Bank of Maharashtra Head Office: 1501, 'Lokmangal', Shivajinagar,
Pune • 411005
CIF No.
CIF No.
Account No.: I I I I I I I

Savings Bank Account Opening Form (Indian Residents)

1/We request you to open my/our deposit account with your branch/bank
Purpose I Type of Account:
Salary D State Pension D Staff D Central Pension D SrCitizen D Minor D
Scholarship (YUVA) D General D Saving D Other D
Constitution :
Individual D Joint Individual D Trust D Association D HUFD Other
Mode of Operation :
Single D Either or Survivor D Former or Survivor D Anyone or Survivor D Jointly by all D Other D
I Your Details (First Applicant) I Your Details (Second Applicant)
Title: Mr.D Mrs. D Master D Miss D Dr. D Others D Title: Mr.D Mrs. D Master D Miss D Dr. D Others D
I~ ------~11 ~ ------~ First Name Middle Name Sur Name First Name Middle Name Sur Name
Father/ Spouse Name:-----------Mother's
Maiden Name:
Date of Birth (dd/mm/yyyy)l D I D I ~ I ~ I Y I Y I Y I Y I
Gender: M D/ F D Marital Status: Single D Married D Other D
Place of Birth:--------------Nationality:
Indian/ Others-----------
Residential Status: Resident D Non resident D
Domicile: India/ Others----------Contact
details:
Phone:----------------Mob:
E-mail id: ----------------
Address Proof: _____________ _
ld No:
Residential Address:
--------- Pin code:
Permanent Address (If different from residential):
--------- Pin code:
Father/ Spouse Name:-----------Mother's
Maiden Name:
Date of Birth (dd/mm/yyyy)l D I D I f\4 I ~ I Y I Y I Y I Y I
Gender: M D/ F D Marital Status: Single D Married D Other D
Place of Birth:--------------Nationality:
Indian/ Others----------
Residential Status: Resident D Non resident D
Domicile: India/ Others----------Contact
details:
Phone:----------------Mob:
E-mail id: ---------------Address
Proof:-------------ld
No:
Residential Address:
--------- Pin code:
Permanent Address (If different from residential):
--------- Pin code:
Proof of Identity: Proof of Identity:
ld No: Valid upto: I I ld No: Valid upto: I I
PAN No. PAN No.
(if not available, attach form No 60/61) (if not available, attach form No 60161)
Name as to be printed on Card (Max 19 Char) Name as to be printed on Addon Card (Max 19 Char)
Education: Education:
Occupation: Occupation:
Annual Income: Annual Income:
Religion: Religion:
Caste: SC I ST I NT I OBC I GENERAL Caste: SCI STINT I OBC I GENERAL
Occupancy of Residence: Self Owned/ Family residence/ Occupancy of Residence: Self Owned! Family residence/
Company Provided/ Rented/ Occupied on Lease/ Purchased on Loan Company Provided/ Rented/ Occupied on Lease/ Purchased on Loan
Introduction of existing Account holder (Only if ID and Introduction of existing Account holder (Only if ID and
address proof not submitted/Account opened under address proof not submitted/Account opened under
relaxed KYC) relaxed KYC)
Name: Name:
Account No: Account No:
Signature: Signature:
Other Mahabank Services you wish to avail:
lntenet Banking Personalized cheque book Phone Banking SMS Banking Mobile Banking Maha e-statement
First Applicant D D D D D D
Second Applicant D D D D D D
D Please send my net banking user id and Password on my mail id ________________ at my risk and
responsibility
Insure yourself ( Mahasuraksha Scheme) (Optional)
Yes, I would like to take advantage of Mahasuraksha scheme to protect myself. Under the scheme Account holders aged between 18 and 59 years are provided
with a Life insurance cover of Rs 1.00 Lakh. ( *Starts from Rs 156/-per annum. Please fill separate application form)
I Wish to know more about:
BOM - SBI Credit Card D Mahabank Swasthya Yojana D National Pension Scheme D Housing Loan D
Mahabank Gold Coin D Mahaswarna RD Scheme D Demat Services D Online Share trading D
Authorisation and Undertaking by applicants
1/We confirm that we have read and understood the account Rules and 1/We hereby accept and agree to be bound by the terms and conditions, outlined in these rules which govern the above selected
account(s) and services and amendments there to made by the Bank from lime to time.
