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~¢H$ O_m-am{e`m| Ho$ g§~§Y _| ~¢qH$J {d{Z_` A{Y{Z`_, 1949 H$s Ymam 45 OoS>E\$ Ed§ ~¢qH$J H§$nZr (Zm_m§H$Z) {Z`_, 1985 Ho$ 2(1) Ho$ VhV Zm_m§H$Z
_¢/h_ ____________________________________________________________________________ Zm_ VWm nVm/nVo {ZåZ{b{IV ì`pŠV`m| H$mo Zm{_V H$aVm hÿ±/H$aVo h¢ {Ogo/{OÝh| _oao/h_mao
Zm~m{bJ H$s _¥Ë`w hmoZo na, O_m-am{e, {OgHo$ {ddaU ZrMo {XE JE h¡, ~¢H$ Am°µ\$ ~‹S>m¡Xm ___________________________________________________________________ emIm Ûmam bm¡Q>m Xr OmE&
O_m am{e Zm{_Vr
O_m am{e H$m {d{eîQ> Z§~a A{V[aŠV {ddaU Zm{_Vr H$m Zm_ Zm{_Vr H$m nVm O_mH$Vm© Ho$ gmW g§~§Y Am`w `{X Zm{_Vr Zm~m{bJ h¡ Vmo
àH$ma (`{X H$moB© hmo) (`{X H$moB© hmo) CgH$s OÝ_-{V{W #

# My§{H$ Bg VmarI H$mo Zm{_Vr Zm~m{bJ h¡, _¢/h_ lr/lr_Vr/Hw$_mar ____________________________________________________________________________________________________________

Am`w H$mo, Zm{_Vr H$s Zm~m{bJVm Ho$ Xm¡amZ _oar/h_mar/Zm~m{bJ H$s _¥Ë`w H$s pñW{V _| Zm{_Vr H$s Amoa go O_m-am{e H$mo àmßV H$aZo Ho$ {bE àm{YH¥$V H$aVo h¢&
ñWmZ: ____________________________
VmarI : ____________________________ # `{X Zm{_Vr Zm~m{bJ Z hmo Vmo H$mQ> X|
@ gmjr Ho$ hñVmja, Zm_ Ed§ nVm * O_mH$Vm©Am| Ho$ hñVmja/A§JyR>m {ZemZ

* Ohm§ Zm~m{bJ Ho$ Zm_ go O_m am{e aIr OmVr h¡, Zm~m{bJ H$s Amoa go Eogo ì`pŠV Ûmam Zm_m§H$Z hñVmj[aV {H$`m OmZm Mm{hE Omo BgHo$ {bE {d{YH$ ê$n go nmÌ h¢&
@ O_mH$Vm©/H$Vm©Am| Ho$ hñVmja/hñVmjam| na EH$ ì`pŠV H$m gmú` hmoZm Mm{hE, O_mH$Vm©/H$Vm©Am| Ho$ A§JyR>m {ZemZ/{ZemZm| na Xmo ì`pŠV`m| H$m gmú` hmoZm Mm{hE&
\$m_© 60/61 (n¡Z Zå~a Z aIZo dmbm| Ûmam ^am OmE)
\$m_© 60
Š`m Amn H$a {ZYm©[aV h¡      hm±      Zht      `{X hm± Vmo
H$) dmS>©/g{H©$b/a|O H$m {ddaU Ohm± {nN>br Am` [aQ>Z© \$mBb H$s JB© Wr
I) n¡Z Z§~a Zht hmoZo H$m H$maU
\$m_© 61
Cg ì`pŠV Ûmam ^am OmE {OgH$s Ho$db H¥${fJV Am` hmo Am¡a H$moB© Eogr Am` Z hmo {Og na Am`H$a à^m[aV {H$`m OmVm hmo&
_¢ EVX²Ûmam KmofUm H$aVm hÿ± {H$ _oar Am` H$m òmoV H¥${f h¡ Am¡a _wPo AÝ` {H$gr ^r Am` na, `{X H$moB© hmo, Am`H$a AXm Zht H$aVm h¡&
gË`mnZ
_¢               EVX²Ûmam KmofUm H$aVm hÿ± {H$ Omo ^r Xem©`m J`m h¡ d _oao gdm}Îm_ kmZ Ed§ OmZH$mar Ho$ AZwgma gË` h¡&
df© 20 ___________________ H$s _________________ VmarI ________________ ({XZ) H$mo gË`m{nV
{XZm§H$ : ______________________
ñWmZ : _______________________ KmofUmH$Vm© Ho$ hñVmja
A{V[aŠV XñVmdoO àmßV {H$E OmE§
JR>Z àñVwV {H$E OmZo XñVmdoO

