Pnb Account Form – Fill Out and Use This PDF

PUNJAB NATIONAL BANK

ACCOUNT OPENING FORM (All BRANCHES)

(FOR OFFICE USE ONLY)

1. I/we request you to open the following account. I/we agree to be bound by the bank’s rules in force from time to time. (Tick the relevant box on right side).

(To be filled in Block Letters)

2.Name of sole/first account holder (in block letters) Mr./Ms.

First Name

Middle Name

Last Name

$I /We am/are not availing any credit facility with any other Bank(s)/branch(es) of your Bank and I/We undertake to inform you, in writing, as soon as any credit facility is availed by me /us from any other Bank/branch of your Bank. OR I/We am/are availing credit facilities with other bank(s)/branch(es) of your bank, as per details given in the enclosed sheet

* Form 15G for General Category & Form 15 H for Senior Citizens

PNB 1084 A

3.Names of the joint account holders (If applicable) (in block letters) i. Mr./Ms.

First Name

Middle Name

Last Name

ii. Mr./Ms.

First Name

Middle Name

Last Name

4. Mode of operation (tick whichever is applicable)

#Specify__________________________

6.ATM/DEBIT CARD: I/we may please be issued ATM Card/ATM cum Debit Card as per following details. I/we have read the terms and conditions governing the use of ATM/DEBIT card.

Name of Ist Card holder

Name of 2nd Card holder

Name of 3rd Card holder

7.Account numbers of the customer on which ATM-cum-Debit card services are required (in case the customer has more than one account with Bank)

Main Account No.

2nd Account No.

3rd Account No.

money payable by the Insurance Company in the event of my/our death. I further declare that his/her receipt shall be sufficient discharge to the bank.

(ii) As the nominee is minor on this date, I appoint Mr./Ms.__________________________________________________________________

9.Internet Banking : I/we may please be allowed Internet Banking as per the following details. I/we have read the terms and conditions governing the use of Internet Banking.

i)Name of the account holder (s) authorized for using internet banking services :

a.________________________________________________________ b.__________________________________________________

ii)Account numbers on which internet banking services are required (in case the customer has more than one account with Bank)

Main Account No.

2 nd Account No.

3 rd Account No.

Date:………………………… Customer’s Signature/ : 1. _______________________________________

Thumb Impression

2. ___________________________________

Place:………………...………

3. ___________________________________

Cheque Book issued bearing No. From:__________________ to _______________

SIGNATURE OF AUTHORISED OFFICIAL

Account No.

SPECIMEN SIGNATURES/THUMB IMPRESSIONS

3.Names of the Account Holder( s) ( I n block letters)

i.Mr. Ms.

ii.Mr. Ms.

iii.Mr. Ms.

FOR BRANCH USE ONLY

(To be filled by bank)

1. Customer ID No.

(Tick the appropriate boxes, wherever required)

1.Name of Account Holder (In block letters) Mr./Ms.

First Name

Middle Name

Last Name

2.Father/Husband’s Name

10.Identification mark__________________________________________________________________

11.Address :

PNB 1084 B

17. Total annual income (individual) ;

18.Annual turnover (in case occupation is business) __________________________

Nature of business (Commodity type)________________________________________________

IF Yes, furnish PAN/GIR NUMBER (If PAN/GIR No. is not applicable, submit Form No. 60/61)

PAN/GIR Number

20. Proof of identity :

21. Proof of address :

22.Name of spouse (In block letters)

Mr./Ms.

If yes, furnish office/Business address

Office/Business

Address

Telephone No. (with STD Code)

23. Whether dealing with any other bank, if yes, please give details

24. Whether already dealing with PNB, if yes, please give details

25. Loans availed: (tick whichever is applicable, if yes, mention name of financing institution/bank with amount)

26.Assets (approximate value) Rs._________________

Details(*) :

Other Assets :_________________________________________________________________________________

27.Investments (approximate value) Rs._________________

Details(*) (Stocks & Shares/NSCs/PPF, other deposits etc) (tick appropriately)

{

28.INTRODUCTION: I know Mr./Ms._____________________________for the past _______years _______months as a

____________________ (e.g.) friend , relative, neighbour etc. and confirm his/ her occupation as a ____________________ and confirm address(s) as mentioned herein.

a. Introducer’s Name_____________________________ b. Introducer’s address: ______________________________________

29(*). Spouse’s qualification :

(*) Optional

32.DECLARATION :

I have read (a) the Account Rules and hereby agree to be bound by the terms and conditions outlined in these rules which govern the account(s) which I am opening/will open with Punjab National Bank and (b) amendments to the rules made from time to time and those relating to various services availed by me. I understand that the bank may at its absolute discretion discontinue any of the services completely or partially without any notice to me. I have also been made aware of the charges applicable on various services provided by the Bank. I authorise the bank to debit my account for recovery of service charges/incidental charges as applicable from time to time. I hereby declare that the information furnished above is true and correct to the best of my knowledge.

Date__________________

Place__________________

SIGNATURE/THUMB IMPRESSION OF CUSTOMER

33. Declaration in case of a minor account :

Ihereby declare that the date of birth of the minor is ____/____/_____ who is my (relationship) __________________ and I am his/her natural guardian/lawful guardian appointed vide court order dated_________________(copy enclosed). I shall represent the said minor in all future transactions of any description in the above account until the said minor attains majority. I indemnify the Bank against the claim of the above minor for any withdrawal/transactions made by me in his / her account.

1. Introducer’s signature verified by

2.Creation of customer master authorized by

3.Account opening Authorized, copies of

documents obtained verified, Customers name checked w ith the barred list and Risk category verified by