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I tender herewith(Rs........................................................................................)No..................... date.......... as initial deposit. Myparticulars are as under:-
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Rs........................../- incash/Cheque/DD.
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| 1. Name of the First account holder |
..................................................................... |
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Husband/Father /mother's name or Guardian appointedby Court
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..................................................................... |
| Date of Birth |
......... |
........... |
.................. |
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(DD / |
MM / |
YYYY ) |
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(In words)................................. |
| 2. Name of Second Account holder (spouse only) |
..................................................................... |
| Husband/Father /mother's name |
..................................................................... |
| Date of Birth |
......... |
........... |
.................. |
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(DD / |
MM / |
YYYY ) |
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(In words)................................. |
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| 3. Aadhaar Number |
(a) of first accountholder(b) of second account holder
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| .................................................................... |
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| 4. Permanent Account Number (PAN) |
(a) of first accountholder(b) of second account holder
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| .................................................................... |
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| 5. Present Address |
................................................................... |
| Permanent Address |
................................................................... |
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................................................................... |
| 6. Contact details |
Telephone Number........................... |
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Mobile Number................................. |
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EmailID................................................
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| 7. Type of Account |
Single or Joint |
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8. Details of proof of date of Birth of accountholder/s
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................................................................ |
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(a) Certificate No.................................................................................
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(b) Date of Issue................................................................................
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(c) Issuing authority................................................................................
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| 9. Details of other KYC documents attached |
1. Proof of identification |
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................................................... |
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2. Address proof |
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................................................... |
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(The following documentsare accepted as valid documents for the purpose of identificationand address proof:1. Passport2. Driving license3. Voter's ID card4. Job card issued byNREGA signed by the State Government officer5. Letter issued by the National PopulationRegister containing details of name and address);
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................................................... |
| 1. Specimen Signatures |
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| 1. ….................................... |
2.............................................3. …...............................
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| (Name) …........................................... |
| 1. ….................................... |
2.............................................3. …...............................
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| (Name) …........................................... |
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