Kvb Account Opening Form PDF Details

Opening a bank account represents a pivotal step towards financial independence and the Karur Vysya Bank Ltd. extends a structured pathway through its M 325 Account Opening Form intended for resident individuals seeking to initiate either a savings or a current account on an individual or joint basis. Designed with user accessibility in mind, this document emphasizes the importance of filling out the application in capital letters with black ink to avoid any readability issues, ensuring that all mandatory fields marked with an asterisk are completed. With sections dedicated to personal details, including familial information and identification numbers like the Aadhaar and PAN, the form meticulously captures essential data to authenticate the identity of the account holder. Furthermore, it details the operational specifics of the account, such as initial payment methods and instructions for the account’s operation, ranging from single to joint management options. The inclusion of introducer’s details substantiates the applicant's credibility, while the segment on required services like cheque book issuance and e-mail statements customization underscores the bank’s commitment to cater to diverse banking needs. The form also incorporates provisions for nominating individuals to manage the account in unforeseen circumstances, alongside declarations that bind the applicant to the bank's terms and conditions, signifying a mutual agreement on operational dynamics. Additionally, a section dedicated to minor accounts provides a framework for guardians to control and oversee the financial transactions made by their wards, ensuring a protective measure is in place. Altogether, the Karur Vysya Bank’s Account Opening Form not only facilitates a seamless account setup process but also meticulously safeguards the interests of both the bank and its prospective customers through thorough data collection and clear terms of engagement.

QuestionAnswer
Form NameKvb Account Opening Form
Form Length16 pages
Fillable?No
Fillable fields0
Avg. time to fill out4 min
Other nameskvb account opening online, karur vysya bank zero balance account opening online, karur vysya bank account opening online, karur vysya bank online account opening

Form Preview Example

This is a machine readable form. Please avoid overwriting while illing the application

M 325

Account Opening Form

FOR RESIDENT INDIVIDUALS

FOR SAVINGS ACCOUNT (INDIVIDUAL/JOINT) AND CURRENT ACCOUNT (INDIVIDUAL)

To

Branch address:

The Branch Manager, The Karur Vysya Bank Ltd.

 

Please open my /our account at your Branch.

 

Please ill all the details in CAPITAL LETTERS and in BLACK INK only. Fields with * are MANDATORY.

FOR OFFICE USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

D

D

M

M

Y

Y

Y

Y

CUSTOMER IC*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CUSTOMER ID

 

 

 

 

 

 

 

 

ACCOUNT NO.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCOUNT OPTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Savings

(Specify category)

 

 

(Product No. _____)

Current (Specify category)

 

 

(Product No. _____)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INDIVIDUAL DETAILS (DETAILS FOR JOINT APPLICANT TO BE GIVEN SEPARATELY)

Mr/ Ms

*

*NAME: INDIVIDUAL (IN THE ORDER OF FIRST, MIDDLE & LASTNAME) leave space between words. Eg. RAM GOPAL VARMA

*FATHER’S NAME

MOTHER’S NAME

SPOUSE NAME

AADHAAR ID:

PAN NO.:

FORM 60/61 (ENCLOSED)

Y N

DATE OF BIRTH*

 

 

 

 

 

 

 

MINOR A/C

 

MARITAL STATUS

NATIONALITY*

 

 

RELIGION

 

GENDER*

 

 

D

D

 

M

 

M

 

Y

 

Y

 

Y

Y

 

 

Y

 

 

M

UM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

F

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOBILE NO.:*

 

 

 

 

 

 

 

 

 

 

 

 

EMAIL ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RES TEL

 

S

 

D

 

C

 

O

 

D

 

 

 

 

 

 

 

 

 

OFF TEL

S

D

C

O

D

 

 

 

 

 

 

 

 

 

 

NO.:

 

T

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

NO.:

T

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*MAILING ADDRESS: FIRST INDIVIDUAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY/TOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRICT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PINCODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERMANENT ADDRESS (IF DIFFERENT FROM ABOVE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY/TOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRICT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PINCODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Note: For Joint holder/s additional SB Joint Applicant Form to be attached.

1 of 12

 

IF MINOR ACCOUNT

Name of the Parent / Guardian ______________________________________________________________________________________________________________________________________________

Relationship

Father

Mother

By Court order (enclose a copy)

I shall represent the minor in all transactions of any description in the above account till the said minor attains majority. I shall fully indemnify the bank against any claim of the above minor for any withdrawal/transaction made by me in his/her account.

Signature of the Guardian

INITIAL PAYMENT DETAILS

`

`IN WORDS

Cash (Please make cash remittance only at the branch. Please do not handover cash to unauthorized persons)

OPERATING INSTRUCTIONS

Single

Either or Survivor

 

Former or Survivor

 

any one or Survivor

PA Holder By_______________________

Jointly by all

 

 

 

 

Minor A/c Operated by Guardian

 

Mandate Holder By_______________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTRODUCER’S DETAILS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction by existing KVB Account Holder.

Introduction by existing Banker.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introducer ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Account No.

I conirm that I personally know the applicant / s detailed herein for more than 6 months and conirm his/her/their identity and address.

_______________________________________________

Signature of Introducer

FOR BANK USE:

Name, Code and Signature of the Manager/Oficer who veriied the introducer’s signature.

SERVICES REQUIRED

1.

CHEQUE BOOK FACILITY

Yes

No

2. E-MAIL STATEMENT

YES

NO

 

3.

A/C STATEMENT FREQUENCY (CURRENT A/C)

M

Q

HY

Y

 

 

4.

CONSENT TO COMMUNICATE NEW PRODUCTS/OFFERS (THROUGH E-MAIL, SMS, POST, TELEBANKING):

YES NO

Customer Signature

2 of 12

Applicant No. 1

Please paste colour photo

here. Please do not use pins,

staples or tape

ACCOUNT NO.:

Applicant No. 2

 

Applicant No. 3

Please paste colour photo

 

Please paste colour photo

here. Please do not use pins,

 

here. Please do not use pins,

staples or tape

 

staples or tape

 

 

 

Applicant No. 4

Please paste colour photo

here. Please do not use pins,

staples or tape

CUSTOMER ID

CUSTOMER ID

CUSTOMER ID

CUSTOMER ID

 

 

 

 

NAME:

NAME:

NAME:

NAME:

 

 

 

 

Signature (with seal)

 

Signature (with seal)

 

 

 

(USE BLACK INK AND SIGN WIThIN ThE BOx ONLY)

Signature (with seal)

Signature (with seal)

(Incase of LTI)

Witness No. 1

 

 

 

 

Witness No. 2

 

 

 

 

 

 

 

 

 

 

 

 

 

____________________________________________

 

 

____________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KYC AND RISK PROFILE CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT

 

PROOF TYPE

NAME OF THE DOCUMENT

NUMBER

 

 

 

ISSUE DATE

 

 

EXPIRY DATE

 

NO.

