(Government of India Undertaking)

SAVING BANK ACCOUNT OPENING FORM

[FOR SMALL ACCOUNT]
1. Name in Full (Mr/Ms)
2. Father/ Husband/Guardian Name
3. Residential address:
C/o
House No. and name :
Street No. and name
Landmark
Village /City District
State
Pincode
Telephone/Landline
Mobile No.
4. Sex : Male/Female Date of Birth: ……./……../……………… (DD/MM/YYYY)
5. a) Occupation --------------------------- (b) Category- GEN/SC/ST/OBC/MINORTIY
6. KYC Documents Provided YES/NO
7. Nomination Required YES/NO
8. Request for ATM Debit Card : YES/NO ; SMS Alert : YES/NO
9. Introduction [if applicable]:
Name of the introducer
Customer ID Account No.
I know Shri/Smt _____________________________for the past_____________Years/months. He/she is residing at the address given above.
Date : ________ Signature of the introducer_________________ __________________________________________
(Name, SS No & Signature of the verifying Branch official)
Please open a Savings Bank account in the name of Mr./Ms. ______________________________(first/sole applicant) and Mr./Ms. ______________________(second Applicant)**. The Saving Bank rules and regulations including those relating to Small Account have been explained to me/us and I/we agree to abide by the same. An additional photograph of sole/each applicant is attached.
Date: ______________
Place:_______________ Signature/Thumb Impression of first/sole Applicant Signature/Thumb Impression of second Applicant
Signature of Business Correspondent/Facilitator________________________
Name, SS No & Signature of the verifying Branch official________________
* DDM - Drop Down Menu
** The Joint Account holder (i.e. second applicant) shall fill up a supplementary Form.
Name & No. of BC/BF.
Affix Passport size Photo
For Bank Use Only
Name & Code of the Branch
Cust ID
A/C No.
(Government of India Undertaking) SAVING BANK ACCOUNT OPENING FORM –ADDITIONAL INFORMATION [For full KYC Compliance]
1. Mode of Operation : SINGLE/Either or Survivor/Former or Survivor/Any One or
Survivor/JOINTLY (Please put √ mark on appropriate option)
2. PAN /GIR NO./FORM 60/61 _____________________
3. Income Per annum Less than Rs. 20,000/Rs. 20,000 to Rs. 50,000/Rs. 50,000 to
Rs. 1,00,000/above Rs. 1,00,000 (Please put √ mark on appropriate range)
4. Educational Qualification Middle School/High School/Intermediate/Graduate/Post
Graduate
5. Email ID
6. KYC Document : Identification Proof :….,……………………………………… (Please see the List I)
Address Proof : …………………………………………. (Please see the List I)
7. Request for add on:-
S.NO.
Product
1
e-Statement of Account
Yes/No
2.
Cheque Book
Yes/No
3.
Mobile Banking
Yes/No
4..
Internet Baking
Yes/No
5.
Credit Card(KCC)
Yes/No
6.
Others
Yes/No
8. Additional Information for Cross Selling
I would like to also avail:-
S.NO.
Product
1
Housing Loan
Yes/No
2.
Vehicle Loan
Yes/No
3.
Mutual Fund
Yes/No
4.
Life/General INsurance
Yes/No
5.
Pension
Yes/No
6.
Others
Yes/No
I/we understand that a booklet on the Banking Codes & Standards Board of India Code(BCSBI) posted on your website shall be provided to me on demand.
Terms & Conditions:
I/we confirm having received, read and understood (a) the accounts rules and hereby agree to be bound by the terms & conditions outlined in these rules which governs the account(s) which I/we am/are opening/will open and (b) amendments to the rules made from time to time and those relating to various services availed by me/us when displayed by the Bank on its notice board or on its website and those relating to various services offered by the Bank including but not limited to debit card, credit card, internet banking mobile banking and other facilities listed in this form. The usage of these facilities is governed by the terms and conditions stipulated by the Bank from time to time.