EH$b ñdm{_ËdYmar \$_© • EH$b ñdm{_ËdYmar nÌ (\$m_© _| {ZJ_ Ed§ eVm] _| em{_b)
• CgH$s Amoa go H$mamo~ma MbmZo Ho$ {bE {H$gr ì`pŠV H$mo àXÎm _w»VmaZm_m (`{X H$moB© hmo)

gmPoXmar \$_© • gmPoXmar nÌ (\$m_© _| {Z`_ Ed§ eVm] _| em{_b)
• n§OrH$aU à_mU-nÌ (`{X H$moB© hmo)
• \$_© H$s Amoa go H$mamo~ma MbmZo Ho$ {bE gmPoXma AWdm {H$gr H$_©Mmar H$mo àXÎm _w»VmaZm_m&
• H$moB© XñVmdoO {Oggo _w»` gmPoXma Am¡a _»VmaZm_m YmaH$ ì`pŠV (ì`{º$`m|) VWm CZHo$ nVm| H$s nhMmZ hmoVr hmo&

qhXÿ A{d^ŠV (EM`yE\$) • g^r d`ñH$ gh-g^m§e^mJr`m| Ûmam hñVmj[aV {ZYm©[aV g§`wŠV qhXÿ n[adma-nÌ&
AWdm g§`wŠV qhXÿ n[adma \$_© • H$Vm© go KmofUm nÌ&
• nhMmZ à_mU Am¡a H$Vm© H$m nVm

{b{_Q>oS> H§$nZr (àmBdoQ>/npãbH$) • {ZJ_Z à_mU-nÌ H$s à{V
• npãbH$ {b{_Q>oS> H§$nZr Ho$ _m_bo _| H$mamo~ma àma§^ g§~§Yr à_mUnÌ H$s àmpßV&
• H§$nZr Ho$ g§ñWm A§V{Z©`_ Ed§ kmnZ Ho$ AÚVZ à_mU-nÌ H$s à{V&
• H§$nZr Ho$ {ZXoeH$ _§S>b Ho$ g§H$ën H$s gË`m{nV à{V {Og_| ~¢H$ go CgHo$ Zm_ na EH$ ImVm ImobZo Ho$ AZwamoY Ho$ gmW n[anmbZ AZwXoem| H$m CëboI H$aZo VWm ImVm ImobZo Ho$ {bE àm{YH¥$V
A{YH$m[a`m| H$s EH$ gyMr hmo&
• Mo`a_oZ Ûmam hñVmj[aV _m¡OyXm {ZXoeH$m| Am¡a CZHo$ nVo H$s gyMr&
• H§$nZr H$s Amoa go H$mamo~ma MbmZo Ho$ {bE AnZo à~§YH$m|, A[YH$m[a`m| AWdm H$_©Mm[a`m| H$mo {X`m J`m _w»VmaZm_m&

