BASIC SAVINGS BANK ACCOUNT OPENING FORM - M333 ‘SMALL ACCOUNT For Bank Use Only Name & Code of the Branch Affix Passport size Photo cust 0 ‘AIC No. [AADHAAR No. [FOR SMALL ACCOUNT] 1. Name in Ful (MMs) 2. roth stan Guan Name WJ 3. Residential aderess co House No, and name Street No, and name Lanark Vilage /city District state Pincode Taephonefiandline [obi No, 4 Sex MALE FEMALE Date of Birth 5. a) Occupation nannennnne (©) Category: 6. _KYC Documents Provided 7. Nomination Required 8. Request for ATM Debit Card Sms Alert 9. Introduction [if apolicabe} ‘Name of the introducer customer ID ‘Recount No LLLLOI 1 know Shri/Smt for the past Years/months. He/she is residing atthe address given above. Date : Signature of the introducer (Sa, Sok Sere hs vert Bane erica) Please open a Savings Bank account in the name of Mr/Ms. (first/sole applicant) and Mr/Ms. (second Applicant)**. The Saving Bank rules and regulations including those relating to Small Account have been explained to me/us and I/we agree to abide by the same. An additional photograph of sole/each applicant is attached. Signature/Thumb Impression of fist/sole Applicant __Signature/Thumb Impression of second Applicant Name & No, of /BF Signature of Business Correspondent/ Facilitator Name, SS No & Signature of the verifying Branch official “The Joint Account holder (Le. second applicant) shall fil up a supplementary Form,SAVINGS BANK ACCOUNT OPENING FORM ~ADDITIONAL INFORMATION [For full KYC Compliance] 41. Mode of Operation 2. PAN /GIR NO/FORM 60/61 3. Income Per annum 4. Edueatonal Qatifeaton 5. emai CODCOD 6 KYC Document : ienttiaton Poot Aaeeoss Poot 7. Request for add on: ‘SNO___[ Product 4 ‘-Statemiont of Account YesiNe 2. ‘Cheque 800k YesiNo 3 Mobile Banking YesiNo 4 Internet Banking YesiNo 5. Credit Card YesiNo 6. ‘Others YesiNo 8, Additional Information for Cross Selling | would lke to also avail- ‘SNO___[ Product 4 Housing Loan YesiNe 2. ‘Venicle Lean YesiNo 3. Mutual Fund YesiNo 4 LiferGeneral Insurance ‘YesiNo. 5. Pension YesiNo 6. Others YesiNo \iwe understand that a booklet on the Banking Codes & Standards Board of India Code(&CSBI) posted on your website shall be provided to me on demand, Terms & Conditions: \iwe confirm having racelved, read and understood (a) the accounts rules and hereby agree to be bound by the terms & Conditions outlined in these rules which governs the account(s) which Iiwe amlare openingiwill open and (b) amendments to the rules made from time to time and those relating to various services availed by me/us when displayed by the Bank fn its notice board or on its website and those relating to various services offered by the Bank and other facilties listed in this form. The usage of these facilties is governed by the terms and conditions stipulated by the Bank from time to time. Date: Place: Signature/Thumb Impression of frst/sole Applicant _Signature/Thumb Impression of second ApplicantBranch Office.. FORM DA-1: NOMINATION Nomination under Section 45 ZA of Banking Regulation Act, 1949 ang Rule 2(1) ofthe Banking Companies (Nomination) Rules 1985 in Deposits, We ( Name(s) Rio, nominate the folowing person to wham in the event of myfour! minor's death, the amount of deposit in the account may be relurmed by Swabhiman Bank. Branch Office DEPOSIT NOMINEE Nature] Account No, ‘Additional | Name ‘Address Relationship | Age | Date ofbinh of Deiais, with depostr, ‘Account any Wrany “As the nominee is minar on this date, we appoint MriMs, Age, Aros to receive the amount of the deposit on behalf of the nominee inthe event of myfouriminor’s death during the minority ofthe nominee Place Date: @ Signature(s) / #Thumb impression(s) of depositors, @where the deposits made in the name of minor, the nomination is to be signed by naluraliegal quardan ofthe minor to act on behalf of the minor. *Stike out if nominee is nat a minor WITNESSES Name & Signature ofthe first witnesses Name & Signature of second witnesses. Name Name Signature: Signature Adress: Adress: Pace: Place: Date Date: ‘Teleahone No, Telephone No. ‘Thumb impression(s) shall be attested by two witnesses; otherwise i shal be attested by one NOMINATION REGISTERED ‘The above mentioned nomination is registered at serial no in respect of (Type of Account ) Deposit Account No Date, For (Authorised official) $5 No. (3)ACCOUNTS OF INDIVIDUALS : LIST OF KYC DOCUMNETS (one document from each list) UST! usT2 Documents accepted as proof of identity Documents accepted as proof of residence 2 pancard 2 Hectraty