INVe agree that the bank may debit my account for service charges /incidental charges as applicable from time to time. I /We understand that the bank may atits absolute discretion discontinue any of
the services completely or partially and I or dose the account without any notice to me I us in case account operations are not satisfactory which indude frequent dishonour of
cheques I dishonour of high value cheques, etc. In the event of death, insolvency or withdrawal of any one or more of us, the monies then and thereafter standing at the credit of the said account and I or
any securities held by you in our account be at the disposal of the survivoror survivors of us.
I I We confirm that I am /We are resident of India and I I we certify that the information furnished above is true and correct to the best of my I our knowledge. 1/We authorize the bank to verify the details
given therein through any third party as necessary. I I We also authorise issuance of Mahabank Debit card I Phone Banking I Mobile banking I Internet Banking facilities, and or any other Mahabank
facilities with linkage to the account. 1/ We undertake to ratify and confirm the transactions that the user/s doles or causes to do through any of the above mentioned multiple delivery channels. This
authority shall be in force until anyone of us revokes by a notice in writing delivered to the bank and duly acknowledged by the bank
INVe hereby declare that the information furnished above is true and correct to my knowledge.I/We authorize the bank to verify the details given herein through any third party as may be necessary. I
give my con scent to make the use of the detail information furnished by me for making analysis and its use for the banks own purpose.
Applicant's Signature: Applicant1 Applicant2
Date: I I
CIFNo.: I I I I I I I I I I I I Account No.:l I I I I I I I I I I I Branch Code: ___ _
Scheme Code ___________ _ Account Scheme: ____________ Branch Name: _____ _
Risk Category: High/ Medium/Low Date: Authorised Official ID ___________ Signature: ______ _
Latest
Photograph
181 Applicant
Signature
Form DA 1-Nomination Form
Latest
Photograph
2nd Applicant
Signature
Latest
Photograph
3m Applicant
Signature
Mode of Operation :
Single D
Either or Survivor D
Former or Survivor D
Anyone or Survivor D
Jointly by all D
Other D
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.
ltwe (Name) residing at
-------------------------------------(Address) nominate the
following person 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 Bank of Maharashtra branch
Name &Addresses of the nominee Relationship with Depositor, if any Age Date of birth of Nominee
As the nominee is a minor on this date, 1/We appoint _________________ (Name) ________ _
(Address) (Age)
__________ (Account No of Nominee if having account with Bank of Maharashtra) to receive the amount ofthe deposit in
the account on behalf of the nominee in the event of my/our/ minor's death during the minority of the nominee.
OR
D 1/We Do not wish to keep Nomination
Signature(s) I Thumb impression of Depositors
• Thumb impression (s) shall be attested by two witnesses.
Personal details & Signature of witness:
1)Name: _______________ ___
2) Name: -------------------
Address: ________________ _ Address: __________________ _
Sign: Sign: ___________________ ___
Place&Date : ______________ _ Place&Date : ________________ ___
FOR BRANCH USE ONLY
Particulars of Form DA 1 (if received) entered in Nomination Register Sr. No. _________ Dt. ---------
Officer __ Ledger Keeper ___ _
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Acknowledgment
We have noted the nomination in Nomination Register Sr. No. _______ ,Dt. ____ for your account No:
Branch Manager'--_______ Branch) Branch Seal
Website: www.bankofmaharashtra.in Net Banking https://www.mahaconnect.in Toll Free No.1800 233 4526
FORM N0.60[See third proviso to rule 1148)
Form of declaration to be filed by a person who does not have either
a permanent account number or General Index Register Number
and who makes payment in cash in respect of transaction specified
in clauses(a)to(h)of rule 118
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. 1fyes,
(i) Details of Ward/Circle/Range where the last return of income was
filed?
(ii) Reasons for not having permanent account number/General
Index Register Number?
6. Details of the document being produced in support of address in
column(1)
Verification
I, .......... ............... ...... ............ ...... ...... ...... ... do hereby declare that
what is stated above is true to the best of my knowledge and belief.
Verify today, the ................................... day of ..... ... ... ... ... ....... ..
Place : .......... ................... .
Signature of the declarant
FORM NO. 61[See provision 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 in clauses (a) to
(h) of rule 1148
1. Full name and address of the declarant
2. Particulars of transaction
3. Details of 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.
Date: ......................... .
Place: ........................ .
Signature of the declarant
Verification
I, ............................... ... ... ........................... do hereby declare
that what is stated above is true to the best of my knowledge
and belief.
Verify today, the ......... ... ... .................... day of ... ... .................. ..
Place: ......... ... ...... ... ....... ..
Signature of the declarant
Any other detail