ghH$mar g{_{V`m±, g§K, Šb~ • g{_{V`m|/g§Km|/Šb~m|, `{X H$moB© hmo, H$m n§OrH$aU à_mU-nÌ&
• g{_{V Am{X Ho$ Cn {Z`_m| H$s à_m{UV à{V&
• ImVm ImobZo Am¡a ImVm n[aMm{bV H$aZo Ho$ {bE eV}{ZYm©[aV H$aZo hoVw ~¢H$ Ho$ ê$n _| ~¢H$ H$mo {Z`wŠV H$aZo g§~§Yr à~§YZ g{_{V H$m g§H$ën&
• à~§YZ g{_{V Ho$ gXñ`m| H$s gyMr (nVo g{hV) {OgHo$ gmW CÝh| g{_{V H$m gXñ` {Z`wŠV H$aZo g§~§Yr g§H$ën hr à{V g§b¾ hmo&
 Y_m©W©/npãbH$ Q´>ñQ>/\$mC§S>oeZ • n§OrH$aU à_mU-nÌ (`{X n§OrH¥$V hmo)
• Q´>ñQ> {dboI/JR>Z g§~§Yr XñVmdoO H$s à{V&
• CgH$s Amoa go H$mamo~ma MbmZo Ho$ {bE ì`pŠV`m| H$mo {X`m J`m _w»VmaZm_m&
• ImVm n[aMm{bV H$aZo Ho$ {bE g^r ì`pŠV`m| Ûmam hñVmj[aV g§H$ën H$s à_m{UV à{V&
• AÝ` H$moB© XñVmdoOr {Og_| Q´>pñQ>`m|, goQ>obg©, bm^m{W©`m|, _w»VmaZm_m YmaH$m| Am¡a ~¢H$ H$s g§VwpîQ> na Ý`mg/nmC§S>oeZ Ho$ {XZ-à{V{XZ Ho$ à~§YZ _| em{_b _w»` à_wI&
• n§OrH¥$V Ý`mg Ho$ _m_bo _| Y_m©W© H${_eZa Ûmam àXÎm à_mUnÌ&
ZmoQ>: g^r ì`{º$`m| H$mo, Omo àmoàmBQ>a/gmPoXma/H$Vm©/{ZXoeH$/àm{YH¥$V hñVmjar h¡, AmdoXZ-nÌ _| Xem©E JE {ddaUm| Ho$ AZwê$n nhMmZ Ed§ nVm| Ho$ à_mU AbJ go Adí` CnbãY H$admE§&
H§$nZr ImVm ImobZo Ho$ {bE g§H$ën (g§H$ën {ZåZ{b{IV go {_bVm-OwbVm hmoZm Mm{hE)
h_ EVX²Ûmam à_m{UV H$aVo h¢ {H$ ________________________________________________________________________H§$nZr {b. Ho$ {ZXoeH$, _§S>b H$m {ZåZ{b{IV g§H$ën ~moS>© H$s {XZm§H$ ________________H$mo
Am`mo{OV ~¡R>H$ _| nm[aV {H$`m Wm Am¡a CŠV H§$nZr Ho$ H$m`©d¥Îm H$mo {d{YdV ê$n go [aH$mS>© H$a {X`m J`m h¡&
`h g§H$ën {b`m J`m {H$ H§$nZr Ho$ {bE EH$ ~¢qH$J ImVm ~¢H$ Amµ°\$ ~‹S>m¡Xm _| Imobm OmE Am¡a CŠV ~¢H$ H$mo EVX²Ûmam MoH$m|, {d{Z_` {~bm| Am¡a Amh[aV dMZ-nÌm| H$mo _____________________________________
_____________________________________________________________________________________________________________________________________________________________________________________

H§$nZr H$s Amoa go gH$maZo Ed§ ImVo Ho$ g§~§Y _| {XE JE {H$gr ^r AZwXoe na H§$nZr Ho$ g§ì`dhma Ho$ g§~§Y _| H$m`© H$aZo, ^bo hr `h A{V AmhaU hmo `m Z hmo hoVw àm{YH¥$V {H$`m OmE&
______________________ _________________________________ ________________________________
AÜ`j g{Md/_¡ZoqOJ EOoÝQ> {ZXoeH$/_¡ZoqOJ EOoÝQ>
g^r n[adV©Zm| na AmÚja {H$E OmE§
`h Amdí`H$ h¡ {H$ g§H$ën Ûmam {X`m J`m àm{YH$ma, H§$nZr Ho$ g§ñWm A§V{Z©`_m| Ûmam àXÎm A{YH$mam| Ho$ AZwê$n hmo&
4
 ImVm - n[aMmbZ Ho$ {bE A{YXoe nÌ
\$m_© g§. 6
(H$moB© ñQ>mån Zht bJmZm h¡)

à~§YH$
~¡H$ Am°µ\$ ~‹S>m¡Xm
_____________________________

_____________________________

{à` _hmoX`,
g§X^© : AmnHo$ nmg _oam/h_mam Mmby ImVm g§»`m: _______________________

_¢/h_ EVX²Ûmam Amngo {ZdoXZ H$aVm hÿ±/H$aVo h¢ {H$ lr ____________________________________________ Ûmam _oao/h_mao ImVo na, Amh[aV {H$`o
OmZodmbo g_ñV MoH$m|, {OZ_| CZHo$ ñd`§ Ho$ nj _| H$mQ>o J`o CZHo$ Ûmam Amh[aV hmoZo H$m VmËn`© aIZodmbo MoH$ ^r gpå_{bV h¢, H$m g_`-g_` na ^wJVmZ
H$a| Am¡a gH$ma| Am¡a Eogo MoH$m| Ho$ ^wJVmZ go AmodaS´>mâQ> hmoZo `m AmodaS´>mâQ> Ho$ {H$gr ^r gr_m VH$ ~‹T> OmZo na ^r Eogo g_ñV MoH$m| H$s am{e H$mo _oao/h_mao
Mmby ImVo _| Zm_o S>mb|& _oao/h_mao Mmby ImVo na lr ______________________________ Ûmam {H$`m J`m H$moB© ^r n[aMmbZ _wPo/h_ na Am~Õ hmoJm&
AV: Amngo {ZdoXZ h¡ {H$ CŠV Mmby ImVo Ho$ g§~§Y _| CZgo {_bZo dmbo AZwXoem| na H$m`©dmhr H$a|&
lr ____________________________________________________ {d{Z_` nÌm|, dMZ-nÌm| AWdm AÝ` naH«$må` {b{IVm| H$mo V¡`ma H$a|Jo AWdm
~Å>m H$Q>|Jo Am¡a YZ, MoH$m|, ZmoQ>mo-S´>mâQ>m|, AmXoem| AÝ` g^r XñVmdoOm| H$mo _oao/h_mao Mmby ImVo _| O_m H$a, CZH$m ^wJVmZ H$a|Jo Am¡a O~ H$^r Amdí`H$Vm
n‹S>o Vmo BZ XñVmdoOm| H$mo _oao/h_mao {bE n¥îR>m§{H$V H$a|Jo Am¡a _oao/h_mao Mmby ImVo H$s O_meof am{e H$s VÏ`Vm à_m{UV H$a|Jo Am¡a _wPgo/h_go Xo` F$U
Applicable for Partnership Firm