 

 

 

 

 

 

 

D

D M M Y Y Y Y

D D M M Y Y Y Y

1.

IDENTITY PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

IDENTITY PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

IDENTITY PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

IDENTITY PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS PROOF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We have perused the Original Documents and as per KYC norms all are correct. Further to know about the customer we have enquired locally and/or we

personally visited the places of addresses given by the customer, to ascertain the correctness. All the signatories have signed before me. I authorize opening of

the account. Also we certify that according to the nature of Business/activity, this account may be treated under the below selected risk category:

 

 

 

 

 

 

 

Expected level of turnover:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RISK LEVEL

LOW

MEDIUM

HIGH

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(In a quarter)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CANVASSED BY

 

CODE NO.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE:

 

SIGNATURE OF ThE MANAGER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3 of 12

*PERSONAL INFORMATION OF ThE APPLICANT

NAME OF THE APPLICANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NO. OF DEPENDENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAMILY MEMBERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOB

 

 

 

 

 

 

 

RELATIONSHIP

 

 

 

OCCUPATION

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUALIFICATION

 

 

UNDERGRADUATE

 

GRADUATE

 

 

 

POST GRADUATE

 

PROFESSIONAL

ILLITERATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYED WITh

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE GOVT

 

CENTRAL GOVT

PUBLIC LTD

PRIVATE LTD

MNC

OTHER ENTITY (specify……………………………………)

 

 

 

NATURE OF BUSINESS

 

 

 

MANUFACTURING

 

TRADING

SERVICES

RETAILING

 

 

AGRICULTURE

 

MONEY SERVICES

AGENCY

 

 

 

 

 

 

 

 

 

 

 

STOCK BROKER

 

 

REAL ESTATE

NGO/NPO

 

 

JEWELS/GEMS/PRECIOUS METAL DEALER

 

 

OTHERS (specify) _______________________

 

 

 

TYPE OF PROFESSION

 

 

 

 

DOCTOR

 

ENGINEER

 

BANKER

 

TEACHER

 

LAWYER

ARCHITECT

 

CONSULTANT

 

 

 

IT PROFESSIONAL

 

 

OTHERS (specify) _________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANNUAL INCOME

 

 

 

 

 

 

 

 

 

 

SELF

 

 

 

 

 

 

 

 

 

 

 

 

SPOUSE

 

 

 

 

 

 

HOUSEHOLD

 

 

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASSETS OWNED

 

 

 

HOUSE

CAR

TWO WHEELER

 

GOLD

SILVER

LAND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOANS WITh OThER BANKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSING

BUSINESS

 

CAR

TWO WHEELER

 

 

 

CREDIT CARD

PERSONAL

JEWEL

PROFESSIONAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OThER INVESTMENTS

 

DEPOSITS

 

INSURANCE

 

SHARES

 

MF

DEMAT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF ThE ACCOUNT hOLDER/S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINATION REQUIRED:

 

 

NO: I / We do not require Nomination facility: Signature ____________________________________

 

 

 

 

 

 

 

 

 

YES (If yes submit Form DA-1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINATION FORM DA-1

 

 

 

NOMINATION UNDER SECTION 45ZA OF THE

NOMINATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BANKING REGULATION ACT 1949 AND RULES (1) OF

REGISTRATION NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE BANKING COMPANIES (NOMINATION) RULES,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1985 IN RESPECT OF BANK DEPOSIT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I/We_________________________________________________________________ nominate the following person to whom in the

event of my/our/minor’s death, the amount of deposit in the account(s), particulars whereof are given below, may be returned by

THE KARUR VYSYA BANK LTD. ____________________ in which the deposit is held.

 

 

 

 

 

 

 

 

 

 

 

 

 

Account Type

 

 

 

 

 

 

 

 

 

 

 

 

 

Account Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINEE NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINEE ID:

 

 

 

 

 

 

RELATIONSHIP

 

 

 

& AGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOB OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOMINEE PAN NO.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. As the nominee is a minor on this date, I/we appoint Shri/Smt./Kum.**

NAME/S AND ADDRESS/ES OF THE WITNESS/ES*

 

 

 

_____________________________________________AGE____

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_____________________________________________________

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_____________________________________________________

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_____________________________________________________

 

SIGNATURE/S OF THE WITNESS/ES

SIGNATURE(S)/THUMB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IMPRESSION(S) OF THE

(Name, address & age) to receive the amount of deposit on behalf of the

1.

 

 

 

 

 

 

 

 

 

 

 

DEPOSITOR(S)*

 

 

 

nominee in the event of my/our minor’s death during the minority of the

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

nominee.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Where the deposit is made in the name of a minor, the nominations should be signed by a person lawfully entitled to act on behalf of the minor.

** Strike out if the nominee is not a minor. *. Thumb impression(s) shall be attested by two witnesses.

 

 

 

 

 

 

 

 

 

 

 

PLACE __________________________________

 

 

 

 

 

 

 

 

 

 

DATE __________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE: The acknowledgement for Nomination Registered is attached to the last sheet of the Account Opening Form.

4 of 12

ACCOUNT NO.:

DECLARATION

I/We have read and understood the Terms and Conditions (a copy of which I/we am/are in possession of ) governing the opening of an account with KVB and those relating to various services including but not limited to (a) ATMs (b) Anywhere Banking Convenience Plus. (2) I/We accept and agree to be bound by the said terms and conditions including those/limiting the Bank’s liability. (3) I/We understand that the Bank may, at its absolute discretion, discontinue any of the services completely or partly without any notice to me/us. (4) I/We agree that the Bank may debit my account for service charges as applicable from time to time. (5) I/We conirm that I/We am/are residents of India. (6) I/We agree to notify the Bank in future if I/We avail any credit facility from any other bank and I/We authorize you to inform the existence of our account with you to the lending banker. (7) I/We also abide by the terms and conditions of the bank for off line transactions. (8) I/We shall be liable to you for any monies owing to you from time to time in case the account is overdrawn and /debit balance is caused including your commission, interest and other incidental charges. (9) In the event of death or insolvency or withdrawal of any of us the survivor/s shall have full control of any monies standing to my/our credit in our account with you and the survivor/s will have full powers to operate the account / close the account. (10) I/We request and authorize you to honor all cheques and other orders drawn or bills of exchange accepted or notes made on our behalf, to debit such cheques to our account with you whether such accounts be for the time being in credit or overdrawn. (11) I/We also request you to accept the endorsement signed by me/us on cheques /orders/bills or notes payable to us. (12) The cheques/Bills presented by us in our account for collection are at our sole risk and responsibility and the bank may engage the services of courier/post ofice for sending the instruments for collection and the bank is not liable for any loss or damages in case the instruments are lost in transit. (13) I/We accept the Bank's right to take steps to close the account if frequent return of cheques for want of funds or any other undesirable feature is observed. (14) The loating rate of interest is subject to loating interest rate ixed by the bank from time to time and notiied by the bank and no separate intimation or notice will be given to the depositor. (15) Failure to maintain monthly/quarterly minimum average balance in the SB/CA attracts penal charges.

