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    Account Opening Form English - CDR

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    rk759603
    This document is an account opening form for financial inclusion at Punjab National Bank. It collects personal details of the applicant such as name, address, occupation, income, existing accounts, and a request for an overdraft facility and debit card. The applicant declares the information is true and agrees to the terms. They can also nominate beneficiaries and provide signatures or thumb impressions as required.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Account Opening Form English - CDR

    Uploaded by

    rk759603
    203 views2 pages
    This document is an account opening form for financial inclusion at Punjab National Bank. It collects personal details of the applicant such as name, address, occupation, income, existing accounts, and a request for an overdraft facility and debit card. The applicant declares the information is true and agrees to the terms. They can also nominate beneficiaries and provide signatures or thumb impressions as required.

    Original Title

    Account Opening Form English.cdr

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    This document is an account opening form for financial inclusion at Punjab National Bank. It collects personal details of the applicant such as name, address, occupation, income, existing accounts, and a request for an overdraft facility and debit card. The applicant declares the information is true and agrees to the terms. They can also nominate beneficiaries and provide signatures or thumb impressions as required.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    203 views2 pages

    Account Opening Form English - CDR

    Uploaded by

    rk759603
    This document is an account opening form for financial inclusion at Punjab National Bank. It collects personal details of the applicant such as name, address, occupation, income, existing accounts, and a request for an overdraft facility and debit card. The applicant declares the information is true and agrees to the terms. They can also nominate beneficiaries and provide signatures or thumb impressions as required.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    FINANCIAL INCLUSION-ACCOUNT OPENING FORM

    Reference No.______________Date: ____________ Account No.

    Name of the Branch____________________ D No_________________ Customer ID No.

    Sub District/Block Name


    SSA Code/Ward No.
    Village Code/Town Code Name of Village/Town
    [as per census 2011] [as per census 2011]
    Applicant Details:
    Full Name Mr./Mrs./Ms.
    (In Capital Letters)
    First Middle Last Name
    Marital Status Married/Single Gender Male/Female
    Name of Spouse No. of Dependents:
    Name of Father
    Address
    City State Pin Code
    Nationality : Religion: Hindu/Muslim/Sikh/Christian/others
    Location Rural/ Semi-urban/Urban/Metro Category: General/OBC/SC/ST/Minority
    Type of Account Individual/Joint/ Sr Citizen Mode of Operation: Self/ Guardian/
    Telephone & Mobile No. Date of Birth d d m m y y y y
    Aadhaar/ EID No.
    PAN /GIR No.
    Voter ID No; If available MNREGA JOB CARD NO:
    Occupation/Profession Agriculture/Service/Housewife/Business/Salaried/Retired/Student/Others
    Annual Income (ü) Up to Rs.60000/- 60001/- to 1.5 lakh 1.5 lakh to 5.00 lakh > 5 lakhs
    Detail of Assets Owning House : Y/N No. of Animals :
    Owning Farm : Y/N Any other :
    Existing Bank A/c of family Y/N If yes Bank A/c No.
    members/household
    Kisan Credit Card Whether Eligible Y/N If already Issued ; Y/N
    I request you to issue me a Rupay Debit Card.
    I authorize UIDAI to share my e-KYC data with Punjab National Bank.
    I request you to sanction me an overdraft facility with the Limit of Rs. 5000/-(Rupees Five Thousand only) in the above account to meet my
    emergency/family needs. I understand that I shall be eligible for an Overdraft facility only after satisfactory operation of my account for 6 months
    from the date of opening my account. I further declare that no other member of my household has availed overdraft facility. I undertake and confirm
    that I shall abide by the terms and conditions stipulated by the Bank in this regard.''
    Declaration: I hereby apply for opening of a Bank Account. I declare that the information provided by me in this application form is true and
    correct. The terms and conditions applicable have been read over and explained to me and I have understood the same. I shall abide by all the
    terms and conditions as may be in force from time to time. I declare that I have not availed any Overdraft or Credit facility from any other bank.

    Place: Date: Signature/LTI/RTI of Applicant


    Name & Signature of witness (In case of illiterate/blind Applicant)
    Name :
    Address :
    Signature :
    Nomination:
    I want to nominate as under
    Name of Nominee Relationship Age Date of Birth Person authorised in case of minor to receive the amount of
    in case deposit on behalf of the nominee in the event of my /minor's
    of minor death during the minority of nominee.

    Place:
    Date:
    Signature / LTI/RTI of Applicant

    WITNESS IN CASE OF NOMINATION (FOR THUMB IMPRESSION ONLY)


    Name & signature of the first witness Name & signature of the second witness

    Name : Name :

    Address: Address:

    Signature : Signature :

    To be filled only by those who do not have either PAN/GIR: (Select appropriate Form)
    Form No. 60 Form No. 61
    To be filled by person without PAN To be filled by a person who has agricultural income and is
    not in receipt of any other income chargeable to income tax
    1. Are you assessed to tax? Yes No
    2. If yes (i) Details of Ward/Circle/Range where the I hereby declare that my source of income is from agriculture and
    last return of income I am not required to pay income-tax on any other income, if any.
    was filed__________________________
    Declaration
    I_______________________________do hereby declare that what is stated is true to the best of my knowledge and belief.

    Place:
    Date: Signature of declarant
    Specimen
    Signature /
    Thumb
    Impression of The
    Customer
    (For Official Use)
    Risk Category of Account: High Risk Medium Risk Low Risk
    Name Signature GBPA/ PF NO DATE
    Rupay Debit Card Issued
    Signature Verified

    Account Verified
    Registration of Nomination

    For Punjab National Bank

    (Authorized Official)

    Name

    GBPA No

    PNB 1209 (E) 100/14 NMI

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