www.online.citibank.co.in
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Submitted URL: https://www.online.citibank.co.in/portal/newgen/cards/tab/apply-now.htm?campaign_id=creditcards7&source=copylink&referralCode=Ka3A...
Effective URL: https://www.online.citibank.co.in/credit-card/apply?campaign_id=creditcards7&source=copylink&referralCode=Ka3AF7E0&referrer=IN0152...
Submission: On November 23 via manual from IE — Scanned from DE
Effective URL: https://www.online.citibank.co.in/credit-card/apply?campaign_id=creditcards7&source=copylink&referralCode=Ka3AF7E0&referrer=IN0152...
Submission: On November 23 via manual from IE — Scanned from DE
Form analysis 1 forms found in the DOM
Name: frmportalstprewards — POST
<form name="frmportalstprewards" id="userForm" class="dynform frmportalstprewards" enctype="multipart/form-data" method="post" onsubmit="return false;" autocomplete="off">
<input type="hidden" id="otpReferenceNo" name="otpReferenceNo"><input type="hidden" id="formExternalId" value="ff6d923c-df95-4206-84f5-3a5991f66e1f">
<input type="hidden" id="formInternalId" value="d5effdc7-4f4a-40d2-adb7-3b89cb6004c2">
<input type="hidden" id="advCondJson" value="{"formId":"4d40547f-2f6c-4cb4-85f3-e9c3d1377aa5","FormData":[{"conditionSet1":[{"IfCondition":[]},{"SetCondition":[]}]}]}">
<script type="text/javascript" src="/formbuilder/js/advanceProperties/advPropsValidation.js"></script>
<script type="text/javascript" src="/formbuilder/js/advanceProperties/updateAdvProps.js"></script>
<input type="hidden" id="showHideJson" value="{"formId":"4d40547f-2f6c-4cb4-85f3-e9c3d1377aa5","FormData":[{"groupCondition1":[{"IfCondition":[]},{"SetCondition":[]}]}]}">
<script type="text/javascript" src="/formbuilder/js/advanceProperties/advPropsValidation.js"></script>
<script type="text/javascript" src="/formbuilder/js/advanceProperties/showHideAdvProps.js"></script>
<input type="hidden" id="enableIncompleteTracking" value="1">
<input type="hidden">
<div id="tabs-wrapper">
<div class="tabs-selector non_visible_mobile">
<div class="inner">
<h2 style="margin-bottom: 0px;text-align: center;padding-top: 5px;">Find a Credit Card that suits you</h2>
<ul id="full-tabs">
<li class="first CitiCredit_card" id="dividend1">
<span class="arrow"></span>
<h3 class="interstate-regular non_visible_mobile" style="height: 24px;">IndianOil Citi Credit Card</h3>
<img alt="IndianOil Citi Credit Card" src="/portal/newgen/cards/tab/images/indianoil-platinumcard.png">
<a title="Fuel" data-ctaname="Fuel" data-ctatype="Button" data-ctaposition="Top" href="#tab-1" class="learn-button interstate-regular">Fuel</a>
</li>
<li id="simplicity1" class="CitiCredit_card">
<span class="arrow"></span>
<h3 class="interstate-regular non_visible_mobile newmobile" style="height: 24px;">Citi Rewards Credit Card</h3>
<img alt="Citi Rewards Credit Card" src="/portal/newgen/cards/tab/images/citibank-rewards-card.png">
<a title="Shopping" data-ctaname="Shopping" data-ctatype="Button" data-ctaposition="Top" href="#tab-4" class="learn-button interstate-regular">Shopping</a>
</li>
<li id="preferred1" class="CitiCredit_card">
<span class="arrow"></span>
<h3 class="interstate-regular non_visible_mobile" style="height: 24px;">Citi Cash Back Credit Card</h3>
<img alt="Citi Cash Back Credit Card" src="/portal/newgen/cards/tab/images/cash-back-credit-card.png" style="padding-top: 0px;">
<a title="Cashback" data-ctaname="Cashback" data-ctatype="Button" data-ctaposition="Top" href="#tab-2" class="learn-button interstate-regular">Cashback</a>
</li>
<li class="last CitiCredit_card" id="diamond1">
<span class="arrow"></span>
<h3 class="interstate-regular non_visible_mobile" style="height: 24px;">Citi PremierMiles Card</h3>
<img alt="Citi PremierMiles Card" src="/portal/newgen/cards/tab/images/premiermiles.png">
<a title="Travel" data-ctaname="Travel" data-ctatype="Button" data-ctaposition="Top" href="#tab-3" class="learn-button interstate-regular">Travel</a>
</li>
</ul>
</div>
</div>
<div class="tabs-content">
<div class="inner" style="padding-top:30px;">
<div class="tab">
<div class="card-showcase">
<h3 style="font-size: 24px;font-weight: 400;line-height: 34px;margin: 7px 0 25px;word-spacing: -1px;" class="interstate-bold"><span class="interstate-regular">IndianOil Citi Credit Card</span></h3>
<img alt="Apply for an IndianOil Citi Credit Card" title="Apply for an IndianOil Citi Credit Card" src="/portal/newgen/cards/tab/images/mob_bdy_simplicity_card.png">
</div>
<div class="card-description">
<ul class="interstate-light">
<li> Get up to 68 litres of free fuel in first year <ul>
<li>Fee waiver of <span class="WebRupee">Rs</span> 1000 on annual spends of <span class="WebRupee">Rs</span> 30000</li>
<li>Turbo points worth <span class="WebRupee">Rs</span> 250^ on card activation</li>
<li>Additional points worth <span class="WebRupee">Rs</span> 4500**</li>
</ul>
</li>
<li>Annual fee : <span class="WebRupee">Rs</span> 1000 + taxes<sup>#</sup></li>
<li>Never - expiring reward points</li>
<li>Simply tap and pay using contactless card</li>
</ul>
</div>
</div>
<div class="tab">
<div class="card-showcase">
<h3 style="font-size: 24px;font-weight: 400;line-height: 34px;margin: 7px 0 25px;word-spacing: -1px;" class="interstate-regular">Citi Rewards Credit Card</h3>
<img alt="Apply for a Citi Rewards Credit Card" title="Apply for a Citi Rewards Credit Card" src="/portal/newgen/cards/tab/images/mob_bdy_peferred_card.png">
</div>
<div class="card-description">
<ul class="interstate-light">
<li> Get benefits worth <span class="WebRupee">Rs</span> 5000+ in first year <ul>
<li>Fee waiver of <span class="WebRupee">Rs</span> 1000 on annual spends of <span class="WebRupee">Rs</span> 30000</li>
<li>Points worth <span class="WebRupee">Rs</span> 850^ on card activation</li>
<li>Additional points worth <span class="WebRupee">Rs</span> 3150**</li>
</ul>
</li>
<li>Annual fee : <span class="WebRupee">Rs</span> 1000 + taxes<sup>#</sup></li>
<li>Never - expiring reward points</li>
</ul>
</div>
</div>
<div class="tab">
<div class="card-showcase">
<h3 style="font-size: 24px;font-weight: 400;line-height: 34px;margin: 7px 0 25px;word-spacing: -1px;" class="interstate-regular">Citi Cash Back Credit Card</h3>
<img alt="Apply for a Citi Cash Back Credit Card" title="Apply for a Citi Cash Back Credit Card" src="/portal/newgen/cards/tab/images/cash-back-visa-platinum.png">
</div>
<div class="card-description">
<ul class="interstate-light">
<li> Get benefits worth <span class="WebRupee">Rs</span> 3,600+ in first year <ul class="interstate-light">
<li><span class="WebRupee">Rs</span> 2400^ on movies, telephone & utility bills</li>
<li><span class="WebRupee">Rs</span> 1200** on other spends</li>
</ul>
</li>
<li>Annual fee : <span class="WebRupee">Rs</span> 500 + taxes</li>
<li>Simply tap and pay using contactless card</li>
</ul>
</div>
</div>
<div class="tab">
<div class="card-showcase">
<h3 style="font-size: 24px;font-weight: 400;line-height: 34px;margin: 7px 0 25px;word-spacing: -1px;" class="interstate-regular"><span class="interstate-regular">Citi PremierMiles Card</span></h3>
<img alt="Apply for a Citi PremierMiles Card" title="Apply for a Citi PremierMiles Card" src="/portal/newgen/cards/tab/images/mob_bdy_dividend_card.png">
</div>
<div class="card-description">
<ul class="interstate-light">
<li> Get benefits worth <span class="WebRupee">Rs</span> 20,000+ in first year <ul>
<li>Welcome miles worth <span class="WebRupee">Rs</span> 4500^</li>
<li>Miles worth <span class="WebRupee">Rs</span> 3200** on airlines spends</li>
<li>Additional miles worth <span class="WebRupee">Rs</span> 11600*** on travel and other spends</li>
</ul>
</li>
<li>Annual fee : <span class="WebRupee">Rs</span> 3000 + taxes</li>
<li>Never expiring miles</li>
<li>Complimentary domestic airport lounge access</li>
</ul>
</div>
</div>
</div>
<div class="downArrowContainer">
<a data-ctaname="Begin Your Application" data-ctatype="Button" data-ctaposition="Bottom" class="downArrow" href="#formjump" title="Down"></a>
</div>
</div>
<div class="hidden-tablet non_visible_desktop visible_mobile" id="mobile-tabs-wrapper" style="height: auto;">
<div class="tabs-selector hidden-tablet non_visible_desktop visible_mobile" id="xxx" style="margin-left: 0px;">
<div class="inner">
<ul>
<li
data-href="/usc/_bt_appredir.asp?app=UNSOL&m=Y39C111111W&intc=7~1~64~1~052914~1~MPCCARDS~MPCCARDSUNCOOKBNR&BT_TX=1&ProspectID=879F2F8B9DFE4E8C8F9E2AA358787DFE&sc=4T5ZM4X4&B=M&ID=3000&uc=DD5&t=t&TID=133075"
class="active first" data-phone="8007541927" id="dividend">
<span class="arrow"></span><img alt="IndianOil Citi Credit Card" src="/portal/newgen/cards/tab/images/indianoil-platinumcard.png">
<h3 class="interstate-regular non_visible_tablet visible_mobile non_visible_desktop" style="height: 24px;">IndianOil Citibank Platinum Card</h3>
<a data-ctaname="Fuel" data-ctatype="Button" data-ctaposition="Top" title="Fuel Card" href="#tab-4" class="learn-button interstate-regular">Fuel Card</a>
</li>
<li
data-href="/usc/_bt_appredir.asp?app=UNSOL&m=339C111111W&intc=7~1~64~1~052914~1~MPCCARDS~MPCCARDSUNCOOKBNR&BT_TX=1&ProspectID=879F2F8B9DFE4E8C8F9E2AA358787DFE&sc=4DPZWRA5&B=M&ID=3018&uc=DU8&t=t&TID=133075"
data-phone="8007541927" class="" id="simplicity">
<span class="arrow"></span> <img alt="Citi Rewards Credit Card" src="/portal/newgen/cards/tab/images/citibank-rewards-card.png">
<h3 class="interstate-regular non_visible_tablet visible_mobile non_visible_desktop" style="height: 24px;">Citibank Rewards Card</h3>
<a data-ctaname="Shopping" data-ctatype="Button" data-ctaposition="Top" title="Shopping Card" href="#tab-1" class="learn-button interstate-regular">Shopping Card</a>
</li>
<li
data-href="/usc/_bt_appredir.asp?app=UNSOL&m=439C111111W&intc=7~1~64~1~052914~1~MPCCARDS~MPCCARDSUNCOOKBNR&BT_TX=1&ProspectID=879F2F8B9DFE4E8C8F9E2AA358787DFE&sc=1NMFF8Q5&B=C&ID=3131&uc=DUP&t=t&naInd=M&TID=133075"
data-phone="8007541927" id="preferred">
<span class="arrow"></span> <img alt="Citi Cash Back Credit Card" src="/portal/newgen/cards/tab/images/cash-back-credit-card.png">
<h3 class="interstate-regular non_visible_tablet visible_mobile non_visible_desktop" style="height: 24px;">Citibank Cash Back Card</h3>
<a data-ctaname="Cash Back" data-ctatype="Button" data-ctaposition="Top" title="Travel Card" href="#tab-2" class="learn-button interstate-regular">Travel Card</a>
</li>
<li
data-href="/usc/_bt_appredir.asp?app=UNSOL&m=339C111111W&intc=7~1~64~1~052914~1~MPCCARDS~MPCCARDSUNCOOKBNR&BT_TX=1&ProspectID=879F2F8B9DFE4E8C8F9E2AA358787DFE&sc=4DNZ5L45&B=M&ID=3000&uc=DU9&t=t&TID=133075"
data-phone="8007541927" class="last" id="diamond">
<span class="arrow"></span> <img alt="Citi PremierMiles Card" src="/portal/newgen/cards/tab/images/premiermiles.png">
<h3 class="interstate-regular non_visible_tablet visible_mobile non_visible_desktop" style="height: 24px;">Citi PremierMiles Card</h3>
<a data-ctaname="Travel" data-ctatype="Button" data-ctaposition="Top" title="Shopping Card" href="#tab-3" class="learn-button interstate-regular">Shopping Card</a>
</li>
</ul>
</div>
</div>
<div class="non_visible_desktop visible_mobile" id="mobile-tabs-content">
<div class="backBar" style="display: none;">
<div><span>Back</span></div>
</div>
<p class="creditBack" style="display: none;">
<img id="microBack" title="Home" class="creditBackbtn" src="/portal/newgen/cards/tab/images/back.jpg">
</p>
<div id="mobBdyCards">
<div class="mobContent" id="dividendID">
<h4 class="interstate-regular">IndianOil Citibank Platinum Card</h4>
<img width="98" height="62" alt="IndianOil Citi Credit Card" src="/portal/newgen/cards/tab/images/indianoil-platinumcard.png">
</div>
<div class="mobContent" id="simplicityID">
<h4 class="interstate-regular">Citibank Rewards Card</h4>
<img width="98" height="62" alt="Citi Rewards Credit Card" src="/portal/newgen/cards/tab/images/citibank-rewards-card.png">
</div>
<div class="mobContent" id="preferredID">
<h4 class="interstate-regular">Citibank Cash Back Card</h4>
<img width="98" height="62" alt="Citi Cash Back Credit Card" src="/portal/newgen/cards/tab/images/cash-back-credit-card.png">
</div>
<div class="mobContent" id="diamondID">
<h4 class="interstate-regular">Citibank PremierMiles Card</h4>
<img width="98" height="62" alt="Citi PremierMiles Card" src="/portal/newgen/cards/tab/images/premiermiles.png">
</div>
</div>
<div class="mobBullets bullet" id="simplicityIDBullets">
<div>
<p class="interstate-light first">Get benefits worth <span class="WebRupee">Rs</span> 5000+ in first year</p>
<p>Fee waiver of <span class="WebRupee">Rs</span> 1000 on annual spends of <span class="WebRupee">Rs</span> 30000</p>
<p>Points worth <span class="WebRupee">Rs</span> 850^ on card activation</p>
<p>Additional points worth <span class="WebRupee">Rs</span> 3150**</p>
<p class="interstate-light first">Annual fee : <span class="WebRupee">Rs</span> 1000 + taxes<sup>#</sup></p>
<p class="interstate-light first">Never - expiring reward points</p>
</div>
</div>
<div class="mobBullets bullet" id="preferredIDBullets">
<div>
<p class="interstate-light first">Get benefits worth <span class="WebRupee">Rs</span> 3,600+ in first year</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;"><span class="WebRupee">Rs</span> 2400^ on movies, telephone & utility bills</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;"><span class="WebRupee">Rs</span> 1200** on other spends</p>
<p class="interstate-light first">Annual fee : <span class="WebRupee">Rs</span> 500 + taxes</p>
<p class="interstate-light first">Simply tap and pay using contactless card</p>
</div>
</div>
<div class="mobBullets bullet" id="diamondIDBullets">
<div>
<p class="interstate-light first">Get benefits worth <span class="WebRupee">Rs</span> 20,000+ in first year</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;">Welcome miles worth <span class="WebRupee">Rs</span> 4500^</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;">Miles worth <span class="WebRupee">Rs</span> 3200** on airlines spends</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;">Additional miles worth <span class="WebRupee">Rs</span> 11600*** on travel and other spends</p>
<p class="interstate-light first">Annual fee : <span class="WebRupee">Rs</span> 3000 + taxes</p>
<p class="interstate-light first">Evergreen miles - never expire</p>
<p class="interstate-light first">Complimentary domestic airport lounge access</p>