i 3 ters erty cnt 5 eleopone ai 5 labor iss by NREGAsuy ened by noes af the State Governmentfar Small | 5 ater‘romempoyr tthe anton ofthe Bank esos 6 etter fom an rcogn sed pu author othe stiection ofthe Bank) 6 Theleer sued by UDA containing desis fame scdretsandAadhasrmumer |? Crest Carastatemert not mae tan rants ole 17 ldeny ard abot ta tenons satan) 4 eareetn Tne ssse ent Orr 9 Governmer(Deenee Dard fissure of such ates 20 Deardsofreputed Publ Sear employes 22 Voter ID Car (oly ft conan th tet aes) 1 Penson Payment Ordes sued to the retred employes by Cemraystate | 12 Pension Paymen Ofees ised to reed evpoyees by Government ‘SovermentDepareens, ube eco Unéaraknes Deparment Publ Sector Underakira, fey contain cae aes 12 Photo ears sued by Post Ofees 13, Copesofegere eave & cers apoemart/S Deed eae Areert 13 Photowsenty cards ring to Borafse udens by» Unwerny, approved by te | 14 Caneste and ao prot of rséons, nmarporming acl aeorer i we Uniesty Grav Conmison (UGC anal on nse approved Sy Ania Coun! | Sermanent addres sud bythe Hostel Warden of he nnereyfnsehe, fortechtal Education (Te). Sahar the studer render, Sly coomerigned by ohe Aap Pepal/oean 11 Photo Kent ued by any publ authority having proper ecard of knuaee of | of Student We, Such axons shal however, be regret breed on deray proof whi vere For recat Canpleson of eduston/ewing. the” Unversty/nsttte povided the 35 Exserveenen Cad wi photograph ‘sttuont dons ot give any athe ect pos! eine ote Bare AE Sor Coure/Meieal ssocationIEAI/ICHAIIC! Crs with protograph 15 for sidents eng wt elatves, sept of lates, slong wth Ter course patios ‘ate stdert related a hime ads staying with ener 18 Deense Dependents card wth shteeap 16 In respec of ofeals of Cervasate Governments and. Puble Sector 133. Marled woman enery prot with maien name, Fsuppored wih 2 verted vue |” underakings, who ate ow risk customers for Bak Brae Heads may vey te op of meriage catia féery. apd confrn resem! 26iess of Suh ofls rom ol ‘rents Th fact steed nyt the Gaeted teen 9 ona 21 Reger ropry document wth ahoto ey Goverert snd senar Monagement and above uncorsre of Publ Sotor 22. emeeensnund by tate Cental Goverment of Undertngs 24 Employee tate nsrarce Card (ESIC) wth aotogaph supported by atest man's | 18 Consume gat anrarioncad/bootPpe gs evs. 19 Certs rom war/ecuver nko, maining ection rl cating 25, Wt Pawar fa oa gow ial auetaion by wayof puting tbe stamp and | asda f the apa signature Grom Srpanch mutha atestation by may of ung ube stamp and | 20. Post Ofc Songs Pass ook ‘leatre For sal Accounts) 22. Domlcleceifste wih communication ass nd photograph 22 Goneat by vile exterionofee [VEO Village Head oF egal or Maher ‘anor hanch to comt the athe of he criste ar that she Scenes byte paron wo hosing es oe NOTE: pstspor Roving caren address ven at proo of ety, there no nee ‘To be filled by these who do not have either PANIGIR FORM NO. 6 FORM NO. 61 [See second proviso rule 148] Form of decaration to be fied by a person who does not [See proviza to cause (of rule THC (T] Form of declaration fo be fled by a person who has agricultural income have s permanent aceount number and whe enter Into and isnot necelpt of any other Income chargeable to Income-tax In respect arytran ied in ule ‘Stteansactions speciod rule 148 1. Fubiname end eddrots oth declarant 1. Fullname and adress of the declarant 2. Amount ofthe transaction, ati. te doce ss 4. Are you assessed to ax? Yes Oo ~[] Yes Ne 5. yo) Datal f Ward.CrlaRange whee the ast tum ot nerdy declare that my soure of Income rom agruture and noone te {aminol requred a pay income ax on any oa" ncome, ny (W) Reasons fornot having permanent acount Numer: 6. Deal of ne cocumant beng produced in sun of adress Iestuma(t) VERIFICATION " So heeby declare that wnat stated above ls tu tote best of my knowledge andl Verld oday, te day of Signature ofthe aectarant “)SAVINGS BANK ACCOUNT OPENING FORM (supplementary form for second applicant) For Bank Use Only Name & Code of the Branch cust LLELLILL] A WENO Passport size Photo 1. Name in Ful (Mr/Ms) (Second applicant) 2, Father) Husbend/Guardian Name 3. Residential aderess co House No, and name Street No, and name Lanamark Vilage /Cty District state Pincode Teephone/iandline Mable No. 4. Sex 5. a) Occupation 6. _KYC Documents Provided Date of Bit: (©) Category SSignature/Thumb Impression of second Applicant Name & No, of BBR Signature of Business Correspondent/ Facilitator Name, SS No & Signature of the verifying Branch official