________ Branch L.F.No. ________
Indian Bank TDR /A/C No. ___________
The Manager Date _______________
To

APPLICATION FORM

‰ Non Resident (External) (in Indian Rupees)
‰ NR-NR-RDS (in Indian Rupees)
‰ FCNR Accounts (In Foreign Currency)
(Use Separate application form for each type of account)

Date of birth _____________ (in case of minor) Phone No. ___________ E-Mail ___________________________
3. Name : Occupation :
2. Name : Occupation :
Overseas Address : __________________________________________________________________________
Local Address : __________________________________________________________________________
1. Name : Occupation :
Please open an account as per details below: (in block letters)
Applicants’ Name
and Address
3.
2.
1.
Nationality Country of Domicile Passport No. & Date of issue
Passport
Details
FCNR ‰ Re-investment Plan account ‰ Fixed Deposit
NR-NR-RDS ‰ Re-investment Plan account ‰ Fixed Deposit
Period
(months)
Amount
‰ Current Account ‰ Savings Bank Account
‰ Fixed Deposit ‰ Re-investment Plan account
‰ Recurring deposit ‰ Please issue me a cheque book
NRE
Type of
account
‰ Single ‰ Anyone or survivor ‰ Any two jointly ‰ All jointly
‰ Either or survivor ‰ Former or survivor
Mode of
Operation
1. Demand Draft No. ______________ dt ________ for (amount) ______________________________________
________________________________________________________________________(in words) (enclosed)
2. Mail Transfer/Telegraphic Transfer for _______________________________________ (in words)
3. Name and Address of the Remitting Bank _____________________________________________
Remittance
Details
Any other instructions __________________________________________________________________________
‰ Credit interest to my SB/CA No. ________________________ with your branch
‰ Please remit interest by draft ‰ Renew the deposit with interest.
‰ Please keep the term deposit in safe custody and renew the deposit on the due date for further period of
______ months at the rate prevalent on the date of maturity.
Standing
Instructions
I/We hereby declare that I am/we are non-resident/s of Indian origin.
I/We understand that the deposits permitted in that Account are only foreign Currency remittances from abroad
through normal banking channels.
I/We agree to abide by all the rules of the Bank applicable to the Account to be opened.
I/We undertake to inform the Bank on my/our return to India for permanent residence.
In the case of NRNRRDS, the resident co-depositor is __________________________ (state relationship) of
_____________________________________ (Non-resident co-depositor); it is expressly agreed by all of us that
the proceeds of the deposits on maturity or earlier would be paid only in Non convertible Indian rupees and the
interest alone can be repatriated in foreign currency.
Declaration
Passport Size
Photograph
_________________________ _________________________ _________________________
Signature of First applicant Signature of Second applicant Signature of Third applicant
I/We understand that the above account will be opened on the basis of the statements/declarations made by
me/us and I/We also agree that if any of the statements/declarations made herein is found to be not correct in
material particulars you are not bound to pay any interest on the deposit made by me/us.
I/We agree that no claim will be made by me/us for any interest on the deposits for any period after date/s of
maturity of the deposits.
I/We agree to abide by the provisions of the FCNR/NRNRRDS/NRE scheme.
I/We agree that if the premature withdrawal is permitted at my/our request, the payment of interest on the deposit
may be allowed in accordance with the prevailing stipulations laid down by RBI in this regard.
Declaration contd..
1. __________________________________________ will sign thus ___________________________________
2. __________________________________________ will sign thus ___________________________________
3. __________________________________________ will sign thus ___________________________________
Name Signature
Specimen
Signature
2. Verification is not required if an account is already held with this Branch. In such cases, please furnish
Account No. SB / Current Account ______________________
1. Authentication of signatures to be made by a Bank / Indian Embassy / High Commission/ Consulate /
Notary Public / Person known to the Bank.
Above signatures verified
_________________________ __________________________________________________
Name and Signature of person verifying with rubber stamp (where applicable)
Introduction
* Strike out if nominee is not a minor ** Thumb Impressions shall be attested by two witnesses
@ 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 / Thumb Impression of depositor/s @
____________________________________________
Name, Signature of witness & Address **
Place : Date :
* As nominee is a minor on this date, I/We appoint _________________________________________________
_________________________________________ (Name, Address and Age) to receive the amount of the deposit
in the account on behalf of the nominee in the event of my/our/minor’s death during the minority of the nominee.
If nominee is a minor,
his/her date of birth Age
Relationship with
depositor, if any
Name & address of Nominee
Nature of deposit Distinguishing Number Additional details if any
Nomination Form - DA 1
Nomination under Sec.45ZA of the Banking Regulation Act 1949 and Rule 2(1) 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 deposit in the account, particulars whereof are given below, may be returned by Indian Bank,
_____________________________________________ Branch.
Nomination
Cheque Book issued on _________
From __________ To ___________
Regn.No._________
Branch Manager Officer-in-Charge Regd. on _________
Open Account Opened Nomination Date : _______________
For Office
use only