Personal Details Bill Payment Registration Form Auto Debit (For existing customers only) Full Name FIRST NAME MIDDLE NAME LAST NAME Credit Card No. Expiry date Primary Bank Account No. Mobile No.* E-mail ID* * Please note that the above mentioned details are mandatory and should be as per Bank records.
In case you choose to provide a different mobile no. or E-mail id, then kindly ll up the tear away form at the end of this form. Your contact details on the Bank record s shall be updated based on the mobile no.
or E-mail id provided by you in the tear away form. I hereby authorise the Bank to debit the above mentioned Bank account Credit card with the amount outstanding on the bill s pertaining to the billers registered by me in the form below.( Please refer to theT &Cs attached below before signing up for this feature.) To register multiple billers for a single category please use separate forms. Before registering a biller please check if the b iller is on the list provided by the bank.You can only register a biller with whom the bank already has a tie up.
To nd out the list of registered billers you ... more. less.
can call up the contact center, check up the list of billers on www.hsbc.co.in or contact your nearest HSBC branch. Phone Telephone Companies Name of the Co. City Consumer / Account No.<br><br> (as provided by the Telephone Co.) Telephone No. Exchange Code Name in which Telephone is registered Mobile Companies Name of Co. City Consumer / Account No.<br><br> (As provided by the Mobile Companies) Mobile Phone No. Name in which Mobile No is registered Life Insurance Cos. Name of Co.<br><br> City Policy No. (As provided by Insurance co.) Client ID Premium Amount Payable Name of Policy Holder P P Bill copy attached Bill copy attached Copy of Premium payment receipt attached Signature1 Name Signature 3 Name Signature 2 Name Non Life Insurance Cos. Name of Co.<br><br> City Policy No. (As provided by Insurance Co.) Client ID Premium Amount Payable Name of Policy Holder P P Electricity / Others Electricity Companies Name of Co. City Consumer / Account No.<br><br> (As provided by the electricity Co.) Cycle No. (if applicable) Billing Unit No. (if applicable) Mahanagar Gas Ltd.<br><br> Account No. Others Name of Co. City Ref Field # 1 Ref Field # 2 Declaration I have read and understood the Terms and Conditions relating to registration for bill payment service.<br><br> I accept and agree to b e bound by the said Terms and Conditions including those excluding / limiting the Bank 9s liability. I understand that the Bank may, disco ntinue any of the services completely or partially by notifying me through its website or through any legally recognised medium of communicat ion giving a minimum notice of 30 days. For Bank use only Branch Signature verified by Account No.<br><br> verified by CAT Branch PRM Staff No. Customer ID Please note that the bill payment facility is available for payments by debit to HSBC bank account as well as debit to HSBC cre dit card account. To be filled up only if the Mobile number or E-mail id is not recorded with the Bank requires amendment.<br><br> Contact details Updatation Mobile No. E-mail ID: I agree that the mobile number provided in this form above is correct and belongs to me. I would like to receive alerts for Bil l payment service on this mobile number.<br><br> I also authorise the Bank to overwrite any existing mobile number and E-mail id that they may ha ve with the one mentioned in the form here in . I authorise the Bank to update the same on Bank records for future reference. Tear away Bill copy attached Bill copy attached Bill copy attached Copy of Premium payment receipt attached Signature1 Name Signature 3 Name Signature 2 Name Signature1 Name Signature 3 Name Signature 2 Name or Please note that the bill amount will be debited to your Bank account/credit card at least **6 business days before the due dat e.<br><br> Please ensure that your bank account/credit card has the necessary balance. 1) This service is brought to you by The Hongkong and Shanghai Banking Corporation Limited, India ( cHSBC/the Bank d) and any participation is voluntary. This service is available to all HSBC Credit Card/ Debit Cardholders and all the Bank account h olders having savings and/or current accounts with the Bank (hereinafter referred to as the cCustomer d).<br><br> 2) Under this service the Customers will be able to pay various bills pertaining to services such as mobile phones, electricity , telephone, insurance premium, etc. (hereinafter referred to as cUtility Bills d) by issuing Auto debit instructions to the Bank to debit th eir Credit Card/Debit Card/Savings/Current Account with HSBC for payment of the Utility Bills. 3) In the registration form for availing the Bill Payment Service, the Customer shall inform the Bank the names of the company, organization or entity that sends a Bill, statement or invoice, for a product or service (hereinafter referred to as cBiller/s d ).<br><br> 4) When the Customer registers a Biller for Auto debit, the Customer authorizes the Bank to debit the Customers 9 registered acc ount/ Credit Card for the specified payment on the due date. Registration for the service is not immediate and the time taken for registration varies from Biller to Biller. By registering for Biller(s) through the Bill Payment service via Auto debit, the Cu stomer agrees that the Bank is authorized to accept the Customers instructions to make payment from the Customer 9s accounts/ Credit Ca rd linked to the Customer 9s PBN (personal banking number)/ Customer ID, only upto a total of Rs.<br><br> 250,000 per day (from 00:01 hours to 24:00 hours Indian Standard Time). For PhoneBanking, this limit will be reduced by any transfer payments to pre-designated paye es initiated by the Customer during the day (from 00:01 hours to 24:00 hours Indian Standard Time). In case of Credit Cards, this would be upto the available credit limit or Rs.250,000/- whichever is lower.<br><br> 5) For any registration received between 1st and 21st of every month, the Service Start Date (SSD) would be the 1st of the subsequent month. However for registrations received after 21st (upto last date of the month), the SSD would be the 1st of the next month. All Auto debit instructions would be debited from your authorized account/ credit card at least 6 business days prior to actual bill due date.<br><br> (Please continue paying your bills as usual until you get intimation from HSBC via E-mail, SMS confirming your registration). 6) The Customer understands that the Bank engages third party agent(s) to provide this service and the Biller information will be shared with the third party service providers as and when required. 