General: I/We have read the terms & condition of the Bank and pertaining to the Savings/Current accounts and anywhere banking, tele-banking, internet banking, and ATM cum Debit Card facility. I/We have understood the same and agree to abide by such/any other terms and conditions that may be in force from time to time. I/We also agree to abide by the Bank’s Schedule of Charges as applicable from time to time for savings/current accounts as published in the bank’s web site/notice board. I/ We also understand that the terms & conditions and the service charges are subject to change without any personal notice. The information furnished/declaration given by me/us in this form is true and I/we shall be held responsible for any wrong/misleading information at all times. For the purpose of providing certain services, the Bank is/may be required to engage the services of specialized and other service providers/ agents. I/We authorize the Bank to furnish any information regarding my/our account to these service providers/agents. I/We also understand that the continuation of the accounts is at the Bank’s sole discretion, and in case of dissatisfaction with the conduct of the account, the Bank has right to close the account after giving suitable notice or withdraw some/all services/ concessions granted to me/us.

Core Banking: (1) The Bank shall facilitate payment and collection of cheques through alI its branches while I/we shall have one account at the branch (for short "Home Branch") Bank shall also accept cash from me/us or my/our representatives and pay in cash against presentation of cheques drawn by me/us in favour of myself/ourselves or third party to the credit or debit to my/our designated account with the Home Branch as per the appIicable Iimits for the account. The cash transaction will be on the same lines as is the case when deposits/ withdrawals take place at the home branch. (2) While the instruments for and on my/our behalf will be collected in local clearing, the credit in respect of the proceeds, thereunder will be afforded at the home branch on and subject to realization at the respective centre(s)/branch(es). (3) The Bank will be entitled to debit by its home and any other branch(es) my/our account at its base branch against the cheques presented at various branches of the Bank. (4) My/our written intimation of "stop payment" to the various branches of the Bank will be at my/our risk and I/We agree to grant a lead time of at least 24 hours for intimation of such "stop payment" instruments to all its branches. In case of any erroneous information which may emerge due to any communication error and if the "stop payment" is not carried out in good faith based on the said information, the Bank shall not be held responsible for the said act. (5)I/We agree at any given time to maintain the average balance in my/our account as applicable for the account and informed to us by the Bank. In the event of my/our failing to maintain the minimum balance and for conduct of the account not being satisfactory, the Bank will at its discretion be entitled to forthwith terminate the facility hereby granted to me/us or to levy service charges as mutually agreed upon. (6) I/We agree to inform my/our existing bankers for the availment of any of the facilities hereby granted to me/us. I/We also agree from time to time to furnish such information/details and the documents to the existing bankers and also to the Bank as is mandatory under the law in force from time to time or as the Bank regards necessary and/ or expedient under the banking practice/procedure or to maintain the comity and fair-play between the Bank and the other bankers. (7) The agreement herein contained shall not affect, prejudice or derogate from the Bank's rights and privileges under the law including the right to claim setoff, general and the bankers disposing or retaining lien or similar rights pertaining to my/our credit balance in the account with the Bank. (8) In the event of any malfunctioning and/or break-down in the working of the said network for the reasons beyond the control of the Bank, the beneits and the facilities hereby granted to me/us will stand suspended during such break-down in which case the Bank will not in any manner be liable and/or responsible to me/us for any damages / compensation and/or for any other consequences arising out of such suspension. (9) I/We agree to hold the Bank indemniied in case the Bank suffers any loss in account of operation of the scheme for my/our beneit.

SIGNATURE OF ThE DECLARANT/APPLICANT

GUARDIANS DECLARATION (MINOR ACCOUNTS)

*My minor son/daughter, Master/Miss ……………………………………………......................................................................................….… has opened as SB Account with your bank with

A/c No. …………………………………………..… in his/her own name. I declare the date of birth of the minor is ……...../………./……….

*I have opened a joint SB A/c with your bank in the name myself and my minor son/daughter, Master/Miss …………….....................................................................................………. with

A/c No. …….......…………….…….....................……… I declare the Date of birth of the minor is…….../……../……........

*I am his/her natural and lawful guardian. *I am the guardian appointed by the court vide order dated……/….../….. (Copy enclosed).

For the sake of operational convenience, I have requested the bank to issue an ATM Debit Card to my minor son/daughter to be used by him/her. I will explain to the minor, the rules of operation of the account as well as safeguards to be followed while using ATM Debit Cards. I will suitably guide my son/daughter for the safekeeping of the ATM Debit card and maintaining the secrecy of PIN number allotted to him/her. I will also explain the consequences of loss/misuse/abuse of the ATM card. I undertake to supervise the use of the ATM debit card by the minor and the account would be operated under my guidance and I will monitor the transactions done through ATM. I will not hold the bank responsible and liable for any transactions done by the minor and I undertake not to make any claim against the Bank for consequences arising out of unauthorized use/misuse/abuse of the card. All the transactions done using the ATM Debit Card will bind me, as if done by me only.

SIGNATURE OF ThE GUARDIAN

*Strike out whichever is not applicable.

5 of 12

Terms & Conditions of EFT Executed in the RBI EFT SYSTEM (as per form FT-2B)

I/We am / are desirous of availing the Electronic Funds Transfer (EFT) through the RBI EFT System. In consideration of the bank agreeing to extend to me/us the said EFT facility, I/we hereby agree to and undertake the following terms and conditions.

1.Deinitions (a) “Customer” means the person named here-in above who has executed this Agreement. (b) "Bank" means Karur Vysya Bank Ltd. (c) "EFT Facility " means the Electronic Funds Transfer Facility through the RBI EFT Systems. (d) "Security Procedure" means a procedure established by agreement between the bank and the customer for the purpose of verifying that the payment order or communication amending or canceling a payment order transmitted electronically is that of the customer or for detecting error in the transmission for the content of the payment order or communication. A security procedure may require the use of algorithms or other codes, identifying words or numbers, encryption callback procedures or similar security devices. (e) Words or expressions use in this Agreement, but not speciically deined herein shall have the respective meanings assigned to them in the RBI EFT Regulations, 1996. 2. Scope of the Agreement (a) This Agreement shall govern payment order issued by the customer during the period of validity of the Agreement. (b) This Agreement shall be in addition to and not in derogation of the RBI EFT Regulations, 1996. The customer has gone through and understood the RBI (EFT System) Regulations, 1996 and agrees that the rights and obligations provided therein in so far as it relates to the originator shall be binding on him/it in regard to every payment order issued by him/it for execution in the EFT System. (c) The customer understands and agrees that nothing in this Agreement shall be construed as creating any contractual or other rights against the Reserve Bank or any participant in the EFT System, other than the bank. 3. Commencement and Termination (a) This Agreement shall come into force as soon as a security procedure is established by mutual agreement between the bank and the customer. (b) The Agreement shall remain valid until it is replaced by another agreement or terminated by either party or the account is closed whichever is earlier. (c) Either party to this Agreement may terminate this Agreement by giving one month's notice in writing to the other party. Notwithstanding the termination of the Agreement the parties to the Agreement shall be bound by all transactions between them in regard to EFT Facility availed of by the customer before the termination of the Agreement.