Date: ______________
Place:_______________ Signature/Thumb Impression of first/sole Applicant Signature/Thumb Impression of second Applicant
(Government of India Undertaking)
Branch Office………………………………
FORM DA-1: NOMINATION
Nomination under Section 45 ZA of Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules 1985 in respect of Bank Deposits,
I/ We ( Name(s)) ________________________________________________________________________________________________
R/o_____________________________________________________________________________________________________________
nominate the following person to whom in the event of my/our/ minor’s death, the amount of deposit in the account may be returned by Swabhiman Bank, Branch Office______________
DEPOSIT
NOMINEE
Nature of Account
Account No.
Additional Details, if any
Name
Address
Relationship with depositor, if any
Age
Date of birth
* As the nominee is minor on this date, I/we appoint Mr/Ms_______________________________________________________
Age________ Address______________________________________________________________________________________
_________________________________________________________________________________________________________
to receive the amount of the deposit on behalf of the nominee in the event of my/our/minor’s death during the minority of the nominee.
Place:_________________________________
Date:__________________________________ @ Signature(s) / #Thumb impression(s) of depositors
@Where the deposit is made in the name of minor, the nomination is to be signed by natural/legal guardian of the minor to act on behalf of the minor.
*Strike out if nominee is not a minor
WITNESSES
Name & Signature of the first witnesses
Name & Signature of second witnesses
Name___________________________
Signature:________________________
Address:_________________________
Place:___________________________
Date:____________________________
Telephone No._____________________
Name___________________________
Signature:________________________
Address:_________________________
Place:___________________________
Date:____________________________
Telephone No._____________________
#Thumb impression(s) shall be attested by two witnesses; otherwise it shall be attested by one witness.………………………………………………………………………………………………………………
NOMINATION REGISTERED
The above mentioned nomination is registered at serial no ____________________________________ in respect of (Type of Account.) _________________ Deposit Account No.________________ ___________________________.
Date_____________________. For ________________
(Authorised Official)
SS No.____________
ACCOUNTS OF INDIVIDUALS : LIST OF KYC DOCUMNETS
(one document from each list)
LIST I
LIST 2
Documents accepted as proof of identity
Documents accepted as proof of residence
1 Passport
2 PAN card
3 Voter’s Identity Card
4 Driving licence
5 Job card issued by NREGA duly signed by an officer of the State Government(For Small Accounts)
6 The letter issued by UIDAI containing details of name, address and Aadhaar number
7 Identity card (subject to the bank’s satisfaction)
8 Letter from a recognized public authority or public servant verifying the identity and residence of the customer to the satisfaction of bank.
9 Government/Defence ID card
10 ID cards of reputed Public Sector employers
11 Pension Payment Orders issued to the retired employees by Central/State Government Departments, Public Sector Undertakings
12 Photo ID cards issued by Post Offices
13 Photo identity cards issued to bonafide students by a University, approved by the University Grants Commission (UGC) and/or an Institute approved by All India Council for Technical Education (AICTE).
14 Photo identity issued by any public authority having proper record of issuance of identity proof which is verifiable from records
15 Ex-Servicemen Card with photograph
16 Bar Council/Medical Association/ICAI/ICWAI/ICSI Card with photograph
17 Student Identity Card with photo issued by reputed colleges with validity during the course period.
18 Defense Dependent’s Card with photograph’
19 Married woman identity proof with maiden name, if supported with a verified true copy of marriage certificate
20 Credit card with photo together with statement of such card, not more than three months old.
21 Registered Property document with photo identity
22 Arms License issued by State / Central Government of India.
23 Freedom fighter’s pass issued by Ministry of Home Affairs, Government of India with photograph of applicant.
24 Employee State Insurance Card (ESIC) with photograph supported by latest month’s pay slip..
25 Talati / Patwari (a local govt. official) attestation by way of putting rubber stamp and signature. Gram Sarpanch / Mukhiya attestation by way of putting rubber stamp and signature (For Small Accounts)
NOTE; If passport having current address is given as proof of identity, there is no need to give separate proof for address from list 2.
