Kotak Mahindra Bank

Account Pool Request Form

The Manager

Kotak Mahindra Bank Ltd

Branch

I / We request you to Create a new Pool of Accounts of the accounts held with your Bank under my CRN

as per details given below –

Primary Account Number:

CRN of Primary Account Holder:

Name of Primary Account Holder:

Purpose of Pool Creation:

Accounts to be added in the Pool of Accounts

Account Number Name of First Holder Account Utilization Signature of

Status* (Y / N) Account Holders

1.

2.

3.

1.

2.

3.

1.

2.

3.

1.

2.

3.

*Account Utilization Status

If Yes – Account will be Contributor + Utilizer of funds

If No – Account will be Contributor only. Can not Utilize pool funds. (These accounts will contribute to the total balance of the Pool and other accounts

will be able to use the balances in these accounts, however these accounts will not be able to utilize the Pool balance)

Modification of Pool

You are requested to modify following Pool ID as per details given below:

Pool ID Primary Account No.

1. Add new Account Delete Account from Pool Account Status

Account Number Name of First Holder Account Utilization Signature of

Status* (Y / N) Account Holders

1.

2.

3.

2. Suspend Pool Revoke Pool Suspension Delete Pool

NOTE: POOL is a facility of automatically sweeping out funds above a pre-specified threshold from your Current / Savings Account /Term

Deposit (TD) / Overdraft Account / Cash-Credit Account. In case of insufficient balance in any Current / Savings Account / Overdraft

Account / Cash-Credit Account the balance will be drawn from the other accounts in the POOL as per the order specified. TD linked to

the POOL will be broken prematurely and the required amount will be transferred to Current / Savings Account in the POOL

Note Features:

1. Operative accounts can be linked to only One Pool

2. Term deposits can be part of multiple Pools

3. Only One Pool can be created with the same relationship type or CIF combination

4. Account under Freeze cannot be added to the Pool

5. The Pool balance will be reduced by the funds utilized by any of the accounts linked to the Pool

6. The Pool Balance will be reduced by the Lien amount marked in any account linked to the Pool.

7. Pool regularization is done as per the scheme type sequence parameterized by the Bank. Multiple accounts in the same scheme

type which are linked to the pool will be regularized as per the order no specified.

8. Accounts with utilization status Y will be able to utilize funds of each other

9. if there would be any deletion of holder from an account which is link to a pool, the account will be deleted from pool & customer

has to provide fresh request for addition of account again.

Declaration

I/We have read and understood the terms and conditions related to the creation of account pool with Kotak Mahindra Bank Ltd. I/We

accept and agree to be bound by the said terms and conditions including those excluding / limiting the Bank’s liability. I/We understand

that the Bank may at its absolute discretion, discontinue any of the services completely or partially or vary the terms without any notice

to me/us. I/We agree that the Bank may debit my account for service charges as applicable from time to time. The Bank will not be liable /

responsible for the return / dishonoring of any cheques issued by me/us and presented to the Bank post the creation / modification of

account pool. The Bank reserves the rights of recovery from any of the accounts in the account pool in case of any future debits accruing

on closed account as a result of any claims or transactions.

Signature

Account Holder Account Holder Account Holder

Date

For Branch Use Only For CPC / RPC Use Only

Signature verified by Pool ID.

Documents sent to CPC on Pool Created on

Approved by Signature verified by

Authorized by