4.Security procedure (a) For the purpose of agreement for security procedure, the bank may offer one or more or a new combination of one or more security device. (b) A security procedure once established by Agreement shall remain valid until it is changed by mutual agreement. 5. Rights and Obligations of Customer (a) The customer shall be entitled, subject to other terms and conditions in the Regulations and this Agreement to issue payment orders for execution by the bank. (b) Payment order shall be issued by the customer in the form annexed hereto, complete in all particulars. The customer shall be responsible for the accuracy of the particulars given in the payment order issued by him and shall be liable to compensate the bank for any loss arising on account of any error in his payment order. (c) The customer shall be bound by any payment order executed by the bank if the bank had executed the payment order in good faith and in compliance with the security procedure, Provided that the customer shall not be bound by any payment order executed by the bank if he proves that the payment order was not issued by him and that it was caused either by negligence or a fraudulent act of any employee of the bank. (d) The customer shall ensure availability of funds in his account properly applicable to the payment order before the execution of the payment order by the bank. Where however, the bank executes the payment order without properly applicable funds being available in the customer's account the customer shall be bound to pay to the bank the amount debited to his account for which on EFT was executed by the bank pursuant to his payment order, together with the charges including interest payable to the bank. (e) The customer hereby authorises the bank to debit to his account any liability incurred by him to the bank for execution by the bank of any payment order issued by him. (f) Customer agrees that the payment order shall become irrevocable when it is executed by bank. (g) Customer agrees that the bank is not bound by any notice of revocation unless it is in compliance with the security procedure. (h) Customer agrees that he shall not be entitled to make my claim against my party in the RBI EFT System except the bank. (i) Customer agrees that in the event of any delay in the completion of the Funds Transfer or any loss on account or error in the execution of the Funds Transfer pursuant to a payment order, the bank's liability shall be limited to the extent of payment of interest at the Bank Rate for my period of delay in the case of delayed payment and refund of the amount together with interest at the Bank Rate upto the date of refund, in the event of loss on account of error, negligence or fraud on the part of any employee of the Bank. (j) Customer agrees that no special circumstances shall attach to my payment order executed under the EFT facility under this Agreement and under no circumstances customer shall be entitled to claim any compensation in excess of that which is provided in clause

(9) above, for any breach of contract or otherwise.

Rights and Obligations of the Bank: 1. The bank shall execute a payment order issued by the customer duly authenticated by him as deined by the security procedure, unless

(a)The funds available in the account of the customer are not adequate or properly applicable to comply with the payment order and the customer has not made any other arrangement to meet the payment obligation. (b) The payment order is incomplete or it is not issued in the agreed form. (c) The payment order is attached with notice of any special circumstances.

(d)The bank has reason to believe that the payment order is issued to carry out an unlawful transaction. (e) The payment order cannot be executed under the RBI EFT System. 2. No payment order issued by the customer shall be binding on the bank until the bank has accepted it. 3. The bank shall, upon execution of every payment order executed by it, be entitled to debit the designated account of the customer, the amount of the funds transferred together with charges payable thereon, whether or not the account has suficient balance.

SIGNATURE OF ThE DECLARANT / APPLICANT

Current Account / Credit facility with other bank

I/We declare that I / We do not enjoy credit facilities with other bank/s.

I/We enjoy credit facility / have current account with other banks, details of which are furnished below: (If credit facility is enjoyed with other bank, NOC should be obtained and produced for opening the account)

Name of the Bank

Account No.

Facility

Amount

SIGNATURE OF ThE DECLARANT / APPLICANT

…….....……………............................................………………….…TEAR hERE…………………………………………………………………………......…..….

ACKNOWLEDGEMENT FOR NOMINATION REGISTRATION (TO BE RETURNED TO CUSTOMER AFTER REGISTRATION)

THE KARUR VYSYA BANK LIMITED

BRANCH ______________________

ACCOUNT NUMBER

NOMINEE NAME AND ADDRESS

RELATIONSHIP

REGISTRATION NO. AND DATE

MANAGER/OFFICER

6 of 12

Application for E-services

For Individuals / Corporate

Please ill all the details in CAPITAL LETTERS and in BLACK INK only.

BRANCH NAME: ________________________________BRANCH CODE: __________DATE_______________

Photo

Please paste colour stamp size photo here. Please do not use pins, staples or tape.

CUSTOMER ID

ACCOUNT

NO.

I/We wish to apply for the following E-Services with your bank. I/We furnish the details of my/our account for which the facility shall be enabled.

FACILITY / SERVICES REQUIRED

ATM Card Debit Card Add on Card Alert (Mob / E-mail) Internet Banking Mobile Banking (M-pay)

Mr./ Ms/ Messers

ACCOUNT NAME : (IN THE ORDER OF FIRST, MIDDLE & LAST NAME) leave space between words.

Fill up the rows applicable to the facility requested

1.ATM/DEBIT CARD

(Name to appear on the card)

PHOTO CARD

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADD ON CARD :

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. ADD ON CARD DETAILS

 

 

 

 

 

CUSTOMER ID

 

JOINT HOLDER

 

 

 

 

 

NON-CUSTOMER (Joint applicant Form to be attached)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADD ON CARD (Name to appear on the card)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. ALERT:

SMS /

E-mail ID

 

 

 

 

 

 

 

Customer ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mobile Number / E-mail ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALERT:

SMS/

E-mail ID

 

 

 

 

 

 

 

Customer ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mobile Number / E-mail ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ALERT:

SMS/

E-mail ID

 

 

 

 

 

 

 

Customer ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mobile Number / E-mail ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SMS: TRANSACTION TYPE –

Debit

 

Credit

 

Balance

 

E-MAIL: TRANSACTION TYPE –

 

Debit

Credit

Balance

AUTHORISED USER NAME – 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(For Alert)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORISED USER NAME – 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(For Alert)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORISED USER NAME – 3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(For Alert)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. MOBILE BANKING – M-PAY (mobile number)

 

 

 

 

 

9

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HANDSET MAKE – MODEL (Eg.: NOKIA -3110C)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORISED USER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(For Mobile banking – M-pay)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. NET BANKING :

Retail –

Fin-Personal

Fin-Personal and Third Party

Non-Fin

 

RSA TOKEN (Optional and charges are applicable)

Corporate –

Fin

Non-Fin (Maker is one who enters the transactions. Checker is the one who authorize the transaction.) RSA TOKEN mandatory.