</div>
</div>
<div class="mobBullets bullet" id="dividendIDBullets">
<div>
<p class="interstate-light first">Get up to 68 litres of free fuel per year</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;"> Fee waiver of <span class="WebRupee">Rs</span> 1000 on annual spends of <span class="WebRupee">Rs</span> 30000 </p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;">Turbo points worth <span class="WebRupee">Rs</span> 250^ on card activation</p>
<p class="interstate-light first" style="margin-left: 25px; margin-top: -15px;">Additional points worth <span class="WebRupee">Rs</span> 4500**</p>
<p class="interstate-light first">Annual fee : <span class="WebRupee">Rs</span> 1000 + taxes<sup>#</sup></p>
<p class="interstate-light first">Never - expiring reward points</p>
<p class="interstate-light first">Simply tap and pay using contactless card</p>
</div>
</div>
</div>
</div>
</div>
<div aria-live="assertive" class="cA-DD-formErrorMsg"></div>
<div class="cA-DD-sections" id="formjump">
<div id="ContactDetail" class="cA-DD-fields cA-DD-active">
<div class="cA-DD-content">
<h2 style="text-align: center;padding-top: 20px;">Online Credit Card Application Form</h2>
<h3 class="cA-DD-sectionTitle padbot">CONTACT DETAILS</h3>
<div class="cA-DD-fieldSummary summarycolor2" aria-hidden="true">Email, Mobile Number, Name</div>
<div class="cA-DD-inputCollection Personalexshow">
<div class="cA-DD-alignment cA-DD-inputBox cA-DD-large EMAIL_ADDRESS cA-DD-responsiveTooltip cA-DD-validField cA-DD-prevFocus firstsec">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent inputconwid CA-DD-inputbordershadow">
<label></label>
<input class="txtfield Email_Id" position="above" id="Email_Id" name="email-email-1598329727016"
pattern="^([a-zA-Z0-9_\-\.]+)@([a-zA-Z0-9\-]+)\.(([a-zA-Z]{2,})|([a-zA-Z]{2,}\.[a-zA-Z]{2,})|([a-zA-Z]{2,}\.[a-zA-Z]{2,}\.[a-zA-Z]{2,}))$" placeholder="*Email ID" type="email" required="true" visibility="show"
error="Please enter a valid email ID" title="Please enter a valid email ID" oninvalid="setCustomValidity('Please enter a valid email ID')" onchange="setCustomValidity('')" tabindex="1">
</div>
<div class="ui-front">
<ul class="ui-autocomplete ui-menu ui-widget ui-widget-content ui-corner-all" role="listbox" style="z-index: 1; top: 0px; left: 0px; display: none;"></ul>
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Field"></div>
</div>
<div class="cA-DD-alignment cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField firstsec">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent CA-DD-inputbordershadow inputconwidCA-DD-inputbordershadow">
<label></label>
<!-- <input
type="tel"
onkeypress="return AllowNumberOnly(event);"
value="*Mobile Number (10 digits only)"
id="M_number"
placeholder="*Mobile Number (10 digits only)"
name="mobile_number"
maxlength="10"
onfocus="if(this.value=='*Mobile Number (10 digits only)'){this.value=''}"
onblur="if(this.value==''){this.value='*Mobile Number (10 digits only)'}"
tabindex="30"
/> -->
<input class="txtfield numOnly" position="above" label="&lt;p&gt;Mobile Number&lt;/p&gt;" id="mobile_number" name="mobile-text-1598329731917" pattern="[6-9]{1}[0-9]{9}" placeholder="*Mobile Number (10 digits only)"
maxlength="10" type="text" required="true" visibility="show" error="Please enter a valid mobile number" title="Please enter a valid mobile number" oninvalid="setCustomValidity('Please enter a valid mobile number')"
onchange="setCustomValidity('')" tabindex="2" onfocus="emailId()">
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div>
<div class="cA-DD-alignment seldroppd firstsec">
<!-- <select class="dropsuffix" tabindex="8" id="PD_title" name="Title" onkeypress="return enter_check(event)">
<option value="Mr.">Mr.</option>
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Mrs.">Mx.</option>
</select> -->
<span class="select-wrapper"><select class="dropsuffix txtfield salutation" tabindex="8" position="above" id="Title" name="salutations-select-1598329735325" visibility="show" error="Please select title" title="Please select title"
oninvalid="setCustomValidity('Please select title')" onchange="setCustomValidity('')" onkeypress="return enter_check(event)">
<option value="Mr.">Mr.</option>
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Mrs.">Mx.</option>
</select><span class="holder">Mr.</span></span>
<div class="cA-DD-inputBox cA-DD-large FIRST_NAME">
<div class="cA-DD-inputContent CA-DD-inputbordershadow inrcwdt">
<label></label>
<!-- <input
type="text"
value="*Full Name"
placeholder="*Full Name"
tabindex="9"
onblur="if(this.value==''){this.value='*Full Name'}"
onfocus="if(this.value=='*Full Name'){this.value=''}"
onmouseover="companytooltip('Please enter your name as it appears on your PAN Card')"
onmouseout="hideddrivetip()"
maxlength="50"
id="F_Name"
name="FirstName"
onkeypress="return AllowAlphabetOnly(event)"
/> -->
<input class="txtfield salutation1 alphaOnly" position="above" id="FirstName" name="firstName-text-1598329735386" pattern="^[A-Za-z]+(?:\s[A-Za-z]+)+$" placeholder="*Full Name" maxlength="50" type="text" required="true"
visibility="show" error="Please enter your name as it appears on your PAN Card" title="Please enter your name as it appears on your PAN Card" oninvalid="setCustomValidity('Please enter your name as it appears on your PAN Card')"
onchange="setCustomValidity('')" tabindex="4" onfocus="Mobilenum()">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div>
<div style="display: none;" id="calc1" class="calc">
<div class="single-slider" style="display: none;">
<input type="hidden" value="0" class="slider-input" tabindex="25">
</div>
<div class="slider-container theme-green" style="width: 800px;">
<div class="back-bar">
<div class="selected-bar" style="width: 1px; left: 0px;"></div>
<div class="pointer low" style="display: none;"></div>
<div class="pointer-label" style="display: none;">123456</div>
<div class="pointer high" style="left: -6px;"></div>
<div class="pointer-label" style="left: 1px;">20</div>
<div class="clickable-dummy"></div>
</div>
<div class="scale"><span style="left: 0%"><ins style="margin-left: 0px;">20</ins></span><span style="left: 20%"><ins style="margin-left: 0px;">30</ins></span><span style="left: 40%"><ins style="margin-left: 0px;">40</ins></span><span
style="left: 60%"><ins style="margin-left: 0px;">50</ins></span><span style="left: 80%"><ins style="margin-left: 0px;">60</ins></span><span style="left: 100%"><ins style="margin-left: 0px;">70</ins></span></div>
</div>
<div class="slider-container theme-green" style="width: 800px;">
<div class="back-bar">
<div class="selected-bar" style="width: 1px; left: 0px;"></div>
<div class="pointer low" style="display: none;"></div>
<div class="pointer-label" style="display: none;">123456</div>
<div class="pointer high" style="left: -6px;"></div>
<div class="pointer-label" style="left: 0px;">20</div>
<div class="clickable-dummy"></div>
</div>
<div class="scale">
<span style="left: 0%;"><ins style="margin-left: 0px;">20</ins></span><span style="left: 20%;"><ins style="margin-left: 0px;">30</ins></span>
<span style="left: 40%;"><ins style="margin-left: 0px;">40</ins></span><span style="left: 60%;"><ins style="margin-left: 0px;">50</ins></span>
<span style="left: 80%;"><ins style="margin-left: 0px;">60</ins></span><span style="left: 100%;"><ins style="margin-left: 0px;">70</ins></span>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="cA-DD-fields" id="nameSection">
<div id="formbar1" class="cA-DD-content">
<ul>
<li class="list-radio-1 secndsec">
<p class="font1">*Do you have a Citibank Savings Account?</p>
<p class="font1 fonts_tab">
<!-- <input type="radio" name="existcust" tabindex="1" value="Yes" id="sbyes" onkeypress="return enter_check(event)" /> -->
<input type="radio" data-ctaname="Do you have a Citibank Saving Account : Yes" data-ctatype="button" data-ctaposition="Middle" class="radiobttn existcust" id="existcust" name="radioButton-radio-group-1598330658729" label="Yes" value="Yes"
required="true" visibility="show" onclick="customRadioBtnValidity('existcust')" error="Please mention whether you have an existing Citibank Relationship"
oninvalid="setCustomValidity('Please mention whether you have an existing Citibank Relationship')" tabindex="5" onkeypress="return enter_check(event)">
<label>Yes</label>
<!-- <input type="radio" tabindex="2" name="existcust" value="No" id="sbno" onkeypress="return enter_check(event)" onclick="sbnofunc();" /> -->
<input data-ctaname="Do you have a Citibank Saving Account : No" data-ctatype="button" data-ctaposition="Middle" type="radio" class="radiobttn existcust" id="existcust" name="radioButton-radio-group-1598330658729" label="No" value="No"
required="true" visibility="show" onclick="customRadioBtnValidity('existcust')" tabindex="6" onkeypress="return enter_check(event)">
<label>No</label>
</p>
</li>
</ul>
</div>
<div class="mainsav" style="display: none;">
<p class="fontfont" style="padding-left: 7px;">*Savings Account No.:</p>
<div class="cA-DD-inputBox cA-DD-large FIRST_NAME secndsec">
<div class="cA-DD-inputContent CA-DD-inputbordershadow">
<label></label>
<!-- <input value="" type="tel" name="saveaccno" tabindex="3" id="S_account" maxlength="10" onkeypress="return AllowNumberOnly(event);" /> -->
<input class="txtfield numOnly" position="above" id="saveaccno" pattern="^[5][0-9]{9}" name="textField-text-1598330674438" type="text" maxlength="10" visibility="show" error="Please enter your Suvidha / Banking Account Number"
title="Please enter your Suvidha / Banking Account Number" oninvalid="setCustomValidity('Please enter your Suvidha / Banking Account Number')" onchange="setCustomValidity('')" tabindex="7" disabled="disabled">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="clear">
<ul>
<li class="list-radio-1 secndsec">
<p class="font1 font1font">*My salary gets credited to the above mentioned bank account:</p>
<p class="font1">
<!-- <input type="radio" value="Yes" tabindex="4" name="salary_credited_to_account" id="salary_credit_yes" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn salary_credit_yes salary_credited_to_account" id="salary_credited_to_account" name="radioButton-radio-group-1598330687411" label="Yes" value="Yes" visibility="show"
onclick="customRadioBtnValidity('salary_credited_to_account')" error="Please confirm if your salary gets credited to the mentioned bank account"
oninvalid="setCustomValidity('Please confirm if your salary gets credited to the mentioned bank account')" tabindex="8" disabled="disabled">
<label>Yes</label>
<!-- <input type="radio" value="No" tabindex="5" name="salary_credited_to_account" id="salary_credit_no" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn salary_credit_no salary_credited_to_account" id="salary_credited_to_account" name="radioButton-radio-group-1598330687411" label="No" value="No" visibility="show"
onclick="customRadioBtnValidity('salary_credited_to_account')" tabindex="9" disabled="disabled">
<label>No</label>
</p>
</li>
</ul>
</div>
<div class="clear">
<ul>
<li class="list-radio-1 secndsec">
<p class="font1 font1font">*I currently reside in the address updated in my bank account:</p>
<p class="font1 font1-font_new">
<!-- <input type="radio" class="checkyesno" value="Yes" name="address_as_per_bank_account" id="addr_update_yes" tabindex="6" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn checkyesno addr_update_yes" id="address_as_per_bank_account" name="radioButton-radio-group-1598330692009" label="Yes" value="Yes" visibility="show"
onclick="customRadioBtnValidity('address_as_per_bank_account')" error="Please confirm if your address details are the same as updated in your bank account"
oninvalid="setCustomValidity('Please confirm if your address details are the same as updated in your bank account')" tabindex="10" onkeypress="return enter_check(event)" disabled="disabled">
<label> Yes</label>
<!-- <input type="radio" value="No" class="checkyesno" name="address_as_per_bank_account" id="addr_update_no" tabindex="7" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn checkyesno addr_update_no" id="address_as_per_bank_account" name="radioButton-radio-group-1598330692009" label="No" value="No" visibility="show"
onclick="customRadioBtnValidity('address_as_per_bank_account')" tabindex="11" onkeypress="return enter_check(event)" disabled="disabled">
<label>No</label>
</p>
</li>
</ul>
</div>
</div>
</div>
<div class="cA-DD-fields" id="PersonalData">
<div class="cA-DD-content">
<h3 class="cA-DD-sectionTitle padbot">Personal Data</h3>
<div aria-hidden="true" class="cA-DD-fieldSummary summarycolor1">Tell us about yourself</div>
<div class="cA-DD-inputCollection Personalexhide personal_data">
<!-- <div style="clear: both; display: none;" id="madian_name">
<p class="font padbot mrgnbtm0">MAIDEN NAME</p>
<span class="select-wrapper2">
<select class="dropsuffix" tabindex="12" id="PD_title_M1" name="Maiden_Title" onkeypress="return enter_check(event)">
<option value="Ms.">Ms.</option>
<option value="Mrs.">Mrs.</option>
<option value="Mx.">Mx.</option>
</select>
</span>
<div class="cA-DD-alignment">
<div class="cA-DD-inputBox cA-DD-large FIRST_NAME">
<div class="cA-DD-inputContent CA-DD-inputbordershadow mobwid">
<label></label>
<input
type="text"
value="*First Name"
placeholder="*First Name"
tabindex="13"
onblur="if(this.value==''){this.value='*First Name'}"
onfocus="if(this.value=='*First Name'){this.value=''};PD_titleVal1();"
onmouseover="companytooltip('Please enter your Maiden First name ')"
onmouseout="hideddrivetip()"
maxlength="50"
id="F_Name_M1"
name="Maiden_FirstName"
onkeypress="return AlphaApos(event);"
/>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-small MIDDLE_NAME padlft2">
<div class="cA-DD-inputContent personal_midname CA-DD-inputbordershadow mobwid">
<label></label>
<input
type="text"
value="Middle Name"
placeholder="Middle Name"
tabindex="14"
onblur="if(this.value==''){this.value='Middle Name'}"
onfocus="if(this.value=='Middle Name'){this.value=''}"
onmouseover="companytooltip('Please enter your Maiden Middle name')"
onmouseout="hideddrivetip()"
maxlength="50"
id="M_Name_M1"
name="Maiden_MiddleName"
onkeypress="return AlphaApos(event);"
/>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-alignment padlft">
<div class="cA-DD-inputBox cA-DD-large LAST_NAME">
<div class="cA-DD-inputContent CA-DD-inputbordershadow cA-DD-inputlname mobwid">