AWdm F$Um| H$mo A{^ñdrH$ma H$a|Jo {Oggo _¢/h_ g~ Bggo Am~Õ hÿ§Jm/hm|Jo Am¡a `o _oar/h_mar Am¡a go Zmo{Q>g| ^r àmßV H$a|Jo&
do gaH$mar Ama AÝ` à{V^y{V`m|, eo`am|, bXmZ {~bm|, aobdo agrXm| Am¡a Bg àH$ma Ho$ AÝ` ànÌm| H$m ^r n¥îR>m§H$Z H$a|Jo& {Jadr aI|Jo, O_m aI|Jo, dmng
b|Jo, ~M|Jo Am¡a _oar/h_mar Am¡a gmInÌ ^r Imob|Jo Am¡a g_ñV boZXoZ Am¡a H$m`© Omo do H$a|Jo Am¡a {Zînm{XV H$a|Jo, CZgo g§~Õ _oao/h_mao ImVo Ho$ g§~§Y
_| AZwXoem| H$mo àXmZ H$a|Jo, ~Xb|Jo Am¡a à{Vg§~Õ H$a|Jo Am¡a Eogo g^r H$m`©-\$_© Am¡a CgHo$ gmPoXmam| Am¡a Eogr {H$gr gmPoXmar Ho$ dm[agm|, {ZînmXH$m| Am¡a
CZHo$ __________________ Am¡a CZHo$ CÎmam{YH$m[a`m| Am¡a g_ZwXo{e{V`m| na Am~ÕH$a hm|Jo Am¡a `{X h_mar lr _________________________ Ûmam
{H$`o J`o g^r H$m`© \$_© na Am¡a h__| go àË`oH$ na Am¡a h_mao {bE AWdm h__| go {H$gr Ho$ {bE Ý`mg (go ì`wËnÝZ A{YH$ma) Ho$ AYrZ AWdm A§VJ©V, `{X
{H$gr `{X {H$gr \$_© Ûmam àm{YH$ma {X`m OmVm h¡ Vmo Xmdm H$aZodmbo AÝ` g^r ì`{º$`m| na Am~ÕH$a hm|Jo Am¡a CŠV Mmby ImVo Ho$ g§~§Y _| Am¡a/AWdm Bg
For Individual Sole Proprietor

A{YXoe Ho$ A§VJ©V CŠV lr _____________________________________________________ Ûmam {H$`o OmZodmbo g_ñV Am¡a {H$gr ^r H$m`© H$mo
h_ gXm Am¡a g^r g_` ñdrH$ma H$a|Jo& AZwg_W©Z H$a|Jo Am¡a nwpîQ> H$a|Jo& _wP na h_ na Am¡a _oao/h_mao dm[agm|, {ZînmXH$m| Am¡a àemgH$mo§ na Am~ÕH$a$hm|Jo
Am¡a CŠV Mmby ImVo Ho$ g§~§Y _| Am¡a/AWdm Bg A{YXoe Ho$ A§VJ©V CŠV lr _____________________________________________ Ûmam {H$`o
OmZodmbo g_ñV Am¡a {H$gr ^r H$m`© H$mo _¢/h_ gXm Am¡a g^r g_` ñdrH$ma AZwg_W©Z/nwpîQ> H$é§Jm/H$a|Jo&
`h A{YXoe _oao/h_mao OrdZH$mb _| à{Vg§h[aV Z hmo Vmo, O~ VH$ _oar/h_mar _¥Ë`w H$s {b{IV gyMZm AmnH$m| Zht Xr OmVr V~ VH$ _oar/h_mar g§nXm Ed§
g§n{Îm`m| na Am¡a h_mao H$mZyZr à{V{Z{Y na Am~ÕH$a hmoJm&
O~ VH$ _wPgo/h_go BgHo$ à{VHy$b {b{IV gyMZm AmnH$mo Zht {_bVr, V~ VH$ `h A{YXoe àd¥Îm ahoJm&