 

AUTHORISED USER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

E-MAIL ID

 

 

 

 

 

 

(F/ NF)

 

Maker / Checker

 

 

 

 

Limit (`)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I/We conirm that the mandate from the competent

authority has been obtained for the corporate user(s) for

operating our

accounts and transaction

through internet

banking services of KVB. The copy of the resolution is enclosed.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF ThE ACCOUNT hOLDER/S

7 of 12

DECLARATION

Debit Card: I/We have read and understood the terms and conditions governing the usage of the Debit Card. I/We accept to be bound by the said terms and conditions and to any changes made therein from time to time by the Bank, at its sole discretion without any notice to me/us. I/We conirm that I/we am/are the sole account holder or have the required mandate to operate all the accounts linked to the Debit Card(s) singly. I/We understand that upon issue of a Debit Card to me/us, the existing ATM card linked to my account will be deactivated. I/We understand and undertake that the usage of the Debit Card shall be strictly in accordance with the Exchange Control Regulation and in 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 the Reserve Bank of India, or rules notiied under the Act or any other Act governing such transactions. I/We accept full responsibility for my Debit Card and agree not to make any claims against Karur Vysya Bank, in respect thereto. I/We agree that the cash deposited by me/us in the ATM will be credited by the Bank to the account after due veriication and if it is found in order within 24 hours from the next working day. I/We agree further that all complaints pertaining to all ATM transactions will be resolved by the Bank within about 2 months.

Mobile Banking (Alert): I / We wish to apply for the SMS banking and subscribe for the Mobile alerts facility offered by KVB. I am herewith furnishing the details of my / our account for which this facility shall be enabled. I/We have read and agree to abide by the terms and conditions governing KVB @ Mobile made available to me / us by THE KARUR VYSYA BANK LTD. I/We am / are responsible for the registration of Mobile Banking at the Hand phone Number/s mentioned above. In the event of availing any additional / specialized facility through Mobile Banking, I/we shall be fully responsible for the account being debited on instruction from the above mobile Number/s. I /We have no objection to the fees, duties or any other charges which is associated with the service. In case of any mistake on my part or that of the mobile service provider in respect of these services, I/we agree that the Bank will not be responsible and agree not to make any claim against the Bank.

Mobile Banking (M-pay): I hereby conirm that the following. I / We have read and agree to abide by the terms and conditions governing Mobile Banking services (KVB mPAY) made available to me/us by THE KARUR VYSYA BANK LTD. (a copy of which I am in possession/displayed in the banks website,www.kvb.co.in) I am the sole account holder or I have the required mandate for joint account to singly operate the account through mobile banking. I am solely responsible for all the transactions happening through my mobile number. I will keep the application password / MPIN / any other form of security/authentication PIN provided by the bank and maintain the conidentiality and secrecy. In case of change in mobile number, I will uninstall /remove the mobile banking application installed in my mobile, for maintaining the conidentiality and secrecy. In case of lost / theft of my mobile / SIM, I will immediately inform the bank to cease /suspend the mobile application facility. I am aware of the charges applicable for this service and hereby authorize Karur Vysya Bank to debit my account(s) towards any service charges for availing mobile banking facility, as and when it is applicable. Charges as per my tarrif plan may be levied by my mobile service provider. I declare that the above details mentioned in the application are true and correct to the best of my knowledge.

INTERNET BANKING: I/We have read and agree to abide by the terms and conditions governing KVB@NET Internet facility of THE KARUR VYSYA BANK LTD. provided to me/us including those excluding/limiting the Bank’s liability and agree to any other changes to be made by the Bank from time to time and acknowledge that the Bank may in its absolute discretion discontinue any of the services completely or partially without notice to me/us. I / We request you to provide access as requested above. I / We agree that the Bank may debit my / our account for the service charges as applicable from time to time.

RSA Security Token: I / We agree to receive RSA token which generates pass code for me/each individual authorized signatory(s) as given above for the purpose of transacting my/our accounts through internet banking. I / We agree and authorize the bank to debit my/our primary account with the bank at the rate applicable from time to time for the issuance of duplicate RSA token if any, for the speciic facility (which is non-refundable) to be issued to me/individually to each of the authorized signatory(s). Issuance of RSA token for retail users is optional and charges are as applicable from time to time. Issuance of RSA token is mandatory for corporate and is free of cost. RSA token is valid for 5 years from the date of issuance. I / We conirm that the mandate from the competent authority has been obtained for the corporate user(s) for operating our accounts and transaction through the Internet banking services of KVB. The detail of the resolution and a copy is enclosed. In order to ensure safety of “Online” banking, I/we shall ensure to observe the following precautions: a) I /We will visit the Internet Banking site directly. I/We will avoid accessing the site through a link from another site or an email and verify the domain name displayed to avoid spoof websites. b) I /We will ignore any e-mail asking me/us the password or PIN and inform the Bank of the same immediately to investigate the same. c) I /We understand that neither the Police nor the Bank will ever contact me/us to ask to reveal my/our online banking or payment card PINs, or my/our password information. d) I /We will not use cyber cafes / shared PCs to access our Internet banking site. e) I /We will update our PC with latest antivirus and spy ware software regularly. I /We will install security programmes to protect against hackers, virus attacks or malicious ‘Trojan Horse’ programmes. I/ We understand that a suitable irewall installed will protect my/our PC and its contents from outsiders on the Internet. f) I /We will disable the ‘File and Print Sharing’ feature on my/our operating system. g) I /We will log off from the bank’s website in my/our PC when not in use. h) I /We agree not to store my/our ID/PIN in the Internet Explorer browser. i) I /We agree to check my/our account and transaction history regularly. j) I /We will use the Bank’s websites to get help and guidance on how to stay online. I/We agree that the Bank is NOT liable

for any loss arising from my/our sharing or otherwise passing of my /our User Ids, passwords, cards, card numbers or PINs with anyone, NOR from their consequent unauthorized use. I /We have read and agree to abide by the above additional terms and conditions governing KVB@NET, Internet Banking facility of THE KARUR VYSYA BANK LTD. provided to me/us which shall constitute an agreement between me/us and the Bank. I / We have read and understood the rules governing the above channel services and agree to abide by the same.

SIGNATURE OF ThE AUThORISED USER

SIGNATURE OF ACCOUNT hOLDERS

Note: 1.

For existing customers the details given in the above application

I certify that all the above information has been veriied, updated appropriately

 

should be same as in the customer master. This should be strictly

and are correct. The above requested services can be enabled for the

 

veriied by the Manager/Oficer before forwarding.

applicant.

 

2.

For new accounts, leave account number column as blank.

 

 

3.

Add on cards should be issued only to the spouse of the account

 

 

 

holder (If not a joint account holder).

 

 

 

 

MANAGER / OFFICER

DATE:

 

 

 

 

8 of 12

LETTER OF MANDATE FOR E-SERVICES

I / We, am/are having account with No. ________________________________________________________________

with your bank.

I / We hereby agree the terms and conditions speciied by the bank for KVB M-PAY/ INTERNET BANKING / DEBIT CARD/

KVB-MOBILE ALERT.