<label></label>
<input
type="text"
value="*Last Name"
placeholder="*Last Name"
tabindex="15"
onblur="if(this.value==''){this.value='*Last Name'}"
onfocus="if(this.value=='*Last Name'){this.value=''};maid_firstname();"
onmouseover="companytooltip('Please enter your Maiden Last name')"
onmouseout="hideddrivetip()"
maxlength="50"
id="L_Name_M1"
name="Maiden_LastName"
onkeypress="return AlphaApos(event);"
/>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div> -->
<div style="clear: both;" class="fsstyle">
<!-- <div class="padbot mrgnbtm0" id="fschange" style="display: none;">
<input type="radio" class="spouse_class" name="faName" id="fscheck" onkeypress="return enter_check(event)" value="FATHERNAME" /><span class="paddng10">FATHER'S NAME</span>
<input type="radio" class="spouse_class" name="faName" id="spousevalid" onkeypress="return enter_check(event)" value="SPOUSENAME" /><span class="paddng10">SPOUSE NAME</span>
</div> -->
<p class="font padbot mrgnbtm0">Father's Name</p>
<!-- <select class="dropsuffix" tabindex="8" id="PD_title1" name="Father_Title" onkeypress="return enter_check(event)">
<option class="mrhide" value="Mr.">Mr.</option>
</select> -->
<span class="select-wrapper"><select class="dropsuffix txtfield salutation PD_title1" position="above" id="Father_Title" name="salutations-select-1598332596260" visibility="show" error="Please select title" title="Please select title"
oninvalid="setCustomValidity('Please select title')" onchange="setCustomValidity('')" tabindex="12" onkeypress="return enter_check(event)">
<option class="mrhide" value="Mr.">Mr.</option>
</select><span class="holder">Mr.</span></span>
<div class="cA-DD-alignment">
<div class="cA-DD-inputBox cA-DD-large FIRST_NAME">
<div class="cA-DD-inputContent CA-DD-inputbordershadow mobwid">
<label></label>
<!-- <input
type="text"
value="*First Name"
placeholder="*First Name"
tabindex="9"
onblur="if(this.value==''){this.value='*First Name'}"
onfocus="if(this.value=='*First Name'){this.value=''}"
onmouseover="companytooltip('Please enter your Father\'s First name')"
onmouseout="hideddrivetip()"
maxlength="50"
id="F_Name1"
name="Father_FirstName"
onkeypress="return AlphaApos(event);"
/> -->
<input class="txtfield salutation1 F_Name1 AlphaApos" position="above" id="Father_FirstName" name="firstName-text-1598332596301" pattern="^(?!\s*$)[a-zA-Z'\s]{1,50}$" placeholder="*First Name" maxlength="50" type="text"
visibility="show" error="Please enter your Father’s First Name" title="Please enter your Father’s First Name" oninvalid="setCustomValidity('Please enter your Father’s First Name')" onchange="setCustomValidity('')" tabindex="13">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-small MIDDLE_NAME padlft2">
<div class="cA-DD-inputContent personal_midname CA-DD-inputbordershadow mobwid">
<label></label>
<!-- <input
type="text"
value="Middle Name"
placeholder="Middle Name"
tabindex="10"
onblur="if(this.value==''){this.value='Middle Name'}"
onfocus="if(this.value=='Middle Name'){this.value=''}"
onmouseover="companytooltip('Please enter your Father\'s Middle name')"
onmouseout="hideddrivetip()"
maxlength="50"
id="M_Name1"
name="Father_MiddleName"
onkeypress="return AlphaApos(event);"
/> -->
<input class="txtfield M_Name1 AlphaApos" position="above" id="Father_MiddleName" name="middleName-text-1598332596305" pattern="^(?!\s*$)[a-zA-Z'\s]{1,50}$" placeholder="Middle Name" maxlength="50" type="text" visibility="show"
error="Please enter your Father’s Middle Name" title="Please enter your Father’s Middle Name" oninvalid="setCustomValidity('Please enter your Father’s Middle Name')" onchange="setCustomValidity('')" tabindex="14">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-alignment padlft">
<div class="cA-DD-inputBox cA-DD-large LAST_NAME">
<div class="cA-DD-inputContent CA-DD-inputbordershadow cA-DD-inputlname mobwid">
<label></label>
<!-- <input
type="text"
value="*Last Name"
placeholder="*Last Name"
tabindex="11"
onblur="if(this.value==''){this.value='*Last Name'}"
onfocus="if(this.value=='*Last Name'){this.value=''}"
onmouseover="companytooltip('Please enter your Father\'s Last name')"
onmouseout="hideddrivetip()"
maxlength="50"
id="L_Name1"
name="Father_LastName"
onkeypress="return AlphaApos(event);"
/> -->
<input class="txtfield L_Name1 AlphaApos" position="above" id="Father_LastName" name="lastName-text-1598332596311" pattern="^(?!\s*$)[a-zA-Z'\s]{1,50}$" placeholder="*Last Name" maxlength="50" type="text" visibility="show"
error="Please enter your Father’s Last Name" title="Please enter your Father’s Last Name" oninvalid="setCustomValidity('Please enter your Father’s Last Name')" onchange="setCustomValidity('')" tabindex="15">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div>
</div>
<div class="cA-DD-inputCollection Personalexhide person_dob">
<p class="font padbot" onmouseout="hideddrivetip()">YOUR DATE OF BIRTH</p>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField cA-DD-prevFocus marbot dobdevicewid">
<div class="cA-DD-nonErrorContent desk-view" style="border: 1px solid #ccc; height: 48px; padding-left: 10px !important; width: 155px;">
<!-- <input
onkeypress="return AllowNumberOnly(event);"
onkeyup="checkLendd();"
name="exist_dob_dd"
id="exist_dob_dd"
tabindex="21"
maxlength="2"
placeholder="DD"
type="tel"
style="float: left; display: inline; width: 19%;"
value="DD"
/> -->
<input class="txtfield numOnly" position="above" id="exist_dob_dd" placeholder="DD" pattern="^[0-9]{2}" name="textField-text-1598333273347" type="tel" maxlength="2" visibility="show" error="Please enter a valid date of your birth"
title="Please enter a valid date of your birth" oninvalid="setCustomValidity('Please enter a valid date of your birth')" onchange="setCustomValidity('')" tabindex="16" style="float: left; display: inline; width: 19%;"> / <!-- <input
onkeypress="return AllowNumberOnly(event);"
onkeyup="checkLenmm();"
name="exist_dob_mm"
id="exist_dob_mm"
tabindex="21"
maxlength="2"
placeholder="MM"
type="tel"
style="display: inline; width: 19%;"
onfocus="dateval();"
value="MM"
/> -->
<input class="txtfield numOnly" position="above" id="exist_dob_mm" placeholder="MM" pattern="^[0-9]{2}" name="textField-text-1598333436215" type="tel" maxlength="2" visibility="show" error="Please enter your Valid Month"
title="Please enter your Valid Month" oninvalid="setCustomValidity('Please enter your Valid Month')" onchange="setCustomValidity('')" onfocus="dateval();" style="display: inline; width: 19%;" tabindex="17"> / <!-- <input
onkeypress="return AllowNumberOnly(event);"
name="exist_dob_yy"
id="exist_dob_yy"
tabindex="21"
maxlength="4"
placeholder="YYYY"
type="tel"
style="display: inline; width: 30%;"
onfocus="monthval();"
value="YYYY"
/> -->
<input class="txtfield numOnly" position="above" id="exist_dob_yy" placeholder="YYYY" pattern="^[0-9]{4}" name="textField-text-1598333439116" type="tel" maxlength="4" visibility="show" error="Please enter a valid year of your birth"
title="Please enter a valid year of your birth" oninvalid="setCustomValidity('Please enter a valid year of your birth')" onchange="setCustomValidity('')" style="display: inline; width: 30%;" onfocus="monthval();" tabindex="18">
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive"></div>
</div>
</div>
<div class="cA-DD-inputCollection Personalexhide personal_marital">
<p class="font padbot">*MARITAL STATUS</p>
<ul class="padno marbot">
<li class="list-radio-1">
<p class="formValue">
<!-- <input type="radio" value="Married" tabindex="16" name="MARITAL_STATUS" id="Married" checked onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Married" id="MARITAL_STATUS" name="radioButton-radio-group-1598334731391" label="Married" value="Married" visibility="show" onclick="customRadioBtnValidity('MARITAL_STATUS')" checked=""
onkeypress="return enter_check(event)" tabindex="19">
<label>Married</label>
<!-- <input type="radio" value="Unmarried" tabindex="17" name="MARITAL_STATUS" id="Unmarried" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Unmarried" id="MARITAL_STATUS" name="radioButton-radio-group-1598334731391" label="Unmarried" value="Unmarried" visibility="show" onclick="customRadioBtnValidity('MARITAL_STATUS')" tabindex="20"
onkeypress="return enter_check(event)">
<label>Unmarried</label>
<!-- <input type="radio" value="Others" tabindex="17" name="MARITAL_STATUS" id="Others" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Others" id="MARITAL_STATUS" name="radioButton-radio-group-1598334731391" label="Others" value="Others" visibility="show" onclick="customRadioBtnValidity('MARITAL_STATUS')" tabindex="21"
onkeypress="return enter_check(event)">
<label>Others</label>
<span class="tick" id="preMailAddr_Error"></span>
</p>
</li>
</ul>
</div>
<div class="cA-DD-inputCollection Personalexhide personal_nationlity">
<div class="formbarpad">
<p class="font padbot">*CITIZENSHIP</p>
<ul class="padno marbot">
<li class="list-radio-1">
<p class="formValue">
<!-- <input type="radio" value="India" tabindex="16" name="CITIZENSHIP" id="N_India" checked onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn N_India" id="CITIZENSHIP" name="radioButton-radio-group-1598334733852" label="Indian" value="Indian" visibility="show" onclick="customRadioBtnValidity('CITIZENSHIP')" tabindex="22" checked=""
onkeypress="return enter_check(event)">
<label>Indian</label>
<!-- <input type="radio" value="Others" tabindex="17" name="CITIZENSHIP" id="N_Others" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn N_Others" id="CITIZENSHIP" name="radioButton-radio-group-1598334733852" label="Others" value="Others" visibility="show" onclick="customRadioBtnValidity('CITIZENSHIP')" tabindex="23"
onkeypress="return enter_check(event)">
<label>Others</label>
<span class="tick" id="preMailAddr_Error"></span>
</p>
</li>
</ul>
</div>
</div>
<div class="cA-DD-inputCollection Personalexhide personal_status">
<div class="formbarpad">
<p class="font padbot">*RESIDENTIAL STATUS</p>
<p class="formValue">
<!-- <input type="radio" value="Resident Individual" tabindex="16" name="RESIDENTIAL_STATUS" id="Individual_India" checked onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Individual_India" id="RESIDENTIAL_STATUS" name="radioButton-radio-group-1598334736134" label="Resident Individual" value="Resident Individual" visibility="show"
onclick="customRadioBtnValidity('RESIDENTIAL_STATUS')" tabindex="24" checked="" onkeypress="return enter_check(event)">
<label>Resident Individual</label>
<!-- <input type="radio" value="Non Resident Indian" tabindex="17" name="RESIDENTIAL_STATUS" id="Non_Resident" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Non_Resident" id="RESIDENTIAL_STATUS" name="radioButton-radio-group-1598334736134" label="Non Resident Indian" value="Non Resident Indian" visibility="show"
onclick="customRadioBtnValidity('RESIDENTIAL_STATUS')" tabindex="25" onkeypress="return enter_check(event)">
<label>Non Resident Indian</label>
<!-- <input type="radio" value="Foreign National" tabindex="16" name="RESIDENTIAL_STATUS" id="Foreign_Resident" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Foreign_Resident" id="RESIDENTIAL_STATUS" name="radioButton-radio-group-1598334736134" label="Foreign National" value="Foreign National" visibility="show"
onclick="customRadioBtnValidity('RESIDENTIAL_STATUS')" tabindex="26" onkeypress="return enter_check(event)">
<label>Foreign National</label>
<!-- <input type="radio" value="Person of Indian Origin" tabindex="16" name="RESIDENTIAL_STATUS" id="Origin" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Origin" id="RESIDENTIAL_STATUS" name="radioButton-radio-group-1598334736134" label="Person of Indian Origin" value="Person of Indian Origin" visibility="show"
onclick="customRadioBtnValidity('RESIDENTIAL_STATUS')" tabindex="27" onkeypress="return enter_check(event)">
<label>Person of Indian Origin</label>
<span class="tick" id="preMailAddr_Error"></span>
</p>
</div>
</div>
<div class="cA-DD-inputCollection PanExshow">
<p class="font padbot">PAN Card</p>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent">
<script type="text/javascript" src="/portal/newgen/cards/tab/js/panVerification.js"></script>
<label></label>
<!-- <input type="text" placeholder="*PAN card" maxlength="10" tabindex="33" onfocus="if(this.value=='*PAN card'){this.value=''} " onblur="if(this.value==''){this.value='*PAN card'}" value="*PAN card" name="panno" id="panno" onkeypress="return AlphaNumCheck(event)" /> -->
<input onfocus="DateBirth();" class="txtfield panCheck panno alphanumOnly" position="above" id="panno" pattern="[A-Za-z]{3}[Pp]{1}[A-Za-z]{1}[0-9]{4}[A-Za-z]{1}" placeholder="*PAN card" maxlength="10" type="text" visibility="show"
error="Please enter your PAN Number" title="Please enter your PAN Number" oninvalid="setCustomValidity('Please enter your PAN Number')" onchange="setCustomValidity('')" name="pan-text-1598335383825" tabindex="28" required="">
</div>
<div class="cA-DDpancard" id="pantxthide">
<p>Fill all the above details as it appears on the PAN Card.</p>
</div>
</div>
<p id="panerrormsg" style="color:red;font-size: 14px;margin: 0; padding: 0;"></p>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="formbarpad">
<p class="font padbot">CKYC/ KIN (if available)</p>
<div class="cA-DD-inputBox cA-DD-medium" id="div_others_KYC1" style="">
<div class="cA-DD-inputContent">
<!-- <input type="text" id="others_KYC1" name="others_KYC1" maxlength="14" onkeypress="return AllowNumberOnly(event);" onfocus="if(this.value=='Central KYC/ KYC Identification'){this.value=''}" value="" onblur="if(this.value==''){this.value='Central KYC/ KYC Identification'}" placeholder="Central KYC/ KYC Identification" /> -->
<input class="txtfield numOnly" position="above" id="others_KYC1" placeholder="Central KYC/ KYC Identification" pattern="^[1-9]{1}[0-9]{13}" name="textField-text-1598335759991" type="text" maxlength="14" visibility="show"
error="Please enter a valid KYC Number" title="Please enter a valid KYC Number" oninvalid="setCustomValidity('Please enter a valid KYC Number')" onchange="setCustomValidity('')" onkeypress="return AllowNumberOnly(event);"
tabindex="29">
</div>
</div>
</div>
<!-- <div class="" style="display: none;">
<p class="font padbot">Aadhaar Number</p>
<ul class="padno">
<li class="list-radio-1">
<div class="cA-DD-inputBox" id="div_others_av" style="">