^dXr`,

lr _________________________________________________

___________________________________________________

Ho$ Z_yZm hñVmja

5
 F. No. 401A

ACCOUNT OPENING FORM FOR NON INDIVIDUALS

Branch : ____________________ DD/MM/YYYY
Date :_____________________
Account No. Branch ALPHA Scheme Code

I/We request you to open my/our deposit account with your branch/bank as under: (Tick () relevant type of account)
Type of Account Scheme Name Type of Account Scheme Account
  Savings Bank A/c   Term Deposit A/c
  Current A/c   Other A/c
TITLE OF THE ACCOUNT (IN BLOCK LETTERS)

Customer ID
Nature of Activity / Business ____________________________________________________________________________
Date of Incorporation / Establishment (dd-mm-yyyy)
PAN (Obtain certified copy of PAN or Form 60/61 of IT Act)

TAN
Sale Tax No. (if any)
Excise No. (if any)
Annual Turnover / Income

Expected Annual Turnover in the A/c: ` ______________________________________________

CONSTITUTION (Tick () mark):
Sole Proprietorship   Partnership   Private Ltd. Co.   Public Ltd. Co.   HUF   Institution   Other Financial Institution   
Society   Association   Trust / Club   Public Sector Bank   Private Sector Bank   Govt. / Semi Govt.   Local Bodies  
Others (Pl. specify) ________________________________________________________

Details of Persons / Karta / Partners / Director / Proprietor of the account (In CAPITAL letters) M/F/TG
1
2
3
4
5

Date of Birth (dd/mm/yyyy) PAN (if not available, please attach form 60/61) Customer ID (if any existing)
1

Status** Annual Income Occupation* Nationality Father’s / Husband’s Name

1
2
3
4
5
*Please choose from the following :
Salaried Self Employed Professional Politician Housewife Student
Retired Stock Broker Agriculture Antique Dealer Arms Dealer Other (Pl. specify)
MTL89/F-401A/27.02.2020

**Please choose from the following :

Minor Sr. Citizen Ex-Staff (EC No.          ) Pensioner NRI Other / General
Operating Instructions (Please mark  
in appropriate box) :
 
Self by Proprietor Jointly by all Others (Pl. Specify)

1
Facilities required (Please mark  in appropriate box/es):
Cheque Book Statement of A/c through - Please Tick ()

Issued Cheque Series No. _________ To _________ Post E-mail Delivery at branch
Date of Issue: Statement Frequency : Monthly Quarterly

# Internet Banking – Yes    No @ ATM / Debit Card   Yes    No # BOB Card        Yes    No
(# Please fill up separate application for Internet Banking – Baroda Connect and/or BOB Card).
@ Please issue Debit Card in the individual name of the Sole Proprietor of the Proprietorship Firm (ONLY IN CURRENT ACCOUNT):
Name to appear on ATM Card (Not to exceed 20 Characters) in CAPITAL LETTERS

Name of the Proprietor

Address of Firm, Company etc. / Residential Address of the authorised persons:
Firm/Company etc. 1st Partner/Director 2nd Partner/Director
Flat No. / Building Name
Street/Road
Area/Locality
City and District
State and Country
Pin Code
Tel No.
Fax No.
Mobile
Email
3rd Partner/Director 4th Partner/Director 5th Partner/Director
Flat No. / Building Name
Street/Road
Area/Locality
City and District
State and Country
Pin Code
Tel No.
Fax No.
Mobile
Email
DECLARATION (Please mark (  ) in appropriate boxes):
[ ] I/we declare that I/we do not enjoy any credit facilities with other bank/s.
[ ] I/we declare that I /we have following deposit accounts and/or credit facilities with your/other banks branches:
Bank and Branch Place of Bank/Branch Type of Account/Facility Amount Account No.