7) The Customer will have to provide the Credit Card number and expiry date of the Credit Card/ Saving or Current Account numbe r to enable the Bank to carry out the Auto debit instruction.<br><br> The Credit Card number and the expiry date will be shared with third p arty payment gateway service provider who would seek authorization on the Credit Card prior to processing the Auto debit transaction . 8) In case of New to Bank (NTB) accounts, the Customer authorizes the Bank to debit the account number/Credit Card number as an d when generated after completion of the necessary account opening formalities. 9) If the Customer registers for a Biller on Auto debit then the Customer shall not be able to register for the same Biller on any other bill payment services provided by the Bank and visa versa.<br><br> 10) In case of an existing registered Auto debit facility with the Bank, the Bank shall not be responsible to initiate any refu nds on account of any duplicate payments made by the Customer via other alternate channels. 11) In the event of change in Credit Card number on account of card renewal/lost card replacements, the Customer shall inform t he Bank about the same and the Bank would thereafter upload the new number for the Auto debit. 12) In case the payment on the Customer 9s Auto debit fails on account of insufficient balance/limit on Credit Card the Bank ret ains the right to cancel the Customer 9s Auto debit instruction with the Bank without giving any prior notice of the same.<br><br> 13) In case of any change in the Customer 9s mobile number or email address the Customer shall inform the Bank about the same an d the Bank will thereafter upload the new number/email address. The Bank shall not be responsible for any delays in payment notificat ion on account of incorrect mobile number or email ids. 14) The Bank shall not be responsible for any delays made by the Billers (Utility Companies) on account of any errors/omissions on the part of Billers in validation or crediting the Customer 9s bill amount to the Customer 9s account.<br><br> The Customer shall have to rai se any disputes in this regard with the concerned Biller. 15) The Bank or its agents shall not be liable if they are unable to effect any instructions to pay (Payment Instruction) on th e date of account being debited (Payment Date) and /or the due date mentioned on the bill (Due Date) due to any one or more of the follo wing circumstances: 1. a) If the Customer 9s Bank Account does not contain sufficient funds to cover the payment of the respective bill or the bill amount exceeds the overdraft limit, if any, granted to the Customer.<br><br> b) If the Customer makes a bill payment through his Credit Card and the attempt to debit the Customer 9s Credit Card results in an authorization failure due to various reasons including but not limited to, sufficient limit not available, credit card in delin quent status, credit card in closed status etc. 3. If the funds available in the Payment Account/credit card are under any attachment, lien or charge.<br><br> 4. The name of Biller and/or details required by the Biller for effecting the payment are not correctly provided by the Custome r. 5.<br><br> Due to refusal of the Biller to receive the payment for any reason whatsoever. 6. For any causes due to Force Majeure such as earthquake, flood, fire and other natural calamities or circumstances beyond the control of the Bank or its agents.<br><br> 16) The Bank shall not be responsible if the payment instructions are not effected for reasons not directly attributable to the Bank or its agents nor for any claim for consequential or punitive damages or for loss of profit. Refunds for rejected payments processed b y the Bank will be credited to the Customer 9s bank account/Credit Card within 5 business days from the date of debit. Terms and Conditions Bill Payment Service for Offline Registration 3 Auto Debit 17) The Bank or its agents shall have the right to suspend the operations of the Bill Payment Service or alter the terms and co nditions of the Bill Payment Service without notice and at their sole discretion.<br><br> 18) The Customer can delete any Biller on an Auto debit instruction or deregister to the service by providing this instruction on the Bank 9s Phone Banking service.T he instruction would be effected within a maximum of 2 working days. 19) The Customer can cancel the Customer 9s existing Auto debit instruction by providing atleast 1 working day 9s prior notice. P ayments scheduled within 1 working day/s would be acted upon as per the original instruction.<br><br> The Customer can also convert from Auto d ebit to any other bill payment facility like View n Pay (VNP) or vice-versa by lling up a new registration form. 20) On deletion of any Biller, the status of the registration will change to cTo be deleted d. There would be a look up period o f 7 days** where the customer would be given an option to 8activate 9 this once again.<br><br> At the end of the 7th Day, the registration would be 8Deleted 9 21) ALTERATIONS AND AMENDMENTS The Bank has the right to amend or supplement any of these terms at any time without prior notice and at its absolute discretio n. Changed terms and conditions will be displayed on the Bank 9s Internet Banking website. By using the Bill Payment Service, you w ill be deemed to have accepted the changed terms and conditions.<br><br> 22) In order to register for this service, the Customer needs to register at least one Biller. The bill copy attached should be of the latest month available. 23) If the customer mentions an incorrect or non existing mobile no.<br><br> or E-mail Id then the Customer 9s Bill payment registration shall not be processed. Also the details mentioned for the Billers registered should match with the bill copy attached. In case of a mismatch the bill registration shall be rejected.<br><br> 24) DISCLOSURE OF ACCOUNT INFORMATION T O T HIRD PARTIES The Customer authorises the Bank to share the Customer 9s per sonal and bill payment related information with its agents, Billers and/or nancial institutions acting as payment gateways/service providers. The Customer accepts and acknowledges that the Bank shall be entitled to assign any activities to any third party agency at its sole discretion ** Days can be modi ed by the Bank time to time. Signature (First/Sole Holder) Signature (Second Holder) Signature (Third Holder) Issued by The Hongkong and Shanghai Banking Corporation Limited, India (HSBC India).<br><br> Incorporated in Hong Kong SAR with limited liability.