Bank Of Baroda Account Opening Form – Fill Out and Use This PDF

ACCOUNT OPENING FORM FOR INDIVIDUALS F. No.-401

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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 Name

Savings Bank A/c

Term Deposit A/c

Current A/c

Other A/c

FULL NAME, in CAPITAL Letters (In the order of first, middle and last name, leaving a space between words)

M/F

1

2

3

Date of Birth (dd/mm/yyyy)

PAN (if not available, please attach Form 60/61)

Customer ID(if any existing)

* Please choose from the following:
Salaried	Self Employed	Professional	Politician	Housewife	Student	Defence Staff
Retired	Stock Broker	Agriculture	Antique Dealer	Arms Dealer	Business	Others

**Please choose from the following (If Staff / Ex-Staff, mention E.C. Number):

Minor

Sr Citizen

Staff (EC No.

)

Ex-Staff (EC No.

)

Pensioner

NRI

Other /General

Name of the Guardian (In case of Minor):

Relationship with minor ( tick one)

(Attach Proof for minor’s DOB)

F & NG

M & NG

Legal*

De facto

Others

*In case of legal guardian (guardian appointed by Court), enclose copy of the court order.

Name and address of Employer

First Applicant	2nd Applicant	3rd Applicant

Facilities required (Please mark in appropriate box/es):

Cheque Book				Statement of Account through
Issued Cheque Series No.___________	to ___________		Pass book	Post	E mail		Delivery at branch
Date of Issue:			Statement Frequency:		Monthly		Quarterly
* Internet Banking – Baroda Connect		Debit cum ATM Card					* BOB Card

(* Please fill up separate application for Internet Banking – Baroda Connect and/ or BOB Card).

Please issue Debit cum ATM card in the name of the first / all applicants (in case of two joint a/c holders with operations as E or S / Any one or S):

Name to appear on Debit cum ATM Card In CAPITAL LETTER (not to exceed 20 Characters)

First applicant

Second Applicant

Third Applicant

			Residential address
		First Applicant		2nd Applicant	3rd Applicant
	Flat No./Bldg Name
	Street/ Road & Area/ Locality
	City and District
	State and Country
	Pin Code
	Tel No., Fax No.
	Mobile
	Email

Permanent Address / In case of NRE, local address in India

Flat No./Bldg Name

Street / Road & Area / Locality

City and District

State and Country

Pin Code

Tel No.,

If Professional: ( tick one)

If Business: ( tick one)

TERMS & CONDITIONS & DECLARATION (Please mark in appropriate boxes):

I/We have read, understood and agree to abide by the Bank’s 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 cheque book and recover charges from my/our account as per norms of the bank (Give Option)

Account will be operated and balance along with interest payable as per operational instructions given above.

I shall represent the said minor in all future transactions of any description in the above account until the said minor attains majority.

I will indemnify the Bank against the claim of the above minor of any withdrawal/transactions made by me in his/her account.

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 / quarterly average balance which the Bank may prescribe as the minimum / quarterly average balance to be maintained to avail the facilities and agree to pay the charges if minimum / quarterly average 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 in this application. 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.

For Debit cum ATM 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 to the person/s as name mentioned in the application of account opening form. I confirm that I am the sole account holder or have the required mandate to operate the account singly linked to the Debit Card. I/We further unconditionally and irrevocably authorize you to debit my/our account annually for Debit Card fees/charges if any stipulated by the bank.

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 so, I/We will be liable for action under the Foreign Exchange 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.

Full Signature (in running handwriting):

___________________	____________________	____________________
(Sole / First Applicant)	(2nd Applicant)	(3rd Applicant)

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:	Email:		Branch Name:
Tel No.	Mobile	Fax	Type of A/c. SB / CA / CC / OD

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)

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Name: _______________________________________	Signature:_________________________ (S.S No: _________)
Bank Official in whose presence signed

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Form DA-1 Nomination Form

Nomination under section 45ZA to 45ZF of the Banking Regulation A/c 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.

#As the nominee is a minor on this date, I / We appoint Shri / Smt / Kumari __________________________________________________ (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		*Signatures / 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).

Details of Identification documents submitted by the applicant/s.

(CARE: FOR NRI APPLICANTS COPY OF PASSPORT MUST BE SUBMITTED AS IDENTIFICATION DOCUMENT)

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Form 60 / 61 (to be filled by those who do not have PAN)			KYC IDENTIFICATION DOCUMENT TO BE SUBMITTED BY APPLICANT
				(Any one document from each of the following two lists subject to Bank’s
Form 60				satisfaction)
Are you a Tax Assessee	Yes No	if Yes	LIST – I (Latest/ recent photo identification documents)
a) Details of Ward / Circle / Range where the last return of income			1.	Passport (Must for NRI)
was filled: ________________________			2.	Driving License with photograph
b) Reason for not having PAN No: _________________________			3.	Voter’s Identity Card
			4.	PAN Card, Government ID Card
Form 61			5.	Identity Card/ Confirmation from employer
			6.	Letter from recognized public authority or public servant verifying the
To be filled by a person who has only agricultural income and no				identity (photo) of customer.
other income chargeable to income tax.			7.	Confirmation letter from employer / other Bank verifying therein
I hereby declare that my source of income is from agriculture and I				photograph of the customer along with other things.
am not required to pay income tax on any other income if any.			8.	Any other document with photograph evidencing identity of the
				applicant/s acceptable to the Bank.
Verification			(For married woman, proof of identity with her maiden name, if supported with
			a verified true copy of marriage certificate is acceptable as valid identity
I ____________________ do hereby declare that what is stated is			proof).
true to the best of my knowledge and belief.
			LIST – II (Latest / recent documents showing address proof)
Verified at ________ this the __________day of _________20			1.	Passport
			2.	Driving License with address, Voters’ Identity Card
			3.	Telephone Bill, Electricity Bill, Ration Card
			4.	Bank account statement (with address)
Date	_____________________		5.	Income / Wealth Tax assessment order (with address)
Place:	Signature of the Declarant.		6.	Letter from employer / Any document of communication issued by any
				authority of Central / State Government or local body showing residential
				address.
			7.	Any documentary evidence in support of residential address acceptable
				to the Bank.
			8.	In case of married women address proof of the groom is acceptable

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For Office Use

KYC CERTIFICATION:

I have met the account opener/s Mr./Ms. ____________________		I have verified the documents
Mr./Ms. ___________________________ Mr./Ms.____________________ in person and		submitted and confirm that KYC
hereby confirm that KYC Norms are fully complied with and further confirm that -		Norms are fully complied with.
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 KYC Compliant.		Signature of Branch Head
		/ Joint Manager / Manager
_____________________________		Specimen Signature
Signature of Head of the Department	Specimen Signature No.__________	No.____________
Date:		Date:
Pkv/ ACCOUNT OPENING FORM FOR INDIVIDUALS-31.01.08	msr08/ ACCOUNT OPENING FORM FOR INDIVIDUALS-31.01.08