POST OFFICE SAVINGS BANK
ACCOUNT OPENING/PURCHASE OF NSC APPLICATION
FORM FOR INDIVIDUALS
For Office
Use
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Post
Office Mumbai GPO
Date SOL
ID -40000100
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Account/Registration
NO.
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CIF ID (2)
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CIF ID (3)
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For Applicant(s)
*1 I/We request you to open
/issue account/certificate in my/our name (please tick √ the empty box) :-
Savings Account
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TD A/C 2
Years
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Sr, Citizen Savings Scheme A/C
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Basic Savings Account
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TD A/C 3
Years
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PPF A/C
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RD Account
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TD A/C 5
Years
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NSC VIIIth
Issue
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TD A/C 1 Year
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Monthly Income A/C
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NSC IXth Issue
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*2 Operation
Instruction (please tick √ the empty box) :-
Single/Self
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Either or
Survivor (Joint-B)
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Jointly
(Joint-A)
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Through
lierate agent
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*3 Full
Name of applicant, in CAPITAL letter (Leave a space between words)
Mr./Mrs./Ms./Other First Name Middle
Name Last
Name Gender
(M/F)
1.
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2.
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3.
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*4 Full
name of father/husband/Mother, in CAPITAL letters (Leave a space between words)
Mr./Mrs./Ms./Other First Name Middle
Name Last
Name Gender
(M/F)
1.
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2.
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3.
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*5
Residential Address
First Applicant
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2nd Applicant
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3rd Applicant
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Flat
No./Bldg. Name
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Street/Road/Locality/Village
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Tehsil/Post
Office
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City and
District
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State
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Pin Code
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Tel./Mobile
No. (optional)
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Email
(optional)
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*6
Applicant Date of Birth (DD/MM/YY) PAN (If Not available, Attach form
60/61) CIF ID (If
already exists)
1.
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2.
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3.
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7 Please
chose from the following (Tick √ any one)
Minor
through Guardian
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Lunatic
Through Guardian
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Blind/physically
Handicapped/llliterate through agent
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Pensioner
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BPL
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Beneficiary
of any welfare Scheme
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Sanchayaka
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orther
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8 in case
of minor/ lunatic Account, Please fill the following :-
Name of
Guardian
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Residential
Address
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Relationship
with minor
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9 in case of other than Minor/Lunatic,
please fill the following :-
Name of Sachayika /Government Welfare
Scheme
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PPO/BPL/Registration/Enrollment No.
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10 Details about AADHAR :-
UIDAI Aadhaar Number
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UIDAI Aadhaar Number of Guardian (in
case of Minor/lunatic account)
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1
*11 Detail of Know Your Customer
(KYC) Documents Submitted :-
Photo ID
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Address
Proof
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Applicant
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Applicant
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1st
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2nd
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3rd
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1st
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2nd
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3rd
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Types of Document
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Document No.
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Valid Up to (if any)
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*12 Detail of First deposit:-
Mode of deposit (Tick √ any one)
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Amount RS. (figures) (Words)
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Cash
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Cheque /DD
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Cheque
/DD No.
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Date of
Issue
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Name of
the Bank/ Post Office
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Transfer
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Transfer
Account No.
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CIF ID
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Name of
the Bank/ Post office
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SBMO
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Postal Orders
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*13 Amount of Monthly Installment (in
case of RD Account)
Rs. (in figures) (in words)
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14 in case of Certificates :- Please
issue certificates as detailed below :-
Denomination (RS.)
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No. of Certificates
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Detail of Certificates issued (to be
entered by Post Office)
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100
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500
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1000
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5000
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10000
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15 In case services of
SAS/PPF/MPKBY Agent are taken
I/We are using the services of
SAS/PPF/MPKBY Agent (Name) ……………………………………………………………………………………………………
Authority No.
…………………………………………………………Valid up to …………………………………………………..
Received Passbook/Certificates on
behalf of depositor
Signature of Agent with date
………………………………………………………………………………………………………………………………………………………
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16 Standing Instructions
Please credit my Monthly/
Quarterly/Yearly interest into following account (in case of MIS/SCSS/TD
accounts) :-
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Savings Account No.
……………………………………………………….Standing at ……………………………………………………..PO / Bank.
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Please debit my following account for
credit my RD installment Monthly/Half yearly/ yearly :-
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Savings Account No
……………………………………………………….. Standing at …………………………………………………… PO/ Bank.
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17 Nomination
I/We
nominate the person (S) named below under Section 4 of the Government Savings
Bank Act, 1873 (5 of 1873 to be the
Sole
recipient(s) of the amount standing at the credit of the account in the even of
my/our death.
Name
& Address of nominee(S)
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Date of
Birth
(in case
of minor)
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Share of
Nomination
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Name
& Address of Person who may receive the said amount during the minority of
the nominee(s)
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Signature of witness in case depositor
wish to make nomination
………………………………………………………………………………………………..
Name & Address of witness
…………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………….
*Mandatory Fields to be filled by
customer.
2
18
Other information
Monthly
Income (Rs.) (Tick
√ any one)
Up to
5000/-
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5001-10000
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10001-20000
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20001-50000
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50001-1
lac
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Above
one lac
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Occupation
(Tick √ any
one)
Salaried
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Self
employed
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Business
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Retired
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Student
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Pensioner
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Agriculture
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Others
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Account
Open mode (Tick
√ any one)
Normal
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Without
Cheque Book
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With