1 Ration Card
2 Electricity Bill
3 Telephone Bill
4 Bank account statement
5 Letter from employer (to the satisfaction of the Bank)
6 Letter from any recognized public authority (to the satisfaction of the Bank)
7 Credit Card Statement- not more than 3 months old
8 Income/Wealth Tax Assessment Order
9 Letter from Public Sector employer
10 Letter from any recognized public authority having proper and verifiable record of issuance of such certificates.
11 Voter ID Card (only if it contains the current address)
12 Pension Payment Orders issued to retired employees by Government Departments/Public Sector Undertakings, if they contain current address.
13 Copies of Registered Leave & License agreement/Sale Deed/Lease Agreement.
14 Certificate and also proof of residence, incorporating local address as well as permanent address, issued by the Hostel Warden of the University/Institute, where the student resides, duly countersigned by the Registrar/Principal/Dean of Student Welfare. Such accounts shall however, be required to be closed on completion of education/leaving the University/Institute provided the constituent does not give any other acceptable proof of residence to the Bank.
15 For students residing with relatives, address proof of relatives, along with their identity proof, can also be accepted provided declaration is given by the relative that the student is related to him/her and is staying with him/her.
16 In respect of officials of Central/State Governments and Public Sector undertakings, who are low risk customers for Bank, Branch Heads may verify the photo/identity and confirm residential address of such officials from independently verifiable sources, to their satisfaction, and permit opening of accounts. This facility is extended only to the Gazetted officers of Central/State Government and Senior Management and above functionaries of Public Sector Undertakings.
17 Latest telephone bills from any telephone service providers and mobile service providers not more than 2 month old, postpaid.
18 Consumer gas connection card/book/Pipe gas bill
19 Certificate from ward/equivalent rank officer, maintaining election roll certifying address of the applicant
20 Post Office Savings Pass Book
21 Domicile Certificate with communication address and photograph
22 Certificate by Village Extension Officer (VEO) / Village Head or equal or higher rank officer. Branch to confirm the authenticity of the certificate and that it has been issued by the person who is holding the said office.
23 Court divorce order – Marriage annulment order issued by Court
To be filled by those who do not have either PAN/GIR
FORM NO. 60
FORM NO. 61
[See second proviso rule 114B]
Form of declaration to be filed by a person who does not
have a permanent account number and who enters into
any transaction specified in rule 114B
1. Full name and address of the declarant__________________
___________________________________________________
2. Particulars of transaction_____________________________
3. Amount of the transaction____________________________
4. Are you assessed to tax? Yes No
5. If yes,(i) Details of Ward/Circle/Range where the last return of
income was filed_____________________________
(ii)Reasons for not having permanent account
Number:____________________________________
6. Details of the document being produced in support of address
In column(1)
[See proviso to clause (a) of rule 114C (1)]
Form of declaration to be filed by a person who has agricultural income and is not in receipt of any other income chargeable to income-tax in respect of transactions specified rule 114B
1. Full name and address of the declarant__________________
___________________________________________________
2. Particulars of transaction_____________________________
3. Details of the 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.
VERIFICATION
I, ______________________, do hereby declare that what is stated above is true to the best of my knowledge and belief. Verified today, the ________________ day of ___________,_____________
Date:_____________ Place:_______________
Signature of the declarant
(Government of India Undertaking)
SAVING BANK ACCOUNT OPENING FORM(supplementary form for second applicant)
1. Name in Full (Mr/Ms)
(second applicant)
2. Father/ Husband/Guardian Name
3. Residential address:
C/o
House No. and name :
Street No. and name
Landmark
Village /City District
State
Pincode
Telephone/Landline
Mobile No.
4. Sex : MALE/FEMALE Date of Birth: ………/…….../………………… (DD/MM/YYYY)
5. a) Occupation--------------------------- (b) Category- GEN/SC/ST/OBC/MINORITY
6. KYC Documents Provided YES/NO
Signature/Thumb Impression of second Applicant
Signature of Business Correspondent/Facilitator________________________
Name, SS No & Signature of the verifying Branch official________________
* DDM - Drop Down Menu
Name & No. of BC/BF.
Affix Passport size Photo
For Bank Use Only
Name & Code of the Branch
Cust ID
A/C No.