PUNJAB NATIONAL BANK

ACCOUNT OPENING FORM (For NRI Single/Joint Accounts) (To be filled in by Bank) Account No Customer ID N0 Date / Month / Year

Photograph

Please affix a recent passport size photograph

To, PUNJAB NATIONAL BANK Branch Office.. Dist. No.. Please open an account as per details below: st Name of the 1 Applicant Customer 2nd Applicant 3rd Applicant Name of Father/Husband 1st Applicant 2nd Applicant 3rd Applicant (To be filled in capital letters) 2. Male Female Gender 3. Identification Mark 4. Type of Account (Please indicate by tick mark) Nature of Deposit Type of deposit*

Amount (Specify Currency)

Period (For Fixed Deposit)

Foreign Currency (Non- Resident) Account (FCNR) Non Resident (External) Account (NRE) Non-Resident Ordinary Account(NRO) *Please specify the desired option such as Saving/Current/ Fixed Deposit 5. Instructions for auto renewal Auto Renewal Required YES No If no, payment instructions are given at item No 14(c) 6. Passport Details Passport No
1st

If yes, number of times it is required.. Whether for entire proceeds / Principal only, for Rs...

Period for which auto renewal is required

Date of Issue

Date of Expiry

Place of Issue

Nationality

Date of Birth

Applicant 2nd Applicant 3rd Applicant FEX 111 59/07 (100X2)SPP

7. Minor Yes No a. Relationship with Minor b. Name of Guardian Mr/Ms c. Address of Guardian

If yes, furnish details of guardian Father Mother Any other

8. Occupation Salaried
1st

Business

Self Employed

Retired

House wife

Student

Other Specify

Applicant 2nd Applicant 3rd Applicant * Please provide details of Name of employer / Line of business / Industry / profession etc. 9. Income per annum Specify Sources 1st Applicant 2nd Applicant 3rd Applicant 10. Education Under Graduate
1st

< Rs 60,000

Rs 60,000 100000

Rs100000 500000

Rs 500000 1500000

Rs > 1500000

Graduate

Post Graduate

Professional

Applicant 2nd Applicant 3rd Applicant 11. Communication Address (Please give all available details) Overseas Office Address ( Land mark is compulsory) Overseas Residential Address ..

Country Name Code Country Name.. Code Phone No Fax No Phone No. Fax No. e-mail Address e-mail Address Indian Address (if any) Phone No e-mail Address 12. Mode of operation Self Any of us or survivor(s) Either of us or survivor(s) All of us jointly or survivor(s) Former or survivor

13. Debit Card - Please issue Debit Card. I/We have read the terms and conditions governing the use of Debit Card Name of 1st Card Holder Name of 2nd Card Holder (i) Nomination For Card Holder Accident Insurance: - I/We hereby nominate Mr./Msto receive money payable by the Insurance Company in the event of my / our death. I/We hereby declare that his/her receipt shall be sufficient discharge to the Bank. (ii) As the nominee is minor on this date, I/We appoint Mr / Msson/daughter/wife of Mr resident of . agedyears to receive money on behalf of nominee during his/her minority. 14. Internet Banking Services - I/We have gone through the Internet Banking Services guidelines and agree to abide by terms and conditions governing its use and availment by me / all of us. Please provide me / us this facility. Facility to be provided to

15. Instructions/Declarations . I/We confirm that all the information given in this application form is true, correct, complete and uptodate in all respect and I/we have not withheld any information. I/We shall be held responsible for the same at all times if it is found incorrect. I/We confirm having read and understood the Rules and Regulations of the Bank including Banks tariff regarding the conduct of the account /deposits and pertaining to the phone banking, ATM, Debit Cards, Internet Banking and Electronic Banking facilities (collectively called the said banking facilities) and agree to be bound and abide by them / any other rules that may be in force from time to time. It is my/our responsibility to obtain the terms and conditions from your bank and read the same. I/We confirm my/our residential status as per Indian Income Tax Act 1962, is Non Resident Indian and I/We agree and undertake to inform the Bank in writing of any change in residential status. I/We undertake to operate and use the account /deposit as well as the said banking facilities strictly in accordance with the Exchange Control Regulation as laid down by the Reserve Bank of India from time to time. Declaration under section 10(5) of FEMA 1999: I/We hereby declare that all foreign exchange transactions as are being entrusted and may be entrusted by me/us to the Bank from time to time do not/ will not involve and are not / will not be designed for the purpose of any contravention or evasion of the provisions of the aforesaid Act or of any rule, regulations, notification, direction or order made thereunder. I/We also hereby agree and undertake to give such information/documents as will reasonably satisfy you about the transaction in terms of above regulation. I/We also undertake that if I/We refuse to comply with any such requirement or make untenable complaint thereagainst, the Bank shall be within its right to refuse in writing or otherwise to undertake the transaction and shall, if it has reason to believe that any contravention /evasion is contemplated by me/us, report the matter to Reserve Bank of India. (a) Please issue me / despatch a cheque book / Pass Book (in case of NRE / NRO account) (b) Please credit interest to my NRE/NRO Account No /or remit interest by DD/TT at my/our Indian/ overseas address /Bank account No.. with.after deducting remitting charges ,as may be applicable from time to time. (c) Please credit proceeds on maturity to my/our Account No with . .

Signature/thumb impressions of 1st applicant

2nd applicant

3rd applicant

1. Mr/Ms will sign as 2. Mr/Ms 3. Mr/Ms 16. Introduction Self (Existing Customer of the Bank Please write your Account Number here New Customers Please enclose Copies of Passport and Resident Visa will sign as will sign as

I know Mr /Ms for the past years as a ...(friend / relative / neighbour) and confirm his/her occupation as a

Signature of the Introducer . Rubber Stamp . (Signatures of person known to the Bank / correspondent bank / Indian Embassy / High Commission / Consulate / Notary Public etc, along with Rubber Stamp, where applicable) (i) In case, introducer is having account with the Bank Name of the Introducer Introducers Account No

(ii) In case of introduction, given by Indian Embassy/High Commission/Consulate/Notary Public etc, a communication (in duplicate) shall be sent thanking them for introducing the customer, and also for returning one copy of the communication, to ascertain the authenticity of the attestation of signatures. 17. Nomination Nomination required

Yes

No

If yes, please fill in the following particulars

FORM DA-1-Nomination under section 45 ZA 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) and address (es), nominate the following person to whom, in the event of my/our /minors death, the amount of deposit, particulars whereof, are given below, may be returned by .(name and address of branch / office in which deposit is held) Deposit Distinguis Addition hing al No details, if any Nominee Relationship Age With depositor, if any

Nature of

Name

Address

If nominee Is a minor, his date of birth

As the nominee is a minor on this date, I/We appoint Mr./Mrs./Ms(name, address and age) to receive the amount of deposit on behalf of the nominee in the event of my/our/minors death during the minority of the nominee. Place Date. Signature(s)/thumb impression (s) of depositor(s) Name (s), Signature (s), and Address (es) of witness (es)

18. FOR OFFICE USE (i) ATM CUM DEBIT CARD NO

Date of Issue Customers Classification

Introducers Customers Signature Verified Signature by attested by

Creation of Customer Master Data Authorised by

Customers classification confirmed & Account opened by

Name GBPA No Date Signature