IaTAMLUK-G~TAL CENTRALCO-OP~RAI.~Y!.§A,,~K,61!Pc •. ACCOUNT OPENING FORM

FOR OFFICE USE ONLYAccount to be opened at ...................................... Branch Date: I I ,-

Branch Code:Phone no Account No I I I I

CUSTOMER NAME ( BLOCK LETTER) CIFNO

1

234

SAVINGS ACCOUNT CURRENT ACCOUNT DWithout Cheque Book D With Cheque Book D Opening Amount RupeesSavings Nofrill Account D 1 1 1 1 1 1

Specification RECURRING DEPOSITqpening Amount Rupees 1

1 1 1 1 1 .1 1 General D Senior Citizen DPeriods c=r=JMMDEPOSIT AT CALL Monthly Installment

Periods c=r=JMM CASH CERTIFICATE

Amount I I I I I I General D Senior Citizen DPeriods c=r=JMM

FIXED DEPOSIT Amount I. Amount I I I I I I FIXED DEPOSIT (MONTHLY INCOME SCHEME)

General D Senior Citizen DPeriods CDMM cr=cJDD Periods c=r=JMM

Amount IAuto Renewal on Maturity :- Yes No

MODE OF OPERA TION0a. Self Only 0 b. Any Three 0 c. Any Two

d. Former or Survivor 0 e. Either or Survivor 0 f Minor AIC operated by Gurdian 0g. jointly 0 h. Any One or Survivor 0 I

Name ojGuardian:1I. Any Other Specify 01 INomination ::- Required Form FiledD Not Required D

STANDING INSTRUCTIONS SERVICES / MULTI OPTION DEPOSIT SCHEME SERVICESForm Account Number Amount

To Account Number Amount

. To Account Number Amount

I / We authorise the Bank I their representative to conduct of the above Accounts I Services

1) ............................................................................. 3) -.............................................................................

2) ............................................................................. 4) -.............................................................................

Signature of the Account Holderts)

IAffix photograph of all persons opening the Account. (Photo Size - 2.5 em x 3.5 em)

Specimen Signature Signature & name of verifying Officials

A User-ID No.

B User-ID No.

C User-ID No.

D User-ID No.

I For 1st Operator I 0 0PAN CARD YES NO If Yes PAN No I I I I I I I I I I IForm 60/61 (to be filled by those who do not have PAN)

Form 60Form 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

Particularsof transaction:I I Amount of the transaction: I IDetails of the document being produced in support of address

Are you a tax assessee if YES 0 NO 0 IIa) Details of Ward/ Circle / Range where the last return of income was filed

b) Reason for not having PAN I IVerification: 1......... _ .... _-.- . ....... - .............. .......................... do hereby declare that what is stated is true to the best of my knowledge and belief.

Signature of Account Holder(s) [ JForm 61To be filled by a person who has only agricultural income and no other income chargeable to income tax I hereby

declare that DlY source of income is from agriculture and I am not required to pay rricorrie tax on any other tric orne if any

Verification: I ........................................................................................ do hereby declare that what is stated is true to thebest of my knowledge and belief.

[ )Signature of Accounr Holder(s)

I For 2nd Operatorl 0 0PAN CARD YES NO If Yes PAN No [ I I I I I I I I I )Form 60/61 (to be filled by those who do not have PAN)

Form 60Form of declaration to be filed by a person who does not have a permanent account number..eru;l

who enters into any transaction speCified in R~114B

Particularsof transaction:I I Amount of the transaction:

I IDetails of the document being produced in support of address

Are you a tax assessee if YES 0 NO 0 IIa) Details of Ward/ Circle / Range where the last return of income was filed

b) Reason for not having PAN I IVerification: I. ................. ...- ••........ - .............. , .... ' ....... ........ do hereby declare that what is stated is true to the best of Illy knowledge and belief.

Signature of Account Holderts) ( JForm 61To be filled by a person who has only agricultural income and no other rnc orne chargeable to income tax I hereby

declare that ITlY source of income is fr orn agriculture and I arn not required to pay income tax on anx. other income if any

Verification: I ........................................................................................ do hereby declare that what is stated is true to thebest of my knowledge and belief.

( JSignature of Accounr Holder(s)

FORM DA-I Nomination FormNomination 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.

I1We..............................................................................................................................................................................................(Name & Addresess .....................................................................................................................................................................Nominate the following person to whom in the event of my/our/minor's death the amount of the deposit particulars where ofare given below, may be returned by Tamluk-Ghatal Coop. Bank Ltd, ................................... Branch

DEPOSIT

A/C No. A/C TYPE NAMEOF NOMINEE RELATIONSHIP WITH NOMINEE

Age Date of Birth Address oi'Nominee Nominee's err No.

IF NOMINEE IS MINOR

NAME ADDRESS Relationship with Depositor Age Date of Birth

Name of Guardian I I I I I I I I I I I I I I I I I I I I I INatural Guardian 0 Father 0 Mother 0 Court Appointed 0Guardian CIF No. [ I I 1 1 1 1 1 1 I 1 1 1 1 I 1 I I I I I IAs the nominee is minor on this date. I/We appoint, Shri / Smt./Kum .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................(Name.Address and Age)

to receive the amount of the deposit on behalf of the nominee, in the event of my/our/minor's death.Place:Time:

Name(s), Siqnaturets) and Signature (st/Thumb impression (s)

address(es) of witnesses of depositorts)

Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act onbehalf of the minor.

# Signature(s) of depositor(s) should be witnessed by one person, thumb impression(s) should be witnessed by two person(s)

(Manager/Authorised Officer).........•...•...•.••••...••..•..••.•••Branch

(Cut Here) TAMLUK-GHATAL CENTRAL CO-OPERATIVE BANK LTD

Branch: I I I I I I I I I I I I IShri/Smti/Kum.

Date:=Dear Sir/ Madam

NOMINATION FACILITY

We acknowledge receipt of nomination made by you in favour of Shri/ Smt .age Years in respect ofyour. Account Number.

(SB/CA/TDRJSTDRJFD/CC etc.)

offorrn DA 1 dated ,' .Yours faithfully,

FOR OFFICE USE ONLY rr-:1. Applicants interviewed and purpose ascertained by .2. Particulars of Identification:

Photo ID I~==================================================~Residence I~--------------------------------------------------------------------------~

3. Open The Account D If Reject, Give reasons I~--------------------------------------~4. Letters of thanks sent to customer on ./. ./. and intrqducer on ./. ./. .5. Nomination form entered in register and its SI. No Date r---r---r---r---r---r---r---r-~

51. No.

II / We have read, understood and agree to abide by the Bank's Rule relating to the Conduct of the aboveAccounts/services fees & charges. I/We authorise the Bank /their representative to verify the details givenherein for FD/CC/FD/MIS accounts. Please renew/continue to renew the deposit for similar period(s) atthe then prevailing rate of interest. Yours faithfully.

1) 3) .

2) 4) .Signature of the Account Holder( s)

Account No DDDDDDDDDDDDDDDDTerm Deposit Receipt no·DDDDD[JDD Date DDDDDDDDAmount DDDDDDDDD Rate Of Interest ODDMatured Amount 000000000 Matured Date00000000Scanedon 00000000 Verified on 00000000I have verified the documents submitted with CIF and confirm that KYC norms and other norms of the bank are

fully complied with while opening the account.

Manager (Branch / Section) / Authorized Official signatureAsst. Manager (Accounts) / (Field Work) Signature

Date: .Account Transferred to Branch Account closed on .

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