of Citibank NA or other bank / Senior Officer of Citibank NA *Name of the other bank / Position with other bank *Relationship Click here for more details on the definition of such positions. "Director" would include Director on Citibank NA's Board abroad or Member of Local Operations Management Committee (LOMC) of Citibank NA, India. (includes 'Nominee directors' and 'Chairman/Managing Director' ). This would also include directors of Subsidiaries/Trustees of Mutual Funds/Venture Capital Funds set up by Citibank or any other bank. "Senior Officer" would include any officer in senior management level in Grade C16 and above (Title 'Managing Director' and above). "Relative" includes: (a) Spouse (b)Father (c) Mother (including step-mother) (d) Son (including step-son) (e) Son's Wife (f) Daughter (including step-daughter) (g) Daughter's Husband (h) Brother (including stepbrother) (i) Brother's wife (j) Sister (including step-sister) (k) Sister's husband (l)Brother (including stepbrother) of the spouse (m) Sister (including stepsister) of the spouse. *Terms and Conditions apply Offer valid on minimum spends of INR 5000 within 60 days of card issuance. Coupon Code: SUBMIT