I authorize the account holder/non-account holder Mr./Mrs./Ms __________________________________________

to the bank for operating the above mentioned account(s) through KVB M-PAY/ INTERNET BANKING / DEBIT CARD /

KVB-MOBILE ALERT.

I / We undertake to ratify and conirm all and what ever Mr./Mrs./Ms _________________________________ does or

causes to do through KVB M-PAY/ INTERNET BANKING / DEBIT CARD / KVB-MOBILE ALERT services offered by KVB.

This authority shall continue to be in force, until I / any one of us revoke this mandate by a notice in writing delivered to you.

I / We request you to provide access as requested above.

Name of Mandate/Authorized user

 

 

 

Signature of Mandate / Authorized user

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of the Account Holders

 

 

 

3.

 

 

 

 

 

1.

 

 

 

4.

 

 

 

 

 

2.

 

 

 

5.

 

 

 

 

 

 

 

 

 

 

Veriied by: Oficer

 

 

 

Authorized by: Branch Head

Date of Dispatch of Application:

/

/

.

 

 

 

 

 

 

Note: Attach separate mandate for each E-service.

 

FOR ATM CELL USE ONLY

 

 

Date of Receipt of Application

 

 

 

Date of Data entry/Upload

 

 

 

Maker Name:

Checker Name:

Name:

Name:

Employee Code:

Employee Code:

Signature:

Signature:

Date:

Date:

9 of 12

“To be handed over to the applicant”

ThE KARUR VYSYA BANK LIMITED__________________________BRANCh

SAVINGS BANK RULES

1. Savings Accounts can be opened in the names of individuals singly/jointly/with either or survivor options. In case of joint accounts, the maximum number of persons is restricted to four.

2. Customers should provide satisfactory introduction, address and ID proof in order to comply with KYC norms.

3. The account should be properly introduced by the existing account holder having satisfactory dealings for a minimum period of 6 months.

4. Self Help Groups (SHGs), Farmer Clubs, Associations, Clubs can open a SB account if they are permitted as per RBI/IBA guidelines.

5. SB account in the name of HUF can be opened provided the HUF is not engaged in trading and business activity. Such SB account should be opened by Kartha only.

6. SB accounts may be opened for the purpose of savings and not for doing any business transactions. The object of the savings bank account is to encourage private individuals to deposit their savings with the bank, allowing them interest on the sums so deposited and at the same time permitting the facility of certain limited withdrawals on demand. Hence irms/companies are not allowed to open SB account. Transactions of commercial nature are not permitted.

7. The SB account can be opened in the name of minor by a natural guardian i.e., father or mother, in circumstances approved by the bank.

8. Suficient balance should be maintained in the account at the time of issuing cheques.

9. A minimum balance shall always be maintained in the account. Non-maintenance of minimum balance will attract charges as prescribed from time to time.

10. The number of all debit transactions including ATM transactions in all Savings Bank accounts (excluding KVB Prestige,

Rainbow SB, Kalpatharu and Grama Jyothi Accounts) is limited to 90 transactions for each half year (excluding system based debits). Where a person has more than one account mapped to a single customer ID, the total number of debit transactions permitted in all such accounts put together will be limited to 90 per half year. When number of withdrawals is more than the maximum stipulated, a service charge will be levied for each transaction in excess of 90 transactions. The Number and amount of transactions will be restricted as per the rules of the bank governing Savings Bank Deposits from time to time.

11. The minimum amount that can be deposited or withdrawn in a savings bank account shall be not less than `50/- except in No Frills Accounts.

12. Charges will be collected on closure of the account.

13. Account opening forms, pay-in-slips will be supplied by the bank free of charge and these forms only should be

used.

14. Initially 20 cheque leaves will be issued for all eligible accounts at free of cost. Charges for subsequent issue of cheque books will be based on Quarterly Average Balance (QAB). Requisition slip should be given duly signed by the account holder every time for getting a new cheque book.

15. Issuance of ATM Debit Card is free. Add-on Card will also be issued provided charges will be collected. Annual charges is FREE in case the customers do 10 transactions in POS else fees applicable. No annual fees for Prestige accounts. Card Renewal charges and duplicate card charges will be levied as per Bank Rules from time to time.

16. The cheque issued by the customer to any third party on or after 01-04-2012 will be valid only for 3 months.

17. The pass book will be supplied by the Bank free of charge. For Issue of duplicate pass book / pass sheet additional

charges will be collected.

18. Interest is calculated on the balance maintained in the SB account on daily balance method and credited to the account on last working day of every March and September. The rate of interest payable is subject to the directives

that may be issued by RBI from time to time.

19. If required by the account holder, outstation cheques / local cheques upto `15,000/- will be discounted by collecting the

regular charges for accounts showing satisfactory transactions.

20. Cheques, drafts and other instruments drawn payable to depositors only will be accepted for collection and drawings against them will not be permitted until they are realized. The entry of any cheque received for collection will be affected on the date of sending such cheque for clearing with a value date credit. But the amount will be allowed to be

withdrawn only after realization of the instrument.

11 of 12

21.Cheques received through clearing will be paid / returned as per previous day’s closing balance.

22.No overdraft facility will be permitted in SB accounts except in KVB Grama Jyothi account.

23.Nomination facility is available for all types of SB accounts.

24.The status of the account will be changed to dormant if there are no operations in the account for a period of 2 years. Only after the request from customer the status will be moved to regular.

25.The Bank reserves its right to take steps to get the account closed if frequent return of cheques for want of funds is observed and cheque return charges will levied to such accounts.

26.The Bank reserves its right to close any account without assigning any reasons.

27.The Bank reserves for itself the right to alter or amend these rules at any time. However such changes will be posted in the banks website and in the Notice Board of the branches.

28.The Bank is a Member of Banking Codes and Standards Board of India and committed to honour the covenants of its Codes. Customers can get a copy from the Branch and the same is also available in the Bank’s web site www.kvb.co.in

Similarly the Bank has a fair practice Code and Policy on deposits which are also available in the same manner.

DOCUMENTATION ChECK LIST

No.

PROOF

Identity

Address

DOB*

 

 

 

 

 

1.

Ration Card

Y

Y

Y

 

 

 

 

 

2.

Passport

Y

Y

Y

3.

Letter from recognized Public authority/servant

Y

Y

Y

4.

Identity Card / Govt. ID Card (Subject to satisfaction of the bank)

Y

Y

Y

5.

Aadhaar ID

Y

Y

Y

6.

Voters Identity Card

Y

Y

Y

7.

Driving License

Y

 

Y

 

 

 

 

 

8.

Letter from employer (Subject to satisfaction of the bank)

Y

Y

Y

9.

Pension Card

Y

Y

Y

10.

PAN Card

Y

 

Y

 

 

 

 

 

11.

Certiicate from Local body/NGO/MFI (Only for rural branches)

Y

Y

 

12.

Telephone Bill

 

Y

 

13.

Bank Account Statement

 

Y

 

 

 

 

 

 

14.

