Saving Bank Account Opening Form – Additional Information

SAVING BANK ACCOUNT OPENING FORM – ADDITIONAL INFORMATION
[For full KYC Compliance]

The Joint Account holder (i.e. second applicant) shall fill up a supplementary Form
1. Name in Full
First Applicant (Mr./Mrs./Ms.)
2. Aadhar Number (if available)
3. Father/ Husband/Guardian
Name
4. Residential address:
Building: Door /House/flat
Bldg. Number and name
Street – Number and Name
Locality
Landmark
Village /City District
State
Pincode
5. Sex: [DDM]* 6. Date of Birth: [DDM]*
7. a) Occupation--------------------------- [DDM] * (b) Category- [ [DDM] *
SMS Alert: Yes / No
Email ID
Mobile No.
Landline No.
8. Request for ATM Debit Card : Yes / No
9. Second Applicant (Mr./Mrs./Ms.)(if any)
Mode of Operation: [DDM]
10. NOMINATION Name of nominee
Please attach Nomination Form*
11. Type of account
[ ] Basic Savings Bank Deposit Account [ ] Regular Savings Bank Deposit Account
DDM DDM
DDM
Affix
Passport size
Photo
12 KYC Document:
12.1 Identification Proof: [DDM]
Number Date of Issue (dd/mm/year)
Issuing Authority
12.2 Address Proof:[DDM]
Number Date of Issue (dd/mm/year)
Issuing Authority
13. PAN No.
To be filled by those who do not have a Permanent Account Number (PAN)
FORM NO. 60 FORM NO. 61
[See second proviso to 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 in 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
14. Request for add on:-
S.No. Product
1 e-Statement of Account Yes/No
2. Cheque Book Yes/No
3. Mobile Banking Mobile No: Yes/No
4.. Internet Baking Email ID : Yes/No
5. Credit Card Yes/No
6. Others Yes/No
15. 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:
16. I/we confirm having received, read and understood (a) the accounts rules and hereby agree to be bound by the terms and
conditions outlined in these rules which govern 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 and those relating to various services offered
by the Bank 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
________________________________________________________________________________________________________________________
For Bank Use Only
1. Account has been opened on _______________________________
2. I have explained the rules / regulations to the applicant __________________
3. I have verified the introduction / the documents of identity proof / residence proof.
4. ATM No. _____________________ has been issued and password has also been issued.
Date:__________________ Officer____________________(SS No)
* DDM - Drop Down Menu
** The Joint Account holder (i.e. second applicant) shall fill up a supplementary Form.
Additional Information for Cross Selling -
Income Per annum [DDM]
Occupation [DDM]
Educational Qualification [DDM]
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
Name & Code of the Branch
Cust. ID
A/C No.