<div class="cA-DD-inputContent">
<input
type="text"
id="others_av"
name=""
maxlength="12"
onkeypress="return AllowNumberOnly(event);"
onfocus="if(this.value=='Aadhaar number'){this.value=''}"
value="Aadhaar number"
onblur="if(this.value==''){this.value='Aadhaar number'}"
placeholder="Aadhaar number"
/>
</div>
</div>
<div class="cA-DD-inputBox" id="div_others_enroll" style="display: none;">
<br />
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK top15 aadhar_terms">
<input type="checkbox" tabindex="97" value="yes" name="aadharterms" id="aadharterms" onkeypress="return enter_check(event)" class="" />
<div class="cA-DD-helpText lft30">
<p>I agree to update Aadhaar on my card account within 182 days of card issuance**</p>
</div>
</div>
</div>
</li>
</ul>
</div> -->
</div>
</div>
</div>
<div class="cA-DD-fields" id="phoneSection">
<div class="cA-DD-content">
<h3 class="cA-DD-sectionTitle">PROFESSIONAL DETAILS</h3>
<div aria-hidden="true" class="cA-DD-fieldSummary summarycolor3">Tell us where you work</div>
<div class="cA-DD-inputCollection PanExhide professional_det_first CA-DD-inputbordershadow">
<!-- <select class="dropsuffix1" tabindex="36" id="Profession_val" name="Profession" onkeypress="return enter_check(event)">
<option value="">*Profession</option>
<option value="Salaried">Salaried</option>
<option value="Self-employed">Self-employed</option>
<option value="Retired">Retired</option>
<option value="Housewife">Housewife</option>
</select> -->
<span class="select-wrapper1"><select class="txtfield dropsuffix1 Profession_val" position="above" id="Profession" type="select" visibility="show" error="Please select your Profession" title="Please select your Profession"
oninvalid="setCustomValidity('Please select your Profession')" onchange="setCustomValidity('')" name="dropdown-select-1598336812496" onkeypress="return enter_check(event)" tabindex="30">
<option value="">*Profession</option>
<option value="Salaried">Salaried</option>
<option value="Self-employed">Self-employed</option>
<option value="Retired">Retired</option>
<option value="Housewife">Housewife</option>
</select><span class="holder">*Profession</span></span>
</div>
<div class="cA-DD-inputCollection PanExhide professional_det">
<div class="cA-DD-inputBox cA-DD-medium ANNUAL_INCOME cA-DD-responsiveTooltip">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent CA-DD-inputbordershadow CA-DD-inputtop Ca-dd-inputtop">
<label></label>
<!-- <input
type="text"
tabindex="37"
placeholder="*Company Name"
onfocus="if(this.value=='*Company Name'){this.value=''} "
onblur="if(this.value==''){this.value='*Company Name'}"
value="*Company Name"
maxlength="80"
name="companyname"
id="office_Name"
/> -->
<input class="txtfield office_Name" position="above" id="companyname" placeholder="*Company Name" name="textField-text-1598336827172" type="text" maxlength="80" visibility="show" error="Please enter the Company Name"
title="Please enter the Company Name" oninvalid="setCustomValidity('Please enter the Company Name')" onchange="setCustomValidity('')" tabindex="31">
</div>
<input id="company_code" name="company_code" type="hidden">
<div id="ajax_loading" style="display: none;">
<img src="/portal/newgen/cards/tab/images/ajax-loader.gif" alt="" title="" style="width: 20px; border: 0;">
</div>
<ul class="companyFilter" id="cfilter">
<span class="result"></span>
</ul>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-inputCollection PanExhide professional_det CA-DD-inputbordershadow" id="designation_value">
<!-- <select class="dropsuffix1" tabindex="38" id="Designation_val" onkeypress="return enter_check(event)">
<option selected="selected" value="">*Designation</option>
<option value="Accountant">Accountant</option>
<option value="Consultant">Consultant</option>
<option value="Engineer">Engineer</option>
<option value="Executive or Officer">Executive/ Officer</option>
<option value="Assistant Manager or Manager">Assistant Manager/ Manager</option>
<option value="AVP or AGM">AVP/ AGM</option>
<option value="VP or GM">VP/ GM</option>
<option value="Contract employee">Contract employee</option>
<option value="Director or CXO">Director/ CXO</option>
<option value="Teacher or Professor">Teacher/ Professor</option>
<option value="Doctor">Doctor</option>
<option value="CA or CS">CA/ CS</option>
<option value="Lawyer">Lawyer</option>
<option value="Architect">Architect</option>
<option value="Real Estate Broker">Real Estate Broker</option>
<option value="Wellness Expert">Wellness Expert</option>
<option value="Artist or Designer">Artist/ Designer</option>
<option value="Others">Others</option>
</select> -->
<span class="select-wrapper1"><select class="txtfield dropsuffix1 Designation_val" position="above" id="designation" type="select" visibility="show" error="Please select your Designation" title="Please select your Designation"
oninvalid="setCustomValidity('Please select your Designation')" onchange="setCustomValidity('')" name="dropdown-select-1598337350154" tabindex="32" onkeypress="return enter_check(event)">
<option class="" value="">*Designation</option>
<option class="selfdesignhide" value="Accountant">Accountant</option>
<option class="selfdesignhide" value="Consultant">Consultant</option>
<option class="selfdesignhide" value="Engineer">Engineer</option>
<option class="selfdesignhide" value="Executive or Officer">Executive/ Officer</option>
<option class="selfdesignhide" value="Assistant Manager or Manager">Assistant Manager/ Manager</option>
<option class="selfdesignhide" value="AVP or AGM">AVP/ AGM</option>
<option class="selfdesignhide" value="VP or GM">VP/ GM</option>
<option class="selfdesignhide" value="Contract employee">Contract employee</option>
<option class="selfdesignhide" value="Director or CXO">Director/ CXO</option>
<option class="selfdesignhide" value="Teacher or Professor">Teacher/ Professor</option>
<option class="selfdesignhide" value="Doctor">Doctor</option>
<option class="selfdesignhide" value="CA or CS">CA/ CS</option>
<option class="selfdesignhide" value="Lawyer">Lawyer</option>
<option class="selfdesignhide" value="Architect">Architect</option>
<option class="selfdesignhide" value="Real Estate Broker">Real Estate Broker</option>
<option class="selfdesignhide" value="Wellness Expert">Wellness Expert</option>
<option class="selfdesignhide" value="Artist or Designer">Artist/ Designer</option>
<option class="otherval" value="Others">Others</option>
<!-- Self_Designation start -->
<option class="selfdesignshow" value="Sole Proprietor">Sole Proprietor</option>
<option class="selfdesignshow" value="Partner">Partner</option>
<option class="selfdesignshow" value="Director">Director</option>
<!-- Self_Designation start end-->
</select><span class="holder">*Designation</span></span>
</div>
<div class="cA-DD-inputCollection professional_det CA-DD-inputbordershadow profess_tbox" style="display: none;">
<span class="select-wrapper1"><select class="dropsuffix1" tabindex="33" id="Self_Designation" onkeypress="return enter_check(event)">
<option selected="selected" value="">*Designation</option>
<option value="Sole Proprietor">Sole Proprietor</option>
<option value="Partner">Partner</option>
<option value="Director">Director</option>
</select><span class="holder">*Designation</span></span>
</div>
<div class="cA-DD-inputCollection rat desgn_othr" style="display: none;">
<div class="cA-DD-inputBox cA-DD-medium ANNUAL_INCOME cA-DD-responsiveTooltip">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent CA-DD-inputbordershadow">
<label></label>
<!-- <input
type="text"
onfocus="if(this.value=='*Other Designation'){this.value=''} "
onblur="if(this.value==''){this.value='*Other Designation'}"
value="*Other Designation"
maxlength="50"
name="designation"
id="Oth_Designation"
onkeypress="return AlphaSplcharCheck(event);"
/> -->
<input class="txtfield" position="above" id="Oth_Designation" placeholder="*Other Designation" pattern="^(?!\s*$)[a-zA-Z0-9\s]{1,50}$" name="textField-text-1598337353574" type="text" maxlength="50" visibility="show"
error="Please do not use any special characters (such as % & #). Please use alphabets and numbers only." title="Please do not use any special characters (such as % & #). Please use alphabets and numbers only."
oninvalid="setCustomValidity('Please do not use any special characters (such as % & #). Please use alphabets and numbers only.')" onchange="setCustomValidity('')" onkeypress="return AlphaSplcharCheck(event);" tabindex="34">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-inputCollection padtop12 PanExshow">
<div class="cA-DD-inputBox cA-DD-medium anualwidth ANNUAL_INCOME cA-DD-responsiveTooltip">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent anualinnerwidth CA-DD-inputbordershadow" id="incomeval">
<label></label>
<input class="txtfield toogleincome annual_income" position="above" id="gross_annual_income" placeholder="*Gross Annual Income" pattern="^[1-9]{5,21}" name="textField-text-1598337356428" type="text" maxlength="21" visibility="show"
error="Please enter your Gross Annual Income" title="Please enter your Gross Annual Income" oninvalid="setCustomValidity('Please enter your Gross Annual Income')" onchange="setCustomValidity('');" onkeyup="comma_seperate(event);"
tabindex="35">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium cA-DD-responsiveTooltip">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent CA-DD-inputbordershadow">
<label></label>
<!-- <input
type="tel"
tabindex="35"
placeholder="Gross Monthly Income"
onfocus="if(this.value=='Gross Monthly Income'){this.value=''} "
onblur="if(this.value==''){this.value='Gross Monthly Income'}"
value="Gross Monthly Income"
readonly
maxlength="11"
name="monthly_income"
id="monthly_income"
disabled="disabled"
onkeypress="return enter_check(event)"
/>
-->
<input class="txtfield monthly_income" position="above" id="monthly_income" placeholder="Gross Monthly Income" name="textField-text-1598338633851" type="tel" maxlength="11" visibility="show" disabled="disabled"
onkeypress="return enter_check(event)" readonly="">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium PanExhide OTHER_INCOME" style="">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent CA-DD-inputbordershadow">
<label></label>
<!-- <input
type="email"
tabindex="35"
placeholder="Corporate Email Id"
onfocus="if(this.value=='Corporate Email Id'){this.value=''} "
onblur="if(this.value==''){this.value='Corporate Email Id'}"
value="Corporate Email Id"
name="prof_email"
id="prof_emailid"
onkeypress="return enter_check(event)"
/> -->
<input class="txtfield" position="above" id="prof_email" name="email-email-1598507947560" pattern="^([a-zA-Z0-9_\-\.]+)@([a-zA-Z0-9\-]+)\.(([a-zA-Z]{2,})|([a-zA-Z]{2,}\.[a-zA-Z]{2,})|([a-zA-Z]{2,}\.[a-zA-Z]{2,}\.[a-zA-Z]{2,}))$"
placeholder="Corporate Email Id" type="email" visibility="show" error="Please enter a valid E-mail Id" title="Please enter a valid E-mail Id" oninvalid="setCustomValidity('Please enter a valid E-mail Id')"
onchange="setCustomValidity('')" tabindex="36">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK cA-DD-validField selfempshw" style="display: none;">
<!-- <input type="checkbox" value="yes" name="auth_annual_income" id="auth_annual_income" onkeypress="return enter_check(event)" /> -->
<input type="checkbox" class="radiobttn" id="auth_annual_income" position="" name="checkbox-checkbox-1598338647747" value="Yes" visibility="show" error="Please select" title="Please select" oninvalid="setCustomValidity('Please select')"
onclick="setCustomValidity('')" onkeypress="return enter_check(event)" tabindex="37">
<div class="cA-DD-helpText auth_annual">
<p>I confirm the annual income entered above is it appears in my latest ITR.</p>
</div>
<div class="formErrorMsg2"></div>
</div>
</div>
</div>
</div>
<div class="cA-DD-fields address" id="addressSection">
<div class="cA-DD-content">
<h3 class="cA-DD-sectionTitle">
<div class="addr_sec">Address <!--<span class="more_info">
<div class="popup1 popupR4" data-close="false" style="display: none;">
<p class="talign">Please fill the below address field of your address.</p>
</div>
</span>-->
</div>
</h3>
<div aria-hidden="true" class="cA-DD-fieldSummary summarycolor4">Tell us where you live</div>
<div class="cA-DD-inputCollection" id="Permanent">
<p class="address-note">Note: Only A-Z a-z 0-9 .,-_ characters are allowed</p>
<p class="fontpadl"> Residence Address (I will be available at this address to submit my KYC documents): <span style="display: none;" class="map-icon" id="resAdd">Locate Me <img src="/portal/newgen/cards/tab/images/map-icon.png"
alt="Get Location" title="Get Location"></span>
<span class="map-icon pointer" id="reset">Reset</span>
</p>
<div class="hideLocate">
<div class="cA-DD-alignment">
<div class="cA-DD-inputBox cA-DD-large ADDRESS_LINE1 cA-DD-responsiveTooltip top5">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent residence_house resisdpage1 text-new">
<label></label>
<!-- <input
type="text"
value="*Flat / House no"
placeholder="*Flat / House no"
tabindex="43"
onblur="if(this.value==''){this.value='*Flat / House no'}"
onfocus="if(this.value=='*Flat / House no'){this.value=''} "
maxlength="10"
name="resi_doorno"
id="Per_Door_house"
onkeypress="return enter_check(event)"
/> -->
<input class="txtfield Per_Door_house" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" position="above" id="resi_doorno" placeholder="*Flat / House no" name="textField-text-1598339234411" type="text" maxlength="50" visibility="show"
error="Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="38" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
value="*Street and road name"
placeholder="*Street and road name"
tabindex="44"
onblur="if(this.value==''){this.value='*Street and road name'}"
onfocus="if(this.value=='*Street and road name'){this.value=''} "
maxlength="50"
name="resi_street_name"
id="Per_streetnam"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Per_streetnam" position="above" id="resi_street_name" placeholder="*Street and road name" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598340536117" type="text" maxlength="50"
visibility="show" error="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="39" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
value="*Area / locality"
placeholder="*Area / locality"
tabindex="45"
onblur="if(this.value==''){this.value='*Area / locality'}"