Electricity Bill

 

Y

 

15.

School Leaving Certiicate

 

 

Y

16.

Insurance Policy

 

 

Y

17.

Birth Certiicate

 

 

Y

* (DOB) Proof Document for Date of Birth to open Minor / Senior Citizen Account.

Note : 1. Original and photo copy are to be produced. Original will be returned after veriication.

2.MANDATORY FOR CASH DEPOSITS > ` 50000/- : Proof of PAN / Form 60/61.

3.MINOR ACCOUNTS: Copy of the Birth Certiicate should be produced.

4.All signatures are to be obtained in the presence of Bank’s Oficial.

12 of 12

ACCOUNT NO.:

M 327

CUSTOMER ID:

DETAILS FOR JOINT APPLICANT – SB / TERM DEPOSIT

Mr/Ms *

*NAME: INDIVIDUAL (IN THE ORDER OF FIRST, MIDDLE & LASTNAME) leave space between words. Eg. RAM GOPAL VARMA

*FATHER’S NAME

MOTHER’S NAME

SPOUSE NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AADHAAR ID:

 

 

 

 

PAN NO.:

 

 

 

 

 

 

 

 

FORM 60/61 (ENCLOSED)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Y

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH*

MARITAL STATUS

NATIONALITY*

 

 

 

RELIGION

 

 

GENDER*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

D

M

M

Y

Y

Y

Y

 

M

 

UM

 

 

 

 

 

 

 

 

 

 

M

F

MOBILE NO.:*

 

 

 

EMAIL ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RES. TEL NO.:

S T

D C O D E

OFF. TEL NO.:

S T

DC

O

D E

*MAILING ADDRESS: JOINT APPLICANT

CITY/TOWN

DISTRICT

STATE

PINCODE

COUNTRY

PERMANENT ADDRESS (IF DIFFERENT FROM ABOVE)

CITY/TOWN

DISTRICT

STATE

PINCODE

COUNTRY

*PERSONAL INFORMATION OF JOINT APPLICANT

FAMILY MEMBERS

 

 

 

DOB

 

RELATIONSHIP

OCCUPATION

1.

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUALIFICATION

UNDERGRADUATE

GRADUATE

POST GRADUATE

PROFESSIONAL

ILLITERATE

NO. OF DEPENDENTS

 

EMPLOYED WITH

STATE GOVT.

CENTRAL GOVT.

PUBLIC LTD.

PRIVATE LTD.

MNC

OTHER ENTITY (specify……………………………………)

NATURE OF BUSINESS

MANUFACTURING

TRADING

SERVICES

RETAILING

 

 

STOCK BROKER

REAL ESTATE

NGO/NPO

JEWELS/GEMS/PRECIOUS METAL DEALER

AGRICULTURE

MONEY SERVICES

AGENCY

OTHERS (specify) ________________________________

TYPE OF PROFESSION

 

DOCTOR

ENGINEER

BANKER

TEACHER

LAWYER

ARCHITECT

CONSULTANT

 

 

 

IT PROFESSIONAL

OTHERS (specify) ______________________________________

 

 

 

 

 

ANNUAL INCOME

 

 

 

SELF

 

 

 

 

SPOUSE

 

 

 

 

HOUSEHOLD

 

 

 

 

`

 

 

 

 

 

`

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

ASSETS OWNED

 

HOUSE

CAR

TWO WHEELER

GOLD

SILVER

LAND

 

 

LOANS WITH OTHER BANKS

 

 

 

 

 

 

 

 

 

 

 

HOUSING

BUSINESS

CAR

TWO WHEELER

CREDIT CARD

PERSONAL

 

JEWEL

PROFESSIONAL

OTHER INVESTMENTS

 

DEPOSITS

INSURANCE

SHARES

MF

DEMAT

 

 

 

 

 

SIGNATURE OF THE JOINT APPLICANT

NOTE: For additional account holders attach this same type of form.

ACCOUNT NO.:

CUSTOMER ID:

DETAILS FOR JOINT APPLICANT – SB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mr/Ms *

*NAME: INDIVIDUAL (IN THE ORDER OF FIRST, MIDDLE & LASTNAME) leave space between words. Eg. RAM GOPAL VARMA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*FATHER’S NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MOTHER’S NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPOUSE NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AADHAAR ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAN NO.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORM 60/61

 

STAFF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Y

N

 

Y

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH*

 

 

 

 

 

 

 

 

MARITAL STATUS

 

NATIONALITY*

 

 

 

 

 

 

RELIGION

 

 

 

 

 

 

GENDER*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

D

M

 

M

 

Y

 

Y

 

Y

Y

 

 

M

 

UM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

 

 

F

 

MOBILE NO.:*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMAIL ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RES. TEL

S

 

 

D

 

 

C

 

O

 

D

 

 

 

 

 

 

 

 

 

 

 

 

 

OFF. TEL

S

 

D

 

C

 

O

D

 

 

 

 

 

 

 

 

 

 

 

 

 

NO.:

T

 

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

NO.:

 

T

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*MAILING ADDRESS: JOINT APPLICANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY/TOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRICT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PINCODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERMANENT ADDRESS (IF DIFFERENT FROM ABOVE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY/TOWN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRICT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PINCODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*PERSONAL INFORMATION OF JOINT APPLICANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAMILY MEMBERS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOB

 

 

 

 

 

 

RELATIONSHIP

 

 

OCCUPATION

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QUALIFICATION

UNDERGRADUATE

 

 

GRADUATE

 

 

POST GRADUATE

PROFESSIONAL

 

 

ILLITERATE

 

 

NO. OF DEPENDENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYED WITH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE GOVT.

 

 

 

CENTRAL GOVT.

 

PUBLIC LTD.

PRIVATE LTD.

 

MNC

 

OTHER ENTITY (specify……………………………………)

 

 

 

 

 

NATURE OF BUSINESS

 

MANUFACTURING

TRADING

SERVICES

RETAILING

AGRICULTURE

 

MONEY SERVICES

 

AGENCY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STOCK BROKER

REAL ESTATE

 

NGO/NPO

JEWELS/GEMS/PRECIOUS METAL DEALER

OTHERS (specify) ________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPE OF PROFESSION

 

DOCTOR ENGINEER

 

BANKER

 

TEACHER

 

LAWYER

ARCHITECT

CONSULTANT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IT PROFESSIONAL

 

 

OTHERS (specify) ______________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANNUAL INCOME

 

 

 

 

 

 

 

 

 

SELF

 

 

 

 

 

 

 

 

SPOUSE

 

 

 

 

 

 

 

 

HOUSEHOLD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

`

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASSETS OWNED

 

 

HOUSE

CAR

TWO WHEELER

 

GOLD

 

 

SILVER

 

LAND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LOANS WITH OTHER BANKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSING

BUSINESS

 

CAR

 

TWO WHEELER

 

CREDIT CARD

PERSONAL

 

JEWEL

 

PROFESSIONAL

 

 

 

 

 

 

 

OTHER INVESTMENTS

DEPOSITS

 

INSURANCE

 

SHARES

 

MF

DEMAT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF THE JOINT APPLICANT

FORM 60 (See third proviso to Rule 114B)

FORM OF DECLARATION TO BE FILLED BY A PERSON WHO DOES NOT HAVE EITHER A PERMANENT ACCOUNT NUMBER OR GENERAL INDEX REGISTER NUMBER AND WHO MAKES PAYMENT IN CASH IN RESPECT OF TRANSACTION SPECIFIED IN CLAUSES (a) to (h) OF RULE 114B

CUSTOMER ID:

ACCOUNT NO.:

 

 

1. FULL NAME AND ADDRESS OF THE DECLARANT

 

2. PARTICULARS OF TRANSACTION

3. AMOUNT OF THE TRANSACTION

4.

