FORM A
[See sub paragraph (1) of paragraph 4]
Serial No……………………

Application for opening a Public Provident Fund Account under the Public Provident Fund Scheme 1968

To
The Branch Manager
Allahabad Bank
……………………… Branch
PAN No
I, ……………………………………….. hereby apply for opening an account under the Public
Provident Fund Scheme 1968 in my name/in the name of Kumar/
Kumari……………………………………….of whom I am the guardian and tender herewith
Rs………………. (Rupees……………………………………………in cash/cheque as the initial
subscription.
Permanent address of subscriber/guardian
I agree to abide by the provisions of the Public Provident Fund Scheme, 1968 and amendments
issued thereto from time to time.
For Online Transactions:
Allahabad Bank Account No(if any):
ACCOUNT IN THE NAME OF A SELF/MINOR(S)
Date of Birth of minor:__/__/____
Applicant’s relationship with minor, if any
(i) I hereby declare that I am not maintaining any other Public Provident Fund Account
(ii) I hereby declare that I am not maintaining any other Public Provident Fund Account, except an
account on behalf of a minor.
Paste here a
copy of recent
passport size
photograph
(iii) I hereby declare that the details of other Public Provident Fund accounts opened earlier by me
are as under:-
SL Description Name/Address of the Bank/Post Office and
Account No.
1. Self Account
2. In the name of minor(s) of whom I
am the guardian
(iv) I also declare that I shall adhere to the ceiling on deposits as provided for by Central
Government from time to time which is Rs.1,00,000/- in a financial year at present in each of the
following types of Public Provident Fund Account.
a Individual Self Account and Account(s) on behalf of minor(s) of whom I am the guardian
In case, at any time the said declaration is found untrue/false, no interest shall be payable to me/the
subscriber on the amount of deposit found in excess of the prescribed limit.
(v) I shall be utilizing the services of Shri/Ms …………………………………………… PPF
Agency No………………… who has canvassed for opening of this PPF account. CR
I shall be investing directly and not through any agent.
………………………………
Date Signature or
Thumb impression of
Subscriber/guardian
Additional specimen signatures
…………………………
** The subscriber/applicant who are not assessed to income tax do not have PAN/GIR No.may
furnish attested copy of the Ration Card or Voter’s Identify Card or Passport for identification.
Note :Delete whichever is not applicable
FOR THE USE OF ACCOUNTS OFFICE
The account has been opened on ………………….. with Rs……………………... under Public
Provident Fund
Account No……………………
Passbook No………………………… has been issued
Date …………………….. Accounts Officer
[Form amended vide Ministry of Finance (DEA) Notifications No.908(E) dated 06/12/2000
No.GSR 679(E) dated 04/10/02 and GSR 768(E) dated 15/11/2002)