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Andhra Bank Account Opening Form
Andhra Bank Account Opening Form
Nomination facility Required Not Required Submit Form DA1 if Nomination is required.
Source of Funds
TDS-(For deposits other than RD) At Normal Rate Form 15 G / 15 H / Exemption Certificate is enclosed.
Due Date Notice Required Not Required Auto Renewal Required Not Required
(Applicant(s) and Guardian should submit Personal Data Form along with this Application form if he/she is not an existing
customer.)
Irrespective of my/our option for Auto Renewal of the deposit, unless you receive demand for payment or instructions to
the contrary on or before the date of maturity of the deposit (other than Recurring Deposit), please renew/continue to
renew the deposit together with interest, if any due thereon, for similar period at the prevailing rate of interest.
I/We hereby declare that the information given above is true and correct to the best of my/our knowledge. I/We further
declare that I/We accept the Terms and Conditions of the deposit scheme, which are provided to me/us. I/We agree that
the Terms and Conditions may be modified by the bank from time to time, which will be binding on me/us for conduct of
the account.
Place:___________________ (1) _________________ (2)___________________ (3) ____________________
Date: ___________________ [Signature(s) / Thumb Impression(s) of the Applicant(s)]
(Verification)
Application is filled in completely and is verified. Signature(s) /
Thumb Impression(s) is/are affixed in my presence. Signature of Verifying Officer and Signature No:
Note:- To avail exemption/concession from TDS annually, Form 15 G / 15 H / Exemption Certificate should be
submitted afresh at the beginning of each Financial Year.
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