TERMS & CONDITIONS & DECLARATION (Please mark () in appropriate boxes):
I/We have read, understood and agree to abide by the Banks rules relating to the conduct of the above accounts/services/products/fee & charges which are displayed on the website
www.bankofbaroda.com/contained in the brochures of the Bank from time to time.
[ ] I/We wish to be informed about the various features/products and promotional offers made by the Bank from time to time.
[ ] Please do not call/contact me/us for various features/products and promotional offers made by the Bank from time to time.
• Please issue Multi-city/Normal (Give Option) cheque book and recover charges from my/our account as per norms of the bank.
• Account will be operated and balance along with interest payable as per operational instructions given above.
• I/We understand that in the event of the death of the depositor(s), premature termination of term deposit would be allowed without any penal charges to the claimant(s) after following
the due procedure.
• I/we also agree to maintain the minimum/average quarterly balance which the Bank may prescribe as the minimum/average quarterly balance to be maintained to avail the facilities and
agree to pay the charges if minimum/average quarterly balance is not maintained and any other charges stipulated by the Bank. I/We understand that any change in this respect will be
notified by the Bank on its website www.bankofbaroda.com and also will be displayed on the notice board of the branches one month in advance.
• I/We shall fill up separate pay-in-slips prescribed by the Bank for various time deposit schemes. I/We understand that the Term deposit shall be under auto-renewal scheme of the Bank
unless otherwise specified by me/us.
• I/We authorize Bank of Baroda/its Group Companies or its/their agents to make references and enquiries as may be deemed necessary in their discretion with regard to the information
furnished to this application/s. Bank of Baroda and its Group entities/companies are empowered to exchange, share or part with all the information, data or documents relating to my/our
application inter se among themselves or to other Banks/Financial Institutions/ Credit Bureaus/Agencies/Statutory Bodies/such other entities/Persons as may be deemed necessary or
appropriate or as may be required for processing of such information/data by such person/s or for furnishing of the processed information/data/products thereof to other Banks/Financial
Institutions/Credit Bureaus/Agencies/users registered with such Agencies.
(Please mark () in appropriate boxes ) : (a) Applicable in case of sole Proprietary firm & (b) Applicable in case of Partnership firm.
• (a) I, the undersigned, am the sole proprietor of the firm and am solely responsible for liabilities thereof. I shall advice you in writing of any change that may take place in the constitution
of the firm and I will be liable to you on any obligation which may be standing in the firm’s name in your books on the date of the receipt of such notice and until all such obligations shall
have been liquidated.
• (b) We, the undersigned, are the only partners in the firm and are jointly and severally responsible for the liabilities thereof. We shall advise you in writing of any change that may take
place in the partnership and, all the present will be liable to you on any obligation which may be standing in the firm’s name in your books on the date of receipt of such notice and until
all such obligations shall have been liquidated.
• For ATM Card (Debit Card) to be issued in the operative deposit account: I/We have read and understood the terms & conditions governing the usage of the Debit Card. I/We accept
to be bound by the said terms & conditions and to any changes made therein from time to time by the Bank at its sole discretion. I/We authorize Bank of Baroda to issue a Debit cum
ATM Card in the name of the Sole Proprietor of the firm as mentioned in the application of account opening form. I/We confirm and that I am the sole proprietor of the firm and am solely
responsible for liabilities thereof. I/We further unconditionally and irrevocably authorize you to debit my/our Firm’s account annually for Debit Card fees/charges as per Bank’s norms.
• I/We understand and undertake that the usage of the Debit Card shall be strictly in accordance with the Exchange Control Regulations and in the event of any failure to do do. I/We will
be liable for action under the Foreign Management Act, 1999 and the amendments thereof stipulated by Reserve Bank of India from time to time.
• I/We accept full responsibility for my/our Debit Card and agree not to make any claims against Bank of Baroda in respect thereto.
2
Signatures in full:
Sr. No. Name of the authorized person Signatures in full (without rubber stamp)
1.
2.
3.
4.
5.
Specimen signature:
TITLE OF THE ACCOUNT
ACCOUNT NO. BRANCH
OPERATING INSTRUCTIONS

1. 2. 3. 4. 5.
Recent Photo Recent Photo Recent Photo Recent Photo Recent Photo

Customer ID Customer ID Customer ID Customer ID Customer ID

Specimen signature of :   (please put rubber stamp wherever required)

1. Mr./Ms. 2. Mr./Ms.

3. Mr./Ms. 4. Mr./Ms. 5. Mr./Ms.

Name __________________________________________________________________ (SS No.:__________________________)

Bank Official in whose presence signed Signature_______________________________
Introduction from an existing account holder (at least six months old satisfactorily conducted and KYC compliant account):
Name : Account No.
Address : Date of opening of the A/c:
Customer ID:
Pin : E-mail : Branch Name :
Tel No. : Mobile : Fax: Type of A/c. SB/CA/CC/CD
I/We certify that, Mr./Mrs./Ms. ____________________________________________________________________________________________ is/are known to me/us personally since last
_________ months/years and confirm the occupation and address stated in this application form for opening account are correct to the best of my/our knowledge & belief.

