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Auto

Debit Instruction for HDFC Bank Credit Card

Primary Card Holder’s Name :____________________________________________



HDFC Bank 16 digit Credit Card No :

HDFC Bank Credit Card Application Ref No :____________________________________________

Savings / Current Account No :

Branch and City :____________________________________________



I have applied for HDFC Bank Credit Card / am a holder of HDFC Bank Credit Card (no. mentioned above). I
unconditionally and irrevocably authorise HDFC Bank Ltd. to debit my Savings / Current account (no.
mentioned above) for

• Minimum Amount Due (MAD)


OR
5% on total outstanding including EMI, or Rs. 200/‐ whichever is higher

• Total Amount Due (TAD)


as indicated in my credit card monthly statement, on the payment due date.

I declare that the information given in this form is correct and complete. If this request is delayed or denied
because of incorrect or incomplete information in this form or for any other reason, I will not hold HDFC Bank
Ltd. responsible.

I agree that nominated HDFC Bank account will be debited for auto-pay on Payment due date (PDD) as
indicated in the Credit Card monthly statement. If my account does not have suf icient funds, I will be liable
to pay applicable charges as indicated in the Credit Card terms and conditions.

I further agree that the auto debit instruction cannot be withdrawn / cancelled without the written consent to
HDFC Bank Ltd.

1. Card Holder’s Name ____________________________ Card Holder’s Signature__________________________

In case of Auto Debit mandate coming from joint account, other account holders also need to sign below.

1. Primary Account Holder’s Name ______________________________ Signature__________________________

2. Second Account Holder’s Name _____________________________ Signature__________________________

3. Third Account Holder’s Name ______________________________ Signature__________________________


Date:‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐

Note:
1. Only Savings/ Current account holders of HDFC Bank Ltd. with operating instruction of single/either or survivor/anyone or
survivor, can request for Auto debit.
2. In the absence of speci ic instruction to carry out autopay for either MAD or TAD, HDFC Bank will activate the option of
minimum amount due (MAD) by default.
3. If suf icient balance is not available for total amount due (TAD) opted card holders, HDFC Bank will try to recover the
minimum amount due (MAD).
4. Auto‐pay will be activated within 7 days from the date of incorporation. If the payment due date is within these 7 days, please
pay this cycle payment through other payment mode (Net Banking / ATM Transfer / Cash / Cheque).
5. Auto Debit return charges 2% on payment amount subject to minimum of Rs. 450/‐*
(* Please note charges are subject to change at the discretion of HDFC Bank. Any changes on the charges will be communicated to
card member)
Please send the completed form to Manager, HDFC Bank Cards Division, P O Box 8654, Thiruvanmiyur, P.O, Chennai 600 041.

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