onfocus="if(this.value=='*Area / locality'){this.value=''} "
maxlength="50"
name="resi_area_locality"
id="Per_arealocal"
onkeypress="return AllowAlphabetOnly(event)"
/> -->
<input class="txtfield Per_arealocal" position="above" id="resi_area_locality" placeholder="*Area / locality" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598340544137" type="text" maxlength="50"
visibility="show" error="Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="40" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY top5 perlandmark">
<div class="cA-DD-inputContent revise_new">
<label></label>
<!-- <input
type="text"
value="Landmark (if any)"
placeholder="Landmark (if any)"
tabindex="46"
onblur="if(this.value==''){this.value='Landmark (if any)'}"
onfocus="if(this.value=='Landmark (if any)'){this.value=''} "
maxlength="30"
name="resi_landmark"
id="Per_landmark"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Per_landmark" position="above" id="resi_landmark" placeholder="Landmark (if any)" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,30}$" name="textField-text-1598342141723" type="text" maxlength="30" visibility="show"
error="Only A-Z a-z 0-9 .,-_ characters are allowed." title="Only A-Z a-z 0-9 .,-_ characters are allowed." oninvalid="setCustomValidity('Only A-Z a-z 0-9 .,-_ characters are allowed')" onchange="setCustomValidity('')" tabindex="41"
onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-alignment">
<div class="">
<div class="cA-DD-inputBox cA-DD-small ZIP top0">
<div class="cA-DD-inputContent resis_new1 autooincode Ca-dd-inputtop pinmobilewid">
<label></label>
<!-- <input
type="tel"
value="*Pincode"
placeholder="*Pincode"
tabindex="48"
onblur="if(this.value==''){this.value='*Pincode'} "
onfocus="if(this.value=='*Pincode'){this.value=''}"
maxlength="6"
name="resi_pincode"
id="Per_Pincode_num"
onkeypress="return AllowNumberOnly(event);"
class="autooincodelabel"
/> -->
<input class="txtfield Per_Pincode_num autooincodelabel numOnly" position="above" id="resi_pincode" placeholder="*Pincode" pattern="^[1-9][0-9]{5}$" name="textField-text-1598342160237" type="tel" maxlength="6" visibility="show"
error="Please enter your Residence Pin Code" title="Please enter your Residence Pin Code." oninvalid="setCustomValidity('Please enter your Residence Pin Code')" onchange="setCustomValidity('')" tabindex="42">
<div id="ajax_loading2" style="display: none;">
<img src="/portal/newgen/cards/tab/images/ajax-loader.gif" alt="" title="" style="width: 20px; border: 0;">
</div>
<ul class="pincodelist" id="pincodefilter">
<span class="result1"></span>
</ul>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY officeExhide ip_hide top5 rght0">
<div class="ofchideLocate revise_new bckzero">
<!-- <input
type="text"
class="dropsuffix pro1 rescitiaddress"
tabindex="47"
id="Per_citiselection"
maxlength="50"
name="resi_city"
onkeypress="return AlphaApos(event);"
onblur="if(this.value==''){this.value='*City'}"
onfocus="if(this.value=='*City'){this.value=''}"
value="*City"
readonly
/> -->
<span class="select-wrapper"><input class="txtfield dropsuffix pro1 rescitiaddress Per_citiselection" position="above" id="resi_city" placeholder="*City" name="textField-text-1598342168615" type="text" visibility="show"
onkeypress="return AlphaApos(event);" tabindex="43" maxlength="50" readonly=""><span class="holder"></span></span>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField top5" style="display: none;">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent residance_std Ca-dd-inputtop widDesk top5">
<label></label>
<input type="tel" value="std code" placeholder="std code" tabindex="44" onfocus="if(this.value=='std code'){this.value=''} " maxlength="4" name="" id="Per_std_num" onkeypress="return AllowNumberOnly(event);" style="display: none;">
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField top5 landlinetap" style="display: none;">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent revise_new Ca-dd-inputtop">
<label></label>
<input type="tel" value="Landline number" placeholder="Landline number" tabindex="45" onfocus="if(this.value=='Landline number'){this.value=''}" maxlength="8" name="" id="Per_Pnone_num" onkeypress="return AllowNumberOnly(event);"
style="display: none;">
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div>
</div>
<div class="address-proof-container">
<div class="address-first">
<div class="address-label">
<label class="poa">Proof of Address*</label>
</div>
<div class="fsstyle">
<!-- <input type="radio" name="proofofaddress" id="same_addr_number" value="available" tabindex="68" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn same_addr_number" id="proofofaddress" name="radioButton-radio-group-1598343874055" label="Available" value="Available" visibility="show" onclick="customRadioBtnValidity('proofofaddress')"
error="Please select one option" oninvalid="setCustomValidity('Please select one option')" tabindex="46" onkeypress="return enter_check(event)">
<span class="paddng10">Available</span>
<!-- <input type="radio" name="proofofaddress" value="notavailable" id="same_addr_yes" tabindex="69" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn same_addr_yes" id="proofofaddress" name="radioButton-radio-group-1598343874055" label="Not Available" value="Not Available" visibility="show" onclick="customRadioBtnValidity('proofofaddress')"
tabindex="47" onkeypress="return enter_check(event)">
<span class="paddng10">Not Available</span>
<p>You will need to submit address proof document which matches exactly with either your current residence or permanent address.</p>
</div>
<p class="resaddressblock" style="display: none;">Please fill in your residence address which matches exactly with the address proof you would be required to submit.</p>
</div>
</div>
</div>
<div class="perblock" style="display: none;">
<div class="cA-DD-inputCollection" id="Residence1">
<p class="fontpadl pad10">Permanent Address:</p>
<div class="hideSec">
<div id="resAddr" class="cA-DD-inputBox fullAddress" style="display: none;">
<textarea rows="4" cols="0" type="text" name="fullAddress" placeholder="*Residential Address" id="fullResAddress" class="" onkeypress="return AlphaNumSplcharCheck(event)" onblur="if(this.value==''){this.value='*Residential Address'}"
onfocus="if(this.value=='*Residential Address'){this.value=''} "></textarea>
</div>
<div class="hideLocate">
<div class="cA-DD-alignment">
<div class="cA-DD-inputBox cA-DD-large ADDRESS_LINE1 cA-DD-responsiveTooltip top5">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent residence_house resisdpage1 text-new">
<label></label>
<!-- <input
type="text"
value="*Door/House no."
placeholder="*Door/House no."
tabindex="18"
onblur="if(this.value==''){this.value='*Door/House no.'}"
onfocus="if(this.value=='*Door/House no.'){this.value=''} "
maxlength="10"
name="per_doorno"
id="Rec_Door_house"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Rec_Door_house" position="above" id="per_doorno" placeholder="*Door/House no." pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598344187385" type="text" maxlength="50"
visibility="show" error="Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Door/House no. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" onkeypress="return AlphaNumSplcharCheck(event)" tabindex="48">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
value="*Street and road name"
placeholder="*Street and road name"
tabindex="19"
onblur="if(this.value==''){this.value='*Street and road name'}"
onfocus="if(this.value=='*Street and road name'){this.value=''} "
maxlength="50"
name="per_street_name"
id="Rec_streetnam"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Rec_streetnam" position="above" id="per_street_name" placeholder="*Street and road name" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598344193396" type="text" maxlength="50"
visibility="show" error="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Street or road name.Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="49" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
value="*Area / locality"
placeholder="*Area / locality"
tabindex="20"
onblur="if(this.value==''){this.value='*Area / locality'}"
onfocus="if(this.value=='*Area / locality'){this.value=''} "
maxlength="50"
name="per_area_locality"
id="Rec_arealocal"
onkeypress="return AllowAlphabetOnly(event)"
/> -->
<input class="txtfield Rec_arealocal" position="above" id="per_area_locality" placeholder="*Area / locality" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598344200197" type="text" maxlength="50"
visibility="show" error="Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Area/Locality.Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Area/Locality.Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="50" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY top5">
<div class="cA-DD-inputContent revise_new">
<label></label>
<!-- <input
type="text"
value="Landmark (if any)"
placeholder="Landmark (if any)"
tabindex="21"
onblur="if(this.value==''){this.value='Landmark (if any)'}"
onfocus="if(this.value=='Landmark (if any)'){this.value=''} "
maxlength="30"
name="per_landmark"
id="Rec_landmark"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Rec_landmark" position="above" id="per_landmark" placeholder="Landmark (if any)" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,30}$" name="textField-text-1598344597357" type="text" maxlength="30" visibility="show"
error="Only A-Z a-z 0-9 .,-_ characters are allowed." title="Only A-Z a-z 0-9 .,-_ characters are allowed." oninvalid="setCustomValidity('Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')"
tabindex="51" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-alignment">
<div class="">
<div class="cA-DD-inputBox cA-DD-small ZIP top0">
<div class="cA-DD-inputContent autooincode resis_new1 Ca-dd-inputtop pinmobilewid">
<label></label>
<!-- <input
type="tel"
value="*Pincode"
placeholder="*Pincode"
tabindex="48"
onblur="if(this.value==''){this.value='*Pincode'}"
onfocus="if(this.value=='*Pincode'){this.value=''} "
maxlength="6"
name="per_pincode"
id="Rec_Pincode_num"
onkeypress="return AllowNumberOnly(event);"
class="autooincodelabel"
/> -->
<input class="txtfield Rec_Pincode_num autooincodelabel numOnly" position="above" id="per_pincode" placeholder="*Pincode" pattern="^[1-9][0-9]{5}$" name="textField-text-1598344848345" type="tel" maxlength="6" visibility="show"
error="Please enter your Residence Pin Code" title="Please enter your Residence Pin Code" oninvalid="setCustomValidity('Please enter your Residence Pin Code')" onchange="setCustomValidity('')" tabindex="52">
<div id="ajax_loading4" style="display: none;">
<img src="/portal/newgen/cards/tab/images/ajax-loader.gif" alt="" title="" style="width: 20px; border: 0;">
</div>
<ul class="pincodelistperm" id="pincodefilterperm">
<span class="result4"></span>
</ul>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY officeExhide ip_hide top5 rght0">
<div class="ofchideLocate revise_new bckzero">
<!-- <input
type="text"
class="dropsuffix pro1 percityaddress"
tabindex="47"
id="Rec_citiselection"
maxlength="50"
name="per_city"
onkeypress="return AlphaApos(event);"
onblur="if(this.value==''){this.value='*City'}"
onfocus="if(this.value=='*City'){this.value=''} "
value="*City"
readonly
/> -->
<span class="select-wrapper"><input class="txtfield dropsuffix pro1 percityaddress Rec_citiselection" position="above" id="per_city" placeholder="*City" name="textField-text-1598344854187" type="text" visibility="show" tabindex="53"
onkeypress="return AlphaApos(event);" readonly=""><span class="holder"></span></span>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField top5">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent residance_std Ca-dd-inputtop widDesk top5">
<label></label>
<!-- <input
type="tel"
value="std code"
placeholder="std code"
tabindex="24"
onblur="if(this.value==''){this.value='std code'}"
onfocus="if(this.value=='std code'){this.value=''} "
maxlength="4"
name="per_std_no"
id="Rec_std_num"
onkeypress="return AllowNumberOnly(event);"
/> -->
<input class="txtfield Rec_std_num numOnly" position="above" id="per_std_no" pattern="^[0]{1}[0-9]{2,3}" name="textField-text-1598345664467" placeholder="std code" type="tel" maxlength="4" visibility="show" tabindex="54">
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField top5">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent revise_new Ca-dd-inputtop">
<label></label>
<!-- <input
type="tel"
value="Landline number"
placeholder="Landline number"
tabindex="25"
onblur="if(this.value==''){this.value='Landline number'}"
onfocus="if(this.value=='Landline number'){this.value=''} "
maxlength="8"
name="per_phone_no"
id="Rec_Pnone_num"
onkeypress="return AllowNumberOnly(event);"
/> -->
<input class="txtfield Rec_Pnone_num numOnly" position="above" id="per_phone_no" pattern="^[1-9][0-9]{7}" name="textField-text-1598345670389" placeholder="Landline number" type="tel" maxlength="8" visibility="show" tabindex="55">
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div>
</div>
</div>
</div>
<div class="cA-DD-inputCollection">
<p class="officeExhide pad10">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.</p>
<p class="fontpadl"> Office: <span style="display: none;" class="map-icon" id="officeAdd">Locate Me <img src="/portal/newgen/cards/tab/images/map-icon.png" alt="Get Location" title="Get Location"></span>
<span id="resetNew" class="map-icon pointer">Reset</span>
</p>
<div id="ofcAddr" class="cA-DD-inputBox fullAddress" style="display: none;">
<textarea rows="4" cols="0" type="text" name="fullOfcAddress" id="fullOfcAddress" placeholder="*Office Address" class="" onkeypress="return AlphaNumSplcharCheck(event)" onblur="if(this.value==''){this.value='*Office Address'}"
onfocus="if(this.value=='*Office Address'){this.value=''}"></textarea>
</div>
<div class="ofchideLocate">
<div class="cA-DD-alignment officeExhide">
<div class="cA-DD-inputBox cA-DD-large ADDRESS_LINE1 cA-DD-responsiveTooltip top5">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent resisdpage1 text-new">
<label></label>
<!-- <input
type="text"
maxlength="50"
tabindex="26"
placeholder="*Bldg name/no./dept."
onfocus="if(this.value=='*Bldg name/no./dept.'){this.value=''}"
onblur="if(this.value==''){this.value='*Bldg name/no./dept.'}"
value="*Bldg name/no./dept."
