FORM A

[See Sub paragraph (1) of paragraph 4]

Application for opening a Public Provident Fund Account under the Public Provident Fund Scheme, 1968.

To
The Chief / Branch manager
Bank of India
_________________Branch.

I, ___________________________ hereby apply for opening an account under the Public

Provident Fund Scheme 1968 in My Name / in the Name of Kumar / Kumari ________________________ of
whom I am the Guardian and tender herewith Rs.__________ (Rupees __________________________ only)
in Cash / Cheque as the initial subscription.

Please affix latest

Name of the applicant Mr./Miss/ Ms. ______________________________________ coloured passport
Guardian Mr./Miss/ Ms. ______________________________________ size photograph
Name (in case of Minor): of applicant

Permanent Address/ ______________________________________

Communication Address:
______________________________________

______________________________________

Bank of India Account (if any ) : _____________________________________

*PAN : ______________________________________

Retail Infinity ID (if any) : ______________________________________

*Account opening Sol Id/Branch : ______________________________________

*Initial Contribution : Cheque / DD No._____________Bank Name :_________________

Branch : ______________________________________

Amount in figures
_____________Rs._________________________

_______________________________________________________

*Debit Mandate :Rs.______________________________

*Debit Account No. : __________________________________

*Standing Instructions : Amount in figures __________________________________

Frequency : Date of debit (Start Date ________________ & End date__________)

SOURCING BRANCH : ___________________

I, agree to abide by the provisions of the Public Provident Fund Scheme, 1968 and amendments issued
thereto from time to time.
----------------------------------------------------------------------------------------------------------------------------------------
ACCOUNT IN THE NAME OF SELF / MINOR(S) :

Date of Birth of Minor ___/___/____ Applicant’s relationship with minor, if any :___________________

(i) I hereby declare that I am not maintaining any other Public Provident Fund Account.
(ii) I hereby declare that I am not maintaining any other Public Provident Fund Account, except an
account on behalf of a Minor or a Hindu Undivided Family or an association of persons.
(iii) I hereby declare that the details of other Public Provident Fund accounts opened earlier by me are
as under :-

Sl. Name / Address of the Bank/Post Office and

Description
No. Account No.
1. Self account
In the name of minor(s) of whom I
2.
am the guardian.
3. HUF Account
In the name of Association of
4.
Persons.

(iv) I also declare that I shall adhere to the ceiling on deposits as provided for by Central Government
fromtime to time which is Rs.1,50,000/- in a financial year at present in each of the following types
of Public Provident Fund Account.

a) Individual Self Account and Account(s) on behalf of minor(s) of whom I am the Guardian.
b) Hindu Undivided Family Account
c) Association of Persons account as applicable in the State of Goa and Union Territories of Dadra
and Nagar Haveli and Daman and Diu.

In case, at any time the said declaration is found untrue/false, no interest shall be payable to me / the
subscriber on the amount of deposit found in excess of the prescribed limit.

Date ___/__/201__ Signature or Thumb impression of

Subscriber/Guardian

__________________________
(Additional specimen signature)

Note 1. Where an account is opened on behalf of a Hindu Undivided Family or an association of

Persons, the letters “HUF” or “Association” as the case may be, shall be added after the name of
the subscriber.
Note 2. Delete whichever is not applicable
FOR THE USE OF BRANCH

The PPF Account has been opened on ___/___/20__ with Rs._________ /- under Public Provident Fund.

Account No. :
Cust ID

DOCUMENTS : PPF NEW ACCOUNT OPENING DOCUMENTS :

1) PAN copy 1) Address Proof (as per Resident 3) Birth Certificate (in case of Minor)
Account Circular

PPF TRANSFER IN ACCOUNT OPENING DOCUMENTS :

1) Form A 2) Photograph 3)PAN NO. 4) Address Proof 5) Transfer in 6)Certified

(as per Resident Cheque/DD copy of
Account Circular) Ledger

Date: __/__/20__ Branch Manager