Date: (Signature of the Introducer)

Details of identification documents of applicant/s obtained (CARE: FOR NRI APPLICANTS COPY OF PASSPORT MUST BE SUBMITTED AS IDENTIFICATION DOCUMENT)
Photo Identity
1 2 3 4 5
Type of Document & Number
Issuing Authority & Date of Issue
Place of issue & Valid upto
Address Proof Identity
Type of Document & Number
Issuing Authority & Date of Issue
Place of issue & Valid upto
For Office Use
Sl. No. Description Name of Authorised Staff Signature
1. Applicant Interviewed & purpose ascertained
2. Document/s of identification/address proof listed above were verified with original by
3. Letter of thanks sent to A/c. holders and Introducer on ____________
Money Laundering Risk Classification
4.
[  ] Low [  ] Medium [   ] High
KYC CERTIFICATION:
I have met the account opener/s Mr./Ms. ________________________________________________________________ I have verified the documents
Mr./Ms. _______________________________________________ Mr./Ms. _______________________________________ in submitted and confirm that KYC Norms
person and hereby confirm that KYC Norms are fully complied with and further confirm that are fully compile
i) a) the introducer has visited the branch OR
b) The introducer has not visited the branch but written confirmation obtained.
ii) The signature of the introducer is verified and his/her Account is more than six months old and Signature of Branch Head/Joint Manager/
KYC Compliant. Manager
Specimen Signature
_______________________________________
Signature of Head of the Department Specimen Signature No. _____________________ No. ________________
Date: _____________________ Date : ______________
3
 Form DA -1 Nomination Form (FOR SOLE PROPRIETOR CONCERN ONLY)
Nomination under Section 45ZA to 45ZF of the Banking Regulation Act, 1949 and 2(i) of the Banking Companies (Nomination) Rules 1985 in respect of bank deposits.
I/We ______________________________________________________________ name(s) and address(es) nominate the following persons to whom in the event of my/our/
minor’s death, the amount of the deposit, particulars whereof are given below may be returned by Bank of Baroda ______________________________ Branch.
Deposit Nominee
Nature of Distinguishing Additional Name Address Relationship Age If Nominee is a Minor,
Deposit No. Details (if any) with depositor (if any) her/his date of birth#

# As the nominee is a minor on this date, I/We appoint Mr./Mrs./Ms. ____________________________________________________________________________ (Name, Address,
and Age) to receive the amount of deposit on behalf of the nominee in the event of my/our minors death during the minority of the nominee.
Place: ____________________________
Date : ____________________________ # Strike out if nominee is not a minor
@ Signature, Name and Address of Witness * Signature/Thumb impression of Depositors

* Where deposit is made in the name of a minor the nomination should be signed by a person lawfully entitled to act on behalf of the minor.
@ Signature(s) of depositor(s) should be witnessed by one person, thumb impression(s) of depositor(s) should be witnessed by two person(s).

Form 60/61 (to be filled by those who do not have PAN)