name="offi_doorno"
id="Door_house"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield Door_house" position="above" id="offi_doorno" placeholder="*Bldg name/no./dept." pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598347889431" type="text" maxlength="50" visibility="show"
error="Please enter a valid Building Name no. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter a valid Building Name no.Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter a valid Building Name no.Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="56" onkeypress="return AlphaNumSplcharCheck(event)" required="">
</div>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
maxlength="50"
tabindex="27"
placeholder="*Street and road name"
onfocus="if(this.value=='*Street and road name'){this.value=''} "
onblur="if(this.value==''){this.value='*Street and road name'} "
value="*Street and road name"
name="offi_street_name"
id="streetnam"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield streetnam" position="above" id="offi_street_name" placeholder="*Street and road name" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598347897425" type="text" maxlength="50"
visibility="show" error="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Street or road name. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="57" onkeypress="return AlphaNumSplcharCheck(event)" required="">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-small ADDRESS_LINE2 officeExhide top5">
<div class="cA-DD-inputContent">
<label></label>
<!-- <input
type="text"
maxlength="50"
tabindex="28"
placeholder="*Area / locality"
onfocus="if(this.value=='*Area / locality'){this.value=''} "
onblur="if(this.value==''){this.value='*Area / locality'}"
value="*Area / locality"
name="offi_area_locality"
id="arealocal"
onkeypress="return AllowAlphabetOnly(event)"
/> -->
<input class="txtfield arealocal" position="above" id="offi_area_locality" placeholder="*Area / locality" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,50}$" name="textField-text-1598347906149" type="text" maxlength="50" visibility="show"
error="Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed." title="Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed."
oninvalid="setCustomValidity('Please enter your Area/Locality. Only A-Z a-z 0-9 .,-_ characters are allowed.')" onchange="setCustomValidity('')" tabindex="58" onkeypress="return AlphaNumSplcharCheck(event)" required="">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY officeExhide top5 rght0">
<div class="cA-DD-inputContent revise_new">
<label></label>
<!-- <input
type="text"
maxlength="30"
tabindex="29"
placeholder="Landmark (if any)"
onfocus="if(this.value=='Landmark (if any)'){this.value=''} "
onblur="if(this.value==''){this.value='Landmark (if any)'}"
value="Landmark (if any)"
name="offilandmark"
id="landmark"
onkeypress="return AlphaNumSplcharCheck(event)"
/> -->
<input class="txtfield landmark" position="above" id="offilandmark" placeholder="Landmark (if any)" pattern="^(?!\s*$)[a-zA-Z0-9\s@@(.,-_)]{1,30}$" name="textField-text-1598347914453" type="text" maxlength="30" visibility="show"
error="Only alphabets and numbers are allowed.Only A-Z a-z 0-9 .,-_ characters are allowed." title="Only alphabets and numbers are allowed" oninvalid="setCustomValidity('Only alphabets and numbers are allowed')"
onchange="setCustomValidity('')" tabindex="59" onkeypress="return AlphaNumSplcharCheck(event)">
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
<div class="cA-DD-alignment">
<div class="">
<div class="cA-DD-inputBox cA-DD-small ZIP officeExhide Ca-dd-inputtop top0">
<div class="cA-DD-inputContent resis_new1 autooincode pinmobilewid">
<label></label>
<!-- <input
type="tel"
maxlength="6"
tabindex="56"
placeholder="*Pincode"
onfocus="if(this.value=='*Pincode'){this.value=''}"
onblur="if(this.value==''){this.value='*Pincode'}"
value="*Pincode"
name="offi_pincode"
id="Pincode_num"
onkeypress="return AllowNumberOnly(event);"
class="autooincodelabel"
/> -->
<input class="txtfield Pincode_num autooincodelabel numOnly" position="above" id="offi_pincode" placeholder="*Pincode" pattern="^[1-9][0-9]{5}$" name="textField-text-1598347926445" type="tel" maxlength="6" visibility="show"
error="Please enter your Office Pin Code" title="Please enter your Office Pin Code" oninvalid="setCustomValidity('Please enter your Office Pin Code')" onchange="setCustomValidity('')" tabindex="60" required="">
<div id="ajax_loading3" style="display: none;">
<img src="/portal/newgen/cards/tab/images/ajax-loader.gif" alt="" title="" style="width: 20px; border: 0;">
</div>
<ul class="pincodelistoffi" id="pincodefilteroffi">
<span class="resultoff"></span>
</ul>
</div>
<div class="cA-DD-formErrorMsg"></div>
</div>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-medium CITY officeExhide ip_hide margzero">
<div class="ofchideLocate bckzero">
<!-- <input
type="text"
name="offi_city"
class="dropsuffix officeExhide"
id="citiselection"
maxlength="50"
onkeypress="return AlphaApos(event);"
placeholder="*City"
tabindex="55"
onfocus="if(this.value=='*City'){this.value=''}"
onblur="if(this.value==''){this.value='*City'}"
value="*City"
readonly
/> -->
<span class="select-wrapper"><input class="txtfield dropsuffix officeExhide citiselection" position="above" id="offi_city" placeholder="*City" name="textField-text-1598347935007" type="text" visibility="show" maxlength="50"
tabindex="61" onkeypress="return AlphaApos(event);" readonly=""><span class="holder"></span></span>
</div>
</div>
<!-- <div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField officeExshow top0" style="display: none;">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent office_std Ca-dd-inputtop widDesk top5">
<label></label>
<input
type="tel"
maxlength="4"
placeholder="*std code"
tabindex="31"
onfocus="if(this.value=='*std code'){this.value=''} "
onblur="if(this.value==''){this.value='*std code'}"
value="*std code"
name=""
id="std_num"
onkeypress="return AllowNumberOnly(event);"
/>
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div> -->
<!-- <div class="cA-DD-inputBox cA-DD-medium HOME_PHONE cA-DD-responsiveTooltip cA-DD-validField officeExshow top0 landlinetap" style="display: none;">
<div class="cA-DD-nonErrorContent">
<div class="cA-DD-inputContent revise_new Ca-dd-inputtop">
<label></label>
<input
type="tel"
maxlength="8"
tabindex="32"
placeholder="*Landline number"
onfocus="if(this.value=='*Landline number'){this.value=''} "
onblur="if(this.value==''){this.value='*Landline number'}"
value=""
name=""
id="Pnone_num"
onkeypress="return AllowNumberOnly(event);"
/>
</div>
</div>
<div class="cA-DD-formErrorMsg" role="alert" aria-live="assertive" aria-label="Telephone Number"></div>
</div> -->
</div>
</div>
</div>
</div>
<div id="agreeSection" class="agreeSection-1">
<div class="cA-DD-content">
<div id="formbar2">
<ul>
<li class="list-radio-1">
<p class="font1">*Preferred mailing address:</p>
<p class="font1 agreechecks">
<!-- <input type="radio" tabindex="39" name="mailing_addr" value="Office" id="Officeid" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Officeid" id="mailing_addr" name="radioButton-radio-group-1598348782413" label="Office" value="Office" required="true" visibility="show" onclick="customRadioBtnValidity('mailing_addr')"
error="Please select your Preferred Mailing Address" oninvalid="setCustomValidity('Please select your Preferred Mailing Address')" tabindex="62" onkeypress="return enter_check(event)">
<label>Office</label>
<!-- <input type="radio" tabindex="40" name="mailing_addr" value="Residence" id="Residenceid" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Residenceid" id="mailing_addr" name="radioButton-radio-group-1598348782413" label="Residence" value="Residence" required="true" visibility="show" onclick="customRadioBtnValidity('mailing_addr')"
tabindex="63" onkeypress="return enter_check(event)">
<label>Residence </label>
</p>
</li>
</ul>
</div>
<!-- <div class="suvidha_acc_orig">
<ul>
<li class="list-radio-1">
<p class="font1">Would you like to apply for Zero balance salary account?</p>
<p class="font1 agreechecks">
<input type="radio" class="radiobttn suvi_con" id="Suvidha_opt" name="radioButton-radio-group-1610529273447" label="Yes" value="Yes" visibility="show" onclick="customRadioBtnValidity('Suvidha_opt')"/>
<label>Yes</label>
<input type="radio" class="radiobttn suvi_con" id="Suvidha_opt" name="radioButton-radio-group-1610529273447" checked="true" label="No" value="No" visibility="show" onclick="customRadioBtnValidity('Suvidha_opt')"/>
<label>No</label>
</p>
</li>
</ul>
</div>-->
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK cA-DD-validField">
<!-- <input type="checkbox" tabindex="41" value="yes" name="auth_tnc" id="auth_tnc" /> -->
<span class="agreechecks">
<input type="checkbox" class="radiobttn" id="auth_tnc" position="" name="checkbox-checkbox-1598350559753" value="Yes" required="true" visibility="show" error="Please accept the Authorisation Statement and Terms & Conditions."
title="Please accept the Authorisation Statement and Terms & Conditions." oninvalid="setCustomValidity('Please accept the Authorisation Statement and Terms & Conditions.')" onclick="setCustomValidity('')" tabindex="64">
</span>
<div class="cA-DD-helpText">
<p> *I have read & fully accepted the <a target="_blank" title="Authorization Statement" href="https://www.online.citibank.co.in/portal/newgen/cards/tab/creditcards_tc.htm?eOfferCode=INCCUCRCADSTC">Authorization Statement</a>,
<a target="_blank" title="Know Your Credit Card" href="https://www.online.citibank.co.in/portal/newgen/cards/tab/Know-your-card.pdf">Know Your Credit Card</a>,
<a target="_blank" title="Card Member Terms and conditions" href="https://www.online.citibank.co.in/portal/newgen/cards/cardmember.pdf">Card Member Terms and conditions</a> and <a target="_blank" title="Most Important Terms and conditions" href="https://www.online.citibank.co.in/portal/newgen/cards/tab/creditcards_tc.htm#termsmitc">
Most Important Terms and conditions
</a> and consent to receiving information from Central KYC Registry through SMS/Email. </p>
</div>
<div class="formErrorMsg"></div>
</div>
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK cA-DD-validField">
<!-- <input type="checkbox" tabindex="43" value="yes" name="marketing_offers" id="auth_tnc3" /> -->
<span class="agreechecks">
<input type="checkbox" class="radiobttn auth_tnc3" id="marketing_offers" position="" name="checkbox-checkbox-1598350567531" value="Yes" visibility="show" tabindex="43">
</span>
<div class="cA-DD-helpText">
<p>I authorize Citibank and/or its associates/subsidiaries/affiliates to contact me for its offers and products. This consent will override any registration for DNC/NDNC.</p>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK cA-DD-validField">
<!-- <input type="checkbox" tabindex="43" value="yes" name="marketing_offers" id="auth_tnc3" /> -->
<span class="agreechecks">
<input type="checkbox" class="radiobttn auth_tnc3" id="axisbank_consent" position="" name="checkbox-checkbox-1658741293458" value="Yes" required="true" visibility="show" error="Please click on the checkbox to continue"
title="Please click on the checkbox to continue" oninvalid="setCustomValidity('Please click on the checkbox to continue')" onclick="setCustomValidity('')" tabindex="44">
</span>
<div class="cA-DD-helpText">
<p>*Before completing this application, we would like to inform you that Citi has entered into an agreement with Axis Bank for the sale of its consumer banking businesses in India. The sale is conditional upon receipt of necessary
regulatory approvals including the approval of the Competition Commission of India.<br> On consummation of the sale subject to receipt of regulatory approvals, your banking relationship with Citi will be migrated to Axis Bank.
Accordingly, Citi hereby seeks your consent for: (a) the transfer of this product being applied for and also on any other product (which requires consent for transfer) that you currently hold or may hold with Citi; (b) the transfer and
disclosure of all your data and information provided to and available with Citi and (c) transfer of your tax documents/declaration provided to and available with Citi to Axis Bank (as permitted by applicable regulations), in each case in
connection with the consummation of the aforesaid sale and use thereof by Axis Bank for continued offering of banking services, including for the purpose of any KYC related compliance.<br> When you consent to transfer the relationship,
there will be no immediate impact on this product being applied for or on the existing products that you may hold with Citi, be it credit cards, loans, deposits, investments, or any others and the same will transfer to Axis Bank on the
same terms and conditions*. <br> If you provide consent to transfer the relationship, your consent will come into effect on and from the date on which the credit card is issued by Citi.<br> *For more details and FAQs, please visit:
<a href="https://citi.asia/consenttnc" target="_blank">https://citi.asia/consenttnc.</a><br> Please click on the checkbox to record your consent for the same.</p>
</div>
</div>
<div class="cA-DD-inputBox cA-DD-checkBox TERMS_CHECK cA-DD-validField EXcustomer" style="display: none;">
<!-- <input type="checkbox" tabindex="44" value="yes" name="suviStanding" id="suviStanding" onkeypress="return enter_check(event)" /> -->
<span class="agreechecks">
<input type="checkbox" class="radiobttn suviStanding" id="suviStanding" position="" name="checkbox-checkbox-1598353113956" value="Yes" visibility="show"
error="Do you agree for placing a standing instruction to debit your bank account against the card outstanding?" title="Do you agree for placing a standing instruction to debit your bank account against the card outstanding?"
