vijaya Bank - Deposit application form

VIJAYA BANK

Branch :

DEPOSIT ACCOUNT OPENING FORM

Open

Branch Manager

Photo
[to be stapled]

To
VIJAYA BANK
Branch :

Date :

Account No :

I / We remit herewith a sum of Rs. _________and request you to open ________account in the name/s furnished herein below :

Name/s	Occupation and address of the first depositor with nationality	Specimen Signature/s
	PAN No : Tel No :

Scheme under which the deposit is made
Date of birth (in case of minor):
Period of deposit	___________ days / months
Daily / Monthly deposit shall be	Rs .

Debit the instalments / credit interest and / or principal, as and when fall due, to my/our______A/c No:_____ with you.

On maturity, please renew the deposit automatically for the same period until I revoke this instruction in writing. I shall abide by the rate of interest and other terms and conditions of this deposit scheme prevailing at that time.

I/We hereby instruct you to send / not to send me / us the due notice in respect of this term deposit.

Mode of operation / repayment shall be `Either or Survivor’ / `Jointly’ / No: 1 or Survivor / _____________.

I/We agree to abide by the Bank’s rules relating to this deposit scheme and maintain a minimum balance of Rs._____in Current Account / Savings Bank Account.

I/We nominate the following person:
Name : _________________ Age: _____ Years.
Relation :
Address :
Date of birth of the minor : ___________________ . As the nominee is a minor on this date, Sri / Smt.
Address :
is appointed to receive the amount of deposit of the nominee, in the event of my/our/minor’s death during period of minority of the nominee.

Signature of witness:

Name & address :

Introduction

Yours faithfully,

I know the applicant/s personally for a period of years and confirm his / her / their occupation.

SIGNATURE

Name :
A/c No :
Address :

Verified

____________________________

Other Required Particulars

1.	Two passport size photographs, duly signed on the reverse, by the applicant and the introducer.
2.	Declaration in Form No: 60 or 61 as the case may be.
3.	Address proof.
4.	Two witnesses, In case of thumb impression.

For Office Use Only

Account No	Printed No	Amount (Rs)	Rate of interest (%)	Period	Date of maturity	Amount payable (Rs)	Initial of
Account No	Printed No	Amount (Rs)	Rate of interest (%)	Period	Date of maturity	Amount payable (Rs)	Clerk	Officer