Form 60
Are you a Tax Assessee      Yes      No      if Yes
a) Details of Ward/Circle/Range where the last return of income was filled : ____________________________________________________________________________________
b) Reason for not having PAN No.: _____________________________________________________________________________________________________________________________
Form 61
To be filled by a person who has only agricultural income and no other income chargeable to income tax.
I hereby declare that my source of income is from agriculture and I am not required to pay income tax on any other income if any.
Verification
I ______________________________________________________________________ do hereby declare that what is stated is true to the best of my knowledge and belief.
Verified at ____________________________________ this the ______________________ day of______________________ 20
Place : _______________________
Date : _______________________ Signature of the Declarant
Additional documents to be obtained
Constitution Document to be submitted
 Sole Proprietorship Firm • Sole Proprietorship Letter (included in terms and conditions in the form)
• Power of Attorney (if any) granted to any person to transact the business on its behalf
 Partnership Firm • Letter of Partnership (included in terms and conditions in the form)
• Registration Certificate (if any)
• Power of Attorney granted to partner or an employee of the firm to transact business on its behalf
• Any document identifying the main partners and the person(s) holding power of attorney and their addresses
 Hind Undivided Family (HUF) • Prescribed Joint Hindu Family letter signed by all adult coparceners
Or • Declaration from Karta
Joint Hindu Family Firm • Proof of Identification and address of Karta
 Limited Company • Copy of Certificate of Incorporation.
(Public/Pvt.) • Copy of Certificate of commencement of Business in case of Public Limited Co.
• Certified copy of Memorandum and Article of Association of the company made up to date
• A certified true copy of the resolution of the Board of Directors of Company, requesting the Bank to open an account in its name and specify
the operating instructions and a list of authorized officials to operate the account
• A list of present directors & their addresses, under the signature of chairman
• Power of Attorney if granted to its manager, officer or employee to transact the business on its behalf
 Co-operative Societies, • Certificate of Registration of association, clubs etc. of the societies/ association/ club if any
Association, Club • Certified copy of the Bylaws of the society etc.
• Resolution of the Management committee appointing the Bank at its Banker for opening of Account and stipulating the conditions for the
conduct of account
• List of members (with address) of managing committee with the copy of resolution electing them to the committee
 Charitable/Public Trust/ • Certificate of Registration, if registered
Foundations • Copy of Trust Deed/Constitution document
• Power of attorney granted to persons to transact the business on its behalf
• Certified copy of the resolution signed by all the trustees in regard to the conduct of the account
• Any document listing out the names and address of trusts, settlers, beneficiaries and those holding Power of Attorney and other key
officials involved in day to day management of the trust/foundation to the satisfaction of Bank
• Certificate from the Charity Commissioner in case of registered trust
Note: All Individual who are Proprietor/Partner/Karta/Director/Authorized Signatory etc. must provide separate identity and address proof in conformity with
the details furnished in the application form.
Resolution for opening Company account : (The Resolution should be somewhat in the following terms)
We hereby certify that the following Resolution of the Board of Directors of the _________________________________________________________________ Company Ltd.,
was passed at a meeting of the Board held on the ______________________________________ and has been duly recorded in the Minute Book of the said Company.
Resolved that a banking account for the Company be opened with the Bank of Baroda and that the said Bank be and is hereby authorized to honour
cheques, bills of exchange and Promissory notes drawn, accepted or made on behalf of the Company by _____________________________________________________
____________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________ and to act on any instructions so given relating
to the account whether the same be overdrawn or not or relating to the transaction of the Company.

______________________ _________________________________ ________________________________

Chairman Secretary/ Managing Agents Directors/Managing Agent
All alterations should be initiated
It is necessary that the authority given by the Resolution shall be in accordance with the powers provided by the Articles of Association of the Company.
4
 LETTER OF MANDATE TO OPERATE ACCOUNT
F. No. 6
(To be without any stamp)

The Manager,
BANK OF BARODA
_________________________

_________________________

Dear Sir,
Ref: MY/OUR CURRENT ACCOUNT No. __________________________ WITH YOU

I/We hereby request you from time to time to pay and honour all cheques which may be drawn by Mr. _______________________________
including cheques made out in his own favour, purporting to be drawn by him
_____________________________________________________________________

and on my/our account and to your books, notwithstanding that payment of such cheques may create an overdraft or increase it to any
extent. Any operation by Mr. _________________________________________________________________________ on my/our current account will be binding on
me/us and you are, therefore, requested to act on instructions received from him in connections with the said current account.

Mr. _____________________________________________________________________________ will also make, draw and endorse and accept or otherwise
sign bills of exchange, promissory notes, or other negotiable instruments and discount the same with your Bank or otherwise, and will
also pay monies, cheques, notes, drafts, orders and all other documents to the credit of my/our Current account and as and when needful
endorse the same for me/us and will also certify the correctness of the balance of my/our current account, and will also acknowledge
debt or debts from me/us so as to bind me/us all and will also receive notices on my/our behalf.
Applicable for Partnership Firm

He will also endorse, pledge, deposit, withdraw, sell Government and other securities, shares, bills of lading, railway receipts and
such other instruments and open letters of credit on my/our behalf, and give, vary and revoke instruction regarding my/our accounts in
respect of all transactions and acts which he may do.

Upon the firm and the partners and perform, and all such acts shall be binding on me/us and my/our heirs executors and administrators
thereof and the heirs, executors of any such partners, their and his successors and I/We shall always and at all times, allow, ratify and
confirm all and whatever said Mr.                          assigns and in the case of dissolution of our
partnership, all acts done by the said              shall do in relation to the said current account and/or under this mandate.

Mr.                          shall be binding upon the firm and each and every one of us and all
For Individual Sole Proprietor

other persons claiming from under or in trust for us or any of us unless notice in writing of such dissolution is previously received by you
and we shall always and at all times allow ratify and confirm all and whatever the said Mr.                  shall
do in relation to the said current account and/or under this mandate.

This mandate if not revoked in my/our life time shall be binding upon my/our estate and effects and our legal representatives until
a written notice of my/our death is given to you.

This mandate shall continue in force until you receive a notice in writing from me/us to the contrary.

Specimen signature of Yours faithfully,

Mr. __________________________________

______________________________________