S.E., S.E.C. & E.Co. Rlys. Employees’ Co-operative Credit Society Ltd. 93, Circular Garden Reach Road, Kolkata - 700 043. APPLICATION FOR RECURRING DEPOSIT WITH THE SOCIETY . NAME OF DEPOSITOR(S) : 1) (IN BLOCK LETTERS) . FATHER'S/HUSBAND'S NAME. : . ADDRESS OF THE : i) Office Address : FIRST DEPOSITOR (with Designation, PF. No., Department Bill Unit No. and Station) ii) Postal Address . DATE OF RETIREMENT OF THE FIRST DEPOSITOR MONTHLY DEPOSIT : InFigures . TERM OF DEPOSIT (In months) .-Months. . SPECIALINSTRUCTIONS — : Amount to be paid on maturity :-i) Self (First Depositor) (Ploase write "Yes" in the appropriate box) ii) Former or Survivor . NAME OF THE NOMINEE AND HIS / HER RELATIONSHIP: WITH THE FIRST DEPOSITOR. DATE OF BIRTH (in Case of Minor) a 2. DATE: ‘SIGNATURE (S) /L T | OF DEPOSITOR(S) PTO.RULES 4. The deposit may be accepted in single / joint name (8). For the deposits with joint names, the first depositor must be a shareholder of the society on the date of application and must continue as such during the tenure of the deposit. 2. For premature withdrawal, the same is to be governed by the rules and regulation as to be framed by the Board of Directors of the Society time to time. 3. The deposit shail be for a minimum period of twelve months or multiple thereof subject to maximum period of sixty months. 4. The Recurring Deposit shall be accepted only in cash through filling up of a deposit slip specified for this, purpose. 5. The monthly deposits will be accepted for a minimum amount of Rs. 100/- and multiple thereof subject to maximum of Rs. 500/- 6. The deposits will not earn any interest from the date from which the first depositor losses the right of membership as per extant rules of the society, 7. Depositor(s) fumishing LT I on the Application Form must submit two copies of recent passport size self photograph. DECLARATION BY DEPOSITOR(S) 1/ We hereby declare that the particulars furnished in the application form by me / us are true & correct and further declare to abide by the rules and regulations as framed and to be framed from time to time in respect of the Recurring Deposit Scheme of the Society. 1) 2) Date: Signature of Depositors For Office Use It is certified that the first depositor is a member of the Society as on the date of the application. Date : Ledger Keeper Accountant / Sub-Head Amount of monthly deposit : Account No. Date of deposit : Ledger/ Folio : Date of Maturity : The deposit may be accepted Date : Branch Manager / Branch Incharge Debentono0ts|