22

SIGNATURE VERIFICATION FORM

Name:

___________________________________________________________________________

Folio No:

____________________ Tel No._____________________

Address: _________________________
_________________________
_________________________
Bank Account Details
Bank Account No.: _________________________
A/C Type:
Savings
OTHERS_____________
(Please tick)
Bank Name:

Current

NRE

NRO

_______________________________ Branch Name: _____________________________

Signature/s (as per Mode of Holding in Folio):

__________________________

_________________________

________________________

2nd Applicant

3rd Applicant

1st Applicant / Guardian /

Authorised Signatory
Signature Verified

(Signature of the Branch Manager with Official Seal and Bank Stamp)
Name: _________________________
Designation: _________________________
Phone Number: _________________________
Date: _________________________