Form DA 1

Nomination under Section 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
Address /es
nominate the following person to whom of my/our/minor’s death, the deposit in the account(s), particulars whereof are given below, may be returned by IDBI Bank
Ltd., ___________________Branch.
Details of the Account
Nature of Account Account Number Additional Details, if any
Nominee
Name
:
Address
:
Relationship with depositor, if any :
Age
:
If nominee is minor, his / her date of birth :
*As the nominee is a minor on this date I/we appoint
Name: _____________________________________________
_______ Age:_______
Address: __________________________________________
___________________to receive the amount of the deposit on behalf of the nominee in the event of my/own/ minor’s death during the minority of the nominee.
** Signature(s) / Thumb impression (s) of depositor (s)
Witnesses ***
Name:
Name:
Signature:
Signature:
Address:
Address:
Place:
Place:
Date:
Date:
*Strike out if nominee is a not a minor. ** Where deposit is made in the name of a minor the nomination must be signed by a person lawfully entitled to act on behalf of the minor. *** Thumb impression(s) to be attested by two witnesses.
Acknowledgement
We acknowledge your Nomination Form DA1 relating to:
Nature of the Account Account Number Additional Details
, if any
In the name of ___________________________ held with us. Please quote the Nomination Number _____________________________ in all your future correspondence with us in this regard.
For IDBI Bank Ltd.
Authorised Signatory