oninvalid="setCustomValidity('Do you agree for placing a standing instruction to debit your bank account against the card outstanding?')" onclick="setCustomValidity('')" tabindex="65" onkeypress="return enter_check(event)"
required="true">
</span>
<div class="cA-DD-helpText">
<p>*I agree for placing a standing instruction to debit my bank account against the card outstanding.</p>
</div>
<div class="formErrorMsg1"></div>
</div>
<div class="EXcustomer" style="display: none;">
<p class="fntsze agreechecks">
<span class="checkbox-label-box">*Standing Instruction Mode: </span>
<span class="checkbox-field-box">
<!-- <input type="radio" tabindex="45" name="SImode" id="TotAmt" value="Total Amount Due" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn TotAmt" id="Simode" name="radioButton-radio-group-1598353123484" label="Total Amount Due" value="Total Amount Due" visibility="show" onclick="customRadioBtnValidity('Simode')"
error="Please select your Standing Instruction Mode" oninvalid="setCustomValidity('Please select your Standing Instruction Mode')" tabindex="66" required="true">
<label>Total Amount Due</label>
<!-- <input type="radio" tabindex="46" name="SImode" id="MinAmt" value="Minimum Amount Due" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn MinAmt" id="Simode" name="radioButton-radio-group-1598353123484" label="Minimum Amount Due" value="Minimum Amount Due" visibility="show" onclick="customRadioBtnValidity('Simode')" tabindex="67"
required="true">
<label>Minimum Amount Due</label>
</span>
</p>
</div>
<div>
<p class="fntsze agreechecks">
<span class="checkbox-label-box">*Are you a director/senior officer of Citibank and/or their Relative AND / OR director of other banks and/or their Relative? </span>
<span class="checkbox-field-box disblocksp">
<!-- <input type="radio" tabindex="47" name="director" value="Yes" id="Relative_yes" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Relative_yes" id="director" name="radioButton-radio-group-1598350961287" label="Yes" value="Yes" visibility="show" onclick="customRadioBtnValidity('director')" tabindex="68"
onkeypress="return enter_check(event)">
<label>Yes</label>
<!-- <input type="radio" tabindex="48" name="director" value="No" id="Relative_no" checked onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn Relative_no" id="director" name="radioButton-radio-group-1598350961287" label="No" value="No" visibility="show" onclick="customRadioBtnValidity('director')" tabindex="69" checked=""
onkeypress="return enter_check(event)">
<label>No</label>
<span class="tick"></span>
</span>
</p>
</div>
<div class="Director_relative agreechecks" style="display: none;">
<div class="cA-DD-inputBox cA-DD-large cA-DD-validField">
<p class="fontfont1">*Name of the Director of Citibank NA or other bank / Senior Officer of Citibank NA</p>
<div class="cA-DD-inputContent">
<!-- <input type="text" name="directorName" id="NamofDirect" maxlength="50" onkeypress="return AllowAlphabetOnly(event)" /> -->
<input class="txtfield NamofDirect" position="above" id="directorName" pattern="^(?!\s*$)[a-zA-Z\s]{1,50}$" name="textField-text-1598351937749" type="text" maxlength="50" visibility="show"
error="Please enter the Name of the Director of Citibank NA or other bank / Senior Officer of Citibank NA" title="Please enter the Name of the Director of Citibank NA or other bank / Senior Officer of Citibank NA"
oninvalid="setCustomValidity('Please enter the Name of the Director of Citibank NA or other bank / Senior Officer of Citibank NA')" onchange="setCustomValidity('')" onkeypress="return AllowAlphabetOnly(event)" tabindex="70">
</div>
</div>
<div class="cA-DD-inputBox cA-DD-large cA-DD-validField">
<p class="fontfont1">*Name of the other bank / Position with other bank</p>
<div class="cA-DD-inputContent">
<!-- <input type="text" name="otherBank" id="NamofOtherBank" maxlength="50" onkeypress="return AllowAlphabetOnly(event)" /> -->
<input class="txtfield NamofOtherBank" position="above" id="otherBank" pattern="^(?!\s*$)[a-zA-Z\s]{1,50}$" name="textField-text-1598351947603" type="text" maxlength="50" visibility="show"
error="Please enter the Name of the other bank / Position with other bank" title="Please enter the Name of the other bank / Position with other bank"
oninvalid="setCustomValidity('Please enter the Name of the other bank / Position with other bank')" onchange="setCustomValidity('')" onkeypress="return AllowAlphabetOnly(event)" tabindex="71">
</div>
</div>
<div class="cA-DD-inputBox cA-DD-large cA-DD-validField fullwidth">
<p class="fontfont1">*Relationship</p>
<div class="cA-DD-inputContent">
<!-- <input type="text" name="relationship" id="Relationship" maxlength="50" onkeypress="return AllowAlphabetOnly(event)" /> -->
<input class="txtfield Relationship" position="above" id="relationship" pattern="^(?!\s*$)[a-zA-Z\s]{1,50}$" name="textField-text-1598351954654" type="text" maxlength="50" visibility="show" error="Please enter the Relationship"
title="Please enter the Relationship" oninvalid="setCustomValidity('Please enter the Relationship')" onchange="setCustomValidity('')" onkeypress="return AllowAlphabetOnly(event)" tabindex="72">
</div>
</div>
</div>
<div>
<p class="fntsze"><a title="Click here" id="directorPopup" href="javascript:;">Click here</a> for more details on the definition of such positions.</p>
</div>
<div>
<p class="fntsze agreechecks">
<span class="checkbox-label-box"> *Do you or your immediate family member/joint account holder or their immediate family members currently hold/have held/are being considered for a position as a
<a title="senior public figure" id="directorPopupnw" href="javascript:;">senior public figure</a>? </span>
<span class="checkbox-field-box disblocksp">
<!-- <input type="radio" tabindex="47" name="SPFDEC" value="Yes" id="SPFDEC_yes" onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn SPFDEC_yes" id="SPFDEC" name="radioButton-radio-group-1598352614202" label="Yes" value="Yes" required="true" visibility="show" onclick="customRadioBtnValidity('SPFDEC')" tabindex="47"
onkeypress="return enter_check(event)">
<label>Yes</label>
<!-- <input type="radio" tabindex="48" name="SPFDEC" value="No" id="SPFDEC_no" checked onkeypress="return enter_check(event)" /> -->
<input type="radio" class="radiobttn SPFDEC_no" id="SPFDEC" name="radioButton-radio-group-1598352614202" label="No" value="No" required="true" visibility="show" onclick="customRadioBtnValidity('SPFDEC')" tabindex="48" checked=""
onkeypress="return enter_check(event)">
<label>No</label>
<span class="tick"></span>
</span>
</p>
<p class="fntsze">Please note that all credit cards comes enabled for Domestic point of sale and ATM transactions by default. Per RBI guidelines*, online, international and contactless usage will be blocked at the time of issuance. Usage can
be instantly enabled via Citibank Online or the Citi Mobile App.</p>
<p class="fntsze">*RBI/2019-20/142 dated 15th January, 2020.</p>
</div>
<div class="SPF_DEC agreechecks" style="display: none;">
<div class="cA-DD-inputBox cA-DD-large cA-DD-validField">
<p class="fontfont1">*SPF's relationship to the Customer:</p>
<div class="cA-DD-inputContent ">
<input type="text" name="SPF_Relationship" id="SPF_Relationship" maxlength="50" onkeypress="return AllowAlphabetOnly(event)">
</div>
</div>
<div class="cA-DD-inputBox cA-DD-large cA-DD-validField">
<p class="fontfont1">*SPF's most influential or politically-exposed position:</p>
<div class="cA-DD-inputContent">
<input type="text" name="SPF_Position" id="SPF_Position" maxlength="50" onkeypress="return AllowAlphabetOnly(event)">
</div>
</div>
</div>
<div id="directorPopupnw1" style="display: none;">
<div id="leelay" class="leelay"> </div>
<div id="popupbox" class="lb-popupbox">
<p><strong>An SPF is a current or former:</strong></p>
<ul>
<li style="list-style: disc outside none; font-family: arial, verdana, times New Roman !important; font-size: 12px; font-size: 12px;"> senior official in the executive, legislative, administrative, military or judicial branches of a
government, whether elected or appointed, or paid or not; or </li>
<li style="list-style: disc outside none; font-family: arial, verdana, times New Roman !important; font-size: 12px; font-size: 12px;">senior official of a major political party; or</li>
<li style="list-style: disc outside none; font-family: arial, verdana, times New Roman !important; font-size: 12px; font-size: 12px;"> senior executive of a government-owned or government-funded corporation, institution or charity. </li>
</ul>
<p>The definition of SPF encompasses both foreign and domestic SPFs.</p>
<p>
<strong>Close Associates and Immediate Family Members</strong><br> In addition, the definition of an SPF includes the "close associates" and "immediate family members" of an SPF. A close associate is a person (i) who is widely and
publicly known to have a close association with an SPF, or (ii) who is actually known by the Business to be a close associate of the SPF, even if the association is not widely known. The immediate family members of an SPF include, for
example, spouses, domestic partners, parents, siblings, children, step-children, the spouses of children, and a spouse's parents and siblings.
</p>
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</span>
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<map name="Map5" id="Map5">
<area id="map5area" alt="Apply Now" title="Apply Now" href="#" target="_self" shape="rect" coords="429,246,607,299">
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<div id="directorPopup1" style="display: none;">
<div id="leelay" class="leelay"> </div>
<div id="popupbox" class="lb-popupbox">
<p> "<strong>Director</strong>" 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. </p>
<p>"<strong>Senior Officer</strong>" would include any officer in senior management level in Grade C16 and above (Title 'Managing Director' and above).</p>
<p> "<strong>Relative</strong>" 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. </p>
<a id="fancybox-close" style="display: inline;"></a>
</div>
</div>
<div id="directorPopup2" style="display: none;">
<div id="leelay" class="leelay"> </div>
<div id="popupbox" class="lb-popupbox">
<p> "Which is defined as a senior official in the executive, legislative, administrative, military or judicial branches of a government, whether or not elected, a senior official of a major political party, or a senior executive of a
government-owned or government-funded corporation, institution or charity. A "Senior Public Figure" also includes any entity that has been formed by or on behalf of a Senior Public Figure, in which the Senior Public Figure is a beneficial
owner of at least twenty-five per cent of the entity. In addition, a "Senior Public Figure" includes the immediate family of a Senior Public Figure and any close associate or relative of a Senior Public Figure. A close associate is a
person who is widely and publicly known to maintain an unusually close relationship with and able to conduct financial transactions on behalf of a Senior Public Figure. </p>
<a id="fancybox-close" style="display: inline;"></a>
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<!-- popup switch browser start -->
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<p>Dear User</p>
<h4>Please use <span><img src="/portal/newgen/cards/tab/images/chrome.png" alt="" title="" width="50px"></span> Chrome</h4>
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<input type="text" class="copylink" placeholder="Copy Link" readonly="">
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<a href="javascript:;" class="copylinkbtn ">Copy Link</a>
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<a href="https://www.google.com/intl/en_in/chrome/" class="dwnld_chrme_cta" target="_blank">Click here to download Chrome browser</a>
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<p class="fntsze" id="message" style="margin: 0 0 0 0px;"></p>
<p class="fntsze" id="platcardtxt" style="margin: 0px; display: none;"><a href="/credit-card/offers/pdf/3k-cashback-tnc.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="platcardtxt1" style="margin: 0px; display: none;">Offer valid on minimum spends of INR 5000 within 30 days of card issuance.</p>
<p class="fntsze" id="platcardtxt3" style="margin: 0 0 0 0px; display: none;"><a href="/portal/newgen/cards/tab/pdf/TandC.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="platcardtxt2" style="margin: 0 0 0 0px; display: none;">Offer valid on minimum spends of INR 5000 within 30 days of card issuance.</p>
<p class="fntsze" id="amazon-platcardtxt" style="display: none; margin: 0 0 0 0px;"><a href="/portal/newgen/cards/tab/pdf/TC_amazon.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="amazon-platcardtxt1" style="display: none; margin: 0 0 0 0px;">Offer valid on minimum spends of INR 2500 within 30 days of card issuance.</p>
<p class="fntsze" id="ola-platcardtxt1" style="display: none; margin: 0 0 0 0px;">Offer valid on minimum spends of INR 2500 within 30 days of card issuance.</p>
<p class="fntsze" id="flipkart-platcardtxt" style="display: none; margin: 0 0 0 0px;"><a href="/portal/standalone/pdf/Flipkart-Giftcard-Tnc.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="flipkart-platcardtxt1" style="display: none; margin: 0 0 0 0px;">Offer valid on minimum spends of Rs 2,500 within 30 days of card issuance.</p>
<p class="fntsze" id="flashsale-platcardtxt" style="display: none; margin: 0px;"><a href="/portal/newgen/cards/tab/pdf/MS_NC_TnC.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="platcardtxt5" style="display: none; margin: 0 0 0 0px;">Offer valid on minimum spends of INR 5000 within 30 days of card issuance</p>
<p class="fntsze" id="platcardtxt05" style="display: none; margin: 0 0 0 0px;">Cashback would be credited within 120 days of the credit card issuance for eligible customers</p>
<p class="fntsze" id="platcardtxt6" style="display: none; margin: 0 0 0 0px;"><a href="/portal/newgen/cards/tab/pdf/MS_TnC.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="platcardtxt01" style="display: none; margin: 0 0 0 0px;">Get Rs. 2500 cash back on spends of Rs. 5000 in 60 days of card issuance</p>
<p class="fntsze" id="platcardtxt02" style="display: none; margin: 0 0 0 0px;"><a href="/credit-card/offers/pdf/3k-cashback-tnc.pdf" target="_blank">*Terms and Conditions apply</a></p>
<p class="fntsze" id="mscardtxt" style="display: none; margin: 0 0 0 0px;"><a href="/credit-card/offers/pdf/3k-cashback-tnc.pdf" target="_blank">*Terms and Conditions apply</a></p>
<div class="coupon-code agreechecks" style="display: none;">
<label for="Agency_Code">Coupon Code: </label>
<!-- <input
type="text"
readonly
id="Agency_Code"
onfocus="if(this.value=='If Available'){this.value=''} "
onblur="if(this.value==''){this.value='If Available'}"
name="Agency_Code"
placeholder="If Available"
maxlength="50"
/> -->
<input class="txtfield Agency_Code" position="above" id="Agency_Code" name="textField-text-1598353135179" type="text" visibility="show" placeholder="If Available" maxlength="50" readonly="">
</div>
</div>
</div>
<div class="cA-DD-content subcenter">
<!-- <a title="SUBMIT" class="blueBtn formCenterBtn" id="formsubmitbutton" href="javascript:;">SUBMIT</a> -->
<div class="loadgif">
<img alt="loading..." style="display: none;" id="buttonreplacement" class="formCenterBtn2" src="/portal/newgen/cards/tab/images/preloading.gif">
</div>
<script src="/formbuilder/js/createJSONCC.js"></script>
<div>
<button title="SUBMIT" type="image" id="formCenterBtn1" class="submitBtn formCenterBtn1" hiddenid="submit">
<input type="hidden" id="PG" value="false">
<input type="hidden" id="clicktocall" value="false">
<img class="submitImg" hiddenid="submit" id="submit-image-1598354305479" src="" name="submit-image-1598354305479" type="image"> SUBMIT</button>
<button data-ctaname="Submit" data-ctatype="Button" data-ctaposition="Bottom" title="SUBMIT" type="image" class="blueBtn apply-sub formCenterBtn" id="applysub"> SUBMIT</button>
<!-- src="https://www.online.citibank.co.in/formbuilder/images/submitbtn.jpg" -->
</div>
</div>
<div class="assumptions">
<div class="submtbtnassump" id="submt1" style="">
<p>^250 turbo points on activation</p>
<p> **<span class="WebRupee">Rs</span> 1600, <span class="WebRupee">Rs</span> 950 and <span class="WebRupee">Rs</span> 1100 on spending <span class="WebRupee">Rs</span> 5000, <span class="WebRupee">Rs</span> 6000 and <span
class="WebRupee">Rs</span> 14000 every month on Fuel, Grocery and other categories respectively. 4 turbo points / <span class="WebRupee">Rs</span> 150 spent on Fuel, 2 turbo point / <span class="WebRupee">Rs</span> 150 spent on Grocery and
1 turbo point / <span class="WebRupee">Rs</span> 150 spent on other category </p>
<p>
<sup>#</sup>No annual fee shall be charged on spend of <span class="WebRupee">Rs</span> 30000 or more in a membership year (a year from the date of issuance of the card), else fee of <span class="WebRupee">Rs</span> 1,000 will be charged at
the end of the said year
</p>
<p> Cashback value per turbo point - <span class="WebRupee">Rs</span> 1. Benefits rounded down to nearest fifty. <a href="/portal/newgen/cards/tab/pdf/TandC.pdf" target="_blank">Click here to know more</a>. </p>
</div>
<div class="submtbtnassump" id="submt2" style="display: none;">
<p>^1500 bonus points on first spend made within 30 days of card issuance and 1,000 bonus points on first spend of <span class="WebRupee">Rs</span> 1000 made within 60 days of card issuance</p>
<p> **<span class="WebRupee">Rs</span> 2350 and <span class="WebRupee">Rs</span> 600 on spending <span class="WebRupee">Rs</span> 7000 and <span class="WebRupee">Rs</span> 18000 every month at apparel / department stores (10 points / <span
class="WebRupee">Rs</span> 125) and other spends (1 point / <span class="WebRupee">Rs</span> 125) respectively. </p>
<p>
<sup>#</sup>No annual fee shall be charged on spend of <span class="WebRupee">Rs</span> 30000 or more in a membership year (a year from the date of issuance of the card), else fee of <span class="WebRupee">Rs</span> 1,000 will be charged at
the end of the said year
</p>
<p>Cashback value per point - 0.35 paise. Benefits rounded down to nearest fifty. <a href="/portal/newgen/cards/tab/pdf/TandC.pdf" target="_blank">Click here to know more</a>.</p>
</div>
<div class="submtbtnassump" id="submt3" style="display: none;">
<p>^5% cashback on monthly spend of <span class="WebRupee">Rs</span> 4000, capped to <span class="WebRupee">Rs</span> 100 per month per category</p>
<p>**0.5% cashback on monthly spend of <span class="WebRupee">Rs</span> 20000</p>
<p>Benefits rounded down to nearest fifty. <a href="/portal/newgen/cards/tab/pdf/TandC.pdf" target="_blank">Click here to know more</a>.</p>
</div>
<div class="submtbtnassump" id="submt4" style="display: none;">
<p>^On first spend of <span class="WebRupee">Rs</span> 1000 within 60 days of card issuance</p>
<p>**On spends of <span class="WebRupee">Rs</span> 6000 every month on airline spends at premier miles website (10 miles / <span class="WebRupee">Rs</span> 100)</p>
<p>***On spends of <span class="WebRupee">Rs</span> 54000 every month on travel and other spends (4 miles / <span class="WebRupee">Rs</span> 100)</p>
<p>Cashback value per mile - 0.45 paise. Benefits rounded down to nearest fifty. <a href="/portal/newgen/cards/tab/pdf/TandC.pdf" target="_blank">Click here to know more</a>.</p>
</div>
</div>
<div class="cA-DD-content">
<p class="disc-sec">
<a target="_blank" href="https://www.online.citibank.co.in/special-offers/home/index.html?eOfferCode=INCITISLOSHME" title="" class="bldclr">Click here to know</a> the offers on various brands with Citi Credit Cards.
</p>
</div>
<ul class="sortable5">
<li>
<input type="hidden" class="txtfield" id="form_id" name="hiddenfield-hiddenfield-1598355658789" defaultvalue="frmportalstprewards" value="frmportalstprewards">
<script type="text/javascript">
$(function() {
//console.log("Set a default value");
$('#form_id').attr('value', 'frmportalstprewards');
});
</script>
</li>
<li>
<input type="hidden" class="txtfield" id="cardselect" name="hiddenfield-hiddenfield-1598355013112" defaultvalue="cardselect" value="IndianOil Citi Credit Card">
<script type="text/javascript">
$(function() {
//console.log("Set a default value");
$('#cardselect').attr('value', 'IndianOil Citi Credit Card');
});
</script>
</li>
<li>
<input type="hidden" class="txtfield" id="gclid_field" name="hiddenfield-hiddenfield-1598355020929" defaultvalue="gclid_field">
<script type="text/javascript">
$(function() {
//console.log("Set a default value");
//$('#gclid_field').attr('value', 'gclid_field');
});
</script>
</li>
<li>
<input type="hidden" class="txtfield" id="version_control" name="hiddenfield-hiddenfield-1598355028625" defaultvalue="version_control" value="WIND-Oct22-1439">
<script type="text/javascript">
$(function() {
//console.log("Set a default value");
$('#version_control').attr('value', 'WIND-Oct22-1439');
});
</script>
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<li>
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$(function() {
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//$('#lead_id').attr('value', 'lead_id');
});
</script>
</li>
<li>
<input type="hidden" class="txtfield" id="Product_Name" name="hiddenfield-hiddenfield-1598355051162" defaultvalue="Product_Name">
<script type="text/javascript">
$(function() {
//console.log("Set a default value");
//$('#Product_Name').attr('value', 'Product_Name');
});
</script>
</li>
</ul>
<div class="clear"></div>
<ul class="sortable5">
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</form>Text Content
Keep these ready before you start filling your details. * PAN Card number * If you are our existing customer: Your Citibank Relationship number / Account number details. Secure Application GET ₹3000 CASHBACK ON SPENDS OF ₹5000 IN 30 DAYS OF CARD ISSUANCE FIND A CREDIT CARD THAT SUITS YOU * INDIANOIL CITI CREDIT CARD Fuel * CITI REWARDS CREDIT CARD Shopping * CITI CASH BACK CREDIT CARD Cashback * CITI PREMIERMILES CARD Travel INDIANOIL CITI CREDIT CARD * Get up to 68 litres of free fuel in first year * Fee waiver of Rs 1000 on annual spends of Rs 30000 * Turbo points worth Rs 250^ on card activation * Additional points worth Rs 4500** * Annual fee : Rs 1000 + taxes# * Never - expiring reward points * Simply tap and pay using contactless card CITI REWARDS CREDIT CARD * Get benefits worth Rs 5000+ in first year * Fee waiver of Rs 1000 on annual spends of Rs 30000 * Points worth Rs 850^ on card activation * Additional points worth Rs 3150** * Annual fee : Rs 1000 + taxes# * Never - expiring reward points CITI CASH BACK CREDIT CARD * Get benefits worth Rs 3,600+ in first year * Rs 2400^ on movies, telephone & utility bills * Rs 1200** on other spends * Annual fee : Rs 500 + taxes * Simply tap and pay using contactless card CITI PREMIERMILES CARD * Get benefits worth Rs 20,000+ in first year * Welcome miles worth Rs 4500^ * Miles worth Rs 3200** on airlines spends * Additional miles worth Rs 11600*** on travel and other spends * Annual fee : Rs 3000 + taxes * Never expiring miles * Complimentary domestic airport lounge access * INDIANOIL CITIBANK PLATINUM CARD Fuel Card * CITIBANK REWARDS CARD Shopping Card * CITIBANK CASH BACK CARD Travel Card * CITI PREMIERMILES CARD Shopping Card Back INDIANOIL CITIBANK PLATINUM CARD CITIBANK REWARDS CARD CITIBANK CASH BACK CARD CITIBANK PREMIERMILES CARD Get benefits worth Rs 5000+ in first year Fee waiver of Rs 1000 on annual spends of Rs 30000 Points worth Rs 850^ on card activation Additional points worth Rs 3150** Annual fee : Rs 1000 + taxes# Never - expiring reward points Get benefits worth Rs 3,600+ in first year Rs 2400^ on movies, telephone & utility bills Rs 1200** on other spends Annual fee : Rs 500 + taxes Simply tap and pay using contactless card Get benefits worth Rs 20,000+ in first year Welcome miles worth Rs 4500^ Miles worth Rs 3200** on airlines spends Additional miles worth Rs 11600*** on travel and other spends Annual fee : Rs 3000 + taxes Evergreen miles - never expire Complimentary domestic airport lounge access Get up to 68 litres of free fuel per year Fee waiver of Rs 1000 on annual spends of Rs 30000 Turbo points worth Rs 250^ on card activation Additional points worth Rs 4500** Annual fee : Rs 1000 + taxes# Never - expiring reward points Simply tap and pay using contactless card ONLINE CREDIT CARD APPLICATION FORM CONTACT DETAILS Email, Mobile Number, Name Mr. Ms. Mrs. Mx. Mr. 123456 20 203040506070 123456 20 2030 4050 6070 * *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 Tell us about yourself Father's Name Mr. Mr. YOUR DATE OF BIRTH / / *MARITAL STATUS * Married Unmarried Others *CITIZENSHIP * Indian Others *RESIDENTIAL STATUS Resident Individual Non Resident Indian Foreign National Person of Indian Origin PAN Card Fill all the above details as it appears on the PAN Card. CKYC/ KIN (if available) PROFESSIONAL DETAILS Tell us where you work *Profession Salaried Self-employed Retired Housewife *Profession *Designation Accountant Consultant Engineer Executive/ Officer Assistant Manager/ Manager AVP/ AGM VP/ GM Contract employee Director/ CXO Teacher/ Professor Doctor CA/ CS Lawyer Architect Real Estate Broker Wellness Expert Artist/ Designer Others Sole Proprietor Partner Director *Designation *Designation Sole Proprietor Partner Director *Designation I confirm the annual income entered above is it appears in my latest ITR. ADDRESS Tell us where you live Note: Only A-Z a-z 0-9 .,-_ characters are allowed Residence Address (I will be available at this address to submit my KYC documents): Locate Me Reset Proof of Address* Available Not Available You will need to submit address proof document which matches exactly with either your current residence or permanent address. Please fill in your residence address which matches exactly with the address proof you would be required to submit. Permanent Address: 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 * *Preferred mailing address: Office Residence *I have read & fully accepted the Authorization Statement, Know Your Credit Card, Card Member Terms and conditions and Most Important Terms and conditions and consent to receiving information from Central KYC Registry through SMS/Email. I authorize Citibank and/or its associates/subsidiaries/affiliates to contact me for its offers and products. This consent will override any registration for DNC/NDNC. *Before completing this application, we would like to inform you that Citi has entered into an agreement with Axis Bank for the sale of its consumer banking businesses in India. The sale is conditional upon receipt of necessary regulatory approvals including the approval of the Competition Commission of India. On consummation of the sale subject to receipt of regulatory approvals, your banking relationship with Citi will be migrated to Axis Bank. Accordingly, Citi hereby seeks your consent for: (a) the transfer of this product being applied for and also on any other product (which requires consent for transfer) that you currently hold or may hold with Citi; (b) the transfer and disclosure of all your data and information provided to and available with Citi and (c) transfer of your tax documents/declaration provided to and available with Citi to Axis Bank (as permitted by applicable regulations), in each case in connection with the consummation of the aforesaid sale and use thereof by Axis Bank for continued offering of banking services, including for the purpose of any KYC related compliance. When you consent to transfer the relationship, there will be no immediate impact on this product being applied for or on the existing products that you may hold with Citi, be it credit cards, loans, deposits, investments, or any others and the same will transfer to Axis Bank on the same terms and conditions*. If you provide consent to transfer the relationship, your consent will come into effect on and from the date on which the credit card is issued by Citi. *For more details and FAQs, please visit: https://citi.asia/consenttnc. Please click on the checkbox to record your consent for the same. *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. *Do you or your immediate family member/joint account holder or their immediate family members currently hold/have held/are being considered for a position as a senior public figure? Yes No Please note that all credit cards comes enabled for Domestic point of sale and ATM transactions by default. Per RBI guidelines*, online, international and contactless usage will be blocked at the time of issuance. Usage can be instantly enabled via Citibank Online or the Citi Mobile App. *RBI/2019-20/142 dated 15th January, 2020. *SPF's relationship to the Customer: *SPF's most influential or politically-exposed position: An SPF is a current or former: * senior official in the executive, legislative, administrative, military or judicial branches of a government, whether elected or appointed, or paid or not; or * senior official of a major political party; or * senior executive of a government-owned or government-funded corporation, institution or charity. The definition of SPF encompasses both foreign and domestic SPFs. Close Associates and Immediate Family Members In addition, the definition of an SPF includes the "close associates" and "immediate family members" of an SPF. A close associate is a person (i) who is widely and publicly known to have a close association with an SPF, or (ii) who is actually known by the Business to be a close associate of the SPF, even if the association is not widely known. The immediate family members of an SPF include, for example, spouses, domestic partners, parents, siblings, children, step-children, the spouses of children, and a spouse's parents and siblings. "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. "Which is defined as a senior official in the executive, legislative, administrative, military or judicial branches of a government, whether or not elected, a senior official of a major political party, or a senior executive of a government-owned or government-funded corporation, institution or charity. A "Senior Public Figure" also includes any entity that has been formed by or on behalf of a Senior Public Figure, in which the Senior Public Figure is a beneficial owner of at least twenty-five per cent of the entity. In addition, a "Senior Public Figure" includes the immediate family of a Senior Public Figure and any close associate or relative of a Senior Public Figure. A close associate is a person who is widely and publicly known to maintain an unusually close relationship with and able to conduct financial transactions on behalf of a Senior Public Figure. Dear User PLEASE USE CHROME Note: This application page works best with Chrome and certain features may not be available in Internet Explorer, Edge and Firefox Copy Link Click here to download Chrome browser *Terms and Conditions apply Offer valid on minimum spends of INR 5000 within 30 days of card issuance. *Terms and Conditions apply Offer valid on minimum spends of INR 5000 within 30 days of card issuance. *Terms and Conditions apply Offer valid on minimum spends of INR 2500 within 30 days of card issuance. Offer valid on minimum spends of INR 2500 within 30 days of card issuance. *Terms and Conditions apply Offer valid on minimum spends of Rs 2,500 within 30 days of card issuance. *Terms and Conditions apply Offer valid on minimum spends of INR 5000 within 30 days of card issuance Cashback would be credited within 120 days of the credit card issuance for eligible customers *Terms and Conditions apply Get Rs. 2500 cash back on spends of Rs. 5000 in 60 days of card issuance *Terms and Conditions apply *Terms and Conditions apply Coupon Code: SUBMIT SUBMIT ^250 turbo points on activation **Rs 1600, Rs 950 and Rs 1100 on spending Rs 5000, Rs 6000 and Rs 14000 every month on Fuel, Grocery and other categories respectively. 4 turbo points / Rs 150 spent on Fuel, 2 turbo point / Rs 150 spent on Grocery and 1 turbo point / Rs 150 spent on other category #No annual fee shall be charged on spend of Rs 30000 or more in a membership year (a year from the date of issuance of the card), else fee of Rs 1,000 will be charged at the end of the said year Cashback value per turbo point - Rs 1. Benefits rounded down to nearest fifty. Click here to know more. ^1500 bonus points on first spend made within 30 days of card issuance and 1,000 bonus points on first spend of Rs 1000 made within 60 days of card issuance **Rs 2350 and Rs 600 on spending Rs 7000 and Rs 18000 every month at apparel / department stores (10 points / Rs 125) and other spends (1 point / Rs 125) respectively. #No annual fee shall be charged on spend of Rs 30000 or more in a membership year (a year from the date of issuance of the card), else fee of Rs 1,000 will be charged at the end of the said year Cashback value per point - 0.35 paise. Benefits rounded down to nearest fifty. Click here to know more. ^5% cashback on monthly spend of Rs 4000, capped to Rs 100 per month per category **0.5% cashback on monthly spend of Rs 20000 Benefits rounded down to nearest fifty. Click here to know more. ^On first spend of Rs 1000 within 60 days of card issuance **On spends of Rs 6000 every month on airline spends at premier miles website (10 miles / Rs 100) ***On spends of Rs 54000 every month on travel and other spends (4 miles / Rs 100) Cashback value per mile - 0.45 paise. Benefits rounded down to nearest fifty. Click here to know more. Click here to know the offers on various brands with Citi Credit Cards. * * * * * * * * * * * * * * * * * * * * * * * CITIGROUP.COM About Citi * Follow us on * * * Citi.com is the global source of information about and access to financial services provided by the Citigroup family of companies. Copyright © 2022 Citigroup Inc.