ARE YOU ASSESSED TO TAX?

4. (i) DETAILS OF WARD/CIRCLE/RANGE WHERE THE LAST RETURN OF INCOME WAS FILED:

 

 

 

 

YES

NO

 

 

 

4.

(ii) REASONS FOR NOT HAVING PERMANENT ACCOUNT NUMBER/GENERAL INDEX REGISTER NUMBER:

 

 

 

 

 

5.

Details of document being produced in support

VERIFICATION: I, ____________________________________________________________________ do

of address in column(1)

 

 

 

 

hereby declare that what is stated above is true to the best of my knowledge and belief. Veriied to-day,

 

 

 

 

 

 

 

 

the_________________ day of ____________________

 

 

 

 

 

DATE :

________________________________

 

 

 

 

PLACE:

SIGNATURE OF THE DECLARANT

INSTRUCTIONS: Documents which can be produced in support of the addresses are:

 

(a)Ration Card (b) Passport (c) Driving License (d) Identity Card issued by any institution (e) Copy of the electricity bill or telephone bill showing residential address

(f)Any document or communication issued by any authority of Central Government, State Government or local bodies showing residential address (g) Any other documentary evidence in support of his address given in the declaration.

Duplicate cOpy:

FORM 60 (See third proviso to Rule 114B)

FORM OF DECLARATION TO BE FILLED BY A PERSON WHO DOES NOT HAVE EITHER A PERMANENT ACCOUNT NUMBER OR GENERAL INDEX REGISTER NUMBER AND WHO MAKES PAYMENT IN CASH IN RESPECT OF TRANSACTION SPECIFIED IN CLAUSES (a) to (h) OF RULE 114B

CUSTOMER ID:

ACCOUNT NO.:

 

 

1. FULL NAME AND ADDRESS OF THE DECLARANT

 

2. PARTICULARS OF TRANSACTION

3. AMOUNT OF THE TRANSACTION

4.

ARE YOU ASSESSED TO TAX?

4. (i) DETAILS OF WARD/CIRCLE/RANGE WHERE THE LAST RETURN OF INCOME WAS FILED:

 

 

 

 

YES

NO

 

 

 

4.

(ii) REASONS FOR NOT HAVING PERMANENT ACCOUNT NUMBER/GENERAL INDEX REGISTER NUMBER:

 

 

 

 

 

5.

Details of document being produced

VERIFICATION: I, ____________________________________________________________________ do

 

in support of address in column(1)

 

 

 

hereby declare that what is stated above is true to the best of my knowledge and belief. Veriied to-day,

 

 

 

 

 

 

 

 

the_________________ day of ____________________

 

 

 

 

 

DATE :

________________________________

 

 

 

 

PLACE:

SIGNATURE OF THE DECLARANT

INSTRUCTIONS: Documents which can be produced in support of the addresses are:

 

(a)Ration Card (b) Passport (c) Driving License (d) Identity Card issued by any institution (e) Copy of the electricity bill or telephone bill showing residential address

(f)Any document or communication issued by any authority of Central Government, State Government or local bodies showing residential address (g) Any other documentary evidence in support of his address given in the declaration.

FORM 61 (See proviso to clause (a) of Rule 114c (1))

FORM OF DECLARATION TO BE FILLED BY A PERSON WHO HAS AGRICULTURAL INCOME AND IS NOT IN RECEIPT OF ANY OTHER INCOME CHARGEABLE TO INCOME-TAX IN RESPECT OF TRANSACTION SPECIFIED IN RULE 114B

CUSTOMER ID:

ACCOUNT NO.:

1. FULL NAME AND ADDRESS OF THE DECLARANT

2. PARTICULARS OF TRANSACTION

3. AMOUNT OF THE TRANSACTION

4. DETAILS OF DOCUMENTS BEING PRODUCED IN SUPPORT OF ADDRESS IN COLUMN 1

YES

NO

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.

DATE :

_____________________________

PLACE :

SIGNATURE OF THE DECLARANT

VERIFICATION: I, _________________________________________________________ do hereby declare that what is stated above is true to the best of my

knowledge and belief. Veriied to-day, the _________________ day of ____________________

DATE :

_____________________________

PLACE :

SIGNATURE OF THE DECLARANT

INSTRUCTIONS: Documents which can be produced in support of the addresses are:

(a)Ration Card (b) Passport (c) Driving License (d) Identity Card issued by any institution (e) Copy of the electricity bill or telephone bill showing residential address

(f)Any document or communication issued by any authority of Central Government, State Government or local bodies showing residential address (g) Any other documentary evidence in support of his address given in the declaration.

Duplicate cOpy:

FORM 61 (See proviso to clause (a) of Rule 114c (1))

FORM OF DECLARATION TO BE FILLED BY A PERSON WHO HAS AGRICULTURAL INCOME AND IS NOT IN RECEIPT OF ANY OTHER INCOME CHARGEABLE TO INCOME-TAX IN RESPECT OF TRANSACTION SPECIFIED IN RULE 114B

CUSTOMER ID:

ACCOUNT NO.:

1. FULL NAME AND ADDRESS OF THE DECLARANT

2. PARTICULARS OF TRANSACTION

3. AMOUNT OF THE TRANSACTION

4. DETAILS OF DOCUMENTS BEING PRODUCED IN SUPPORT OF ADDRESS IN COLUMN 1

YES

NO

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.

DATE :

_____________________________

PLACE :

SIGNATURE OF THE DECLARANT

VERIFICATION: I, _________________________________________________________ do hereby declare that what is stated above is true to the best of my

knowledge and belief. Veriied to-day, the _________________ day of ____________________

DATE :

_____________________________

PLACE :

SIGNATURE OF THE DECLARANT

INSTRUCTIONS: Documents which can be produced in support of the addresses are:

(a)Ration Card (b) Passport (c) Driving License (d) Identity Card issued by any institution (e) Copy of the electricity bill or telephone bill showing residential address

(f)Any document or communication issued by any authority of Central Government, State Government or local bodies showing residential address (g) Any other documentary evidence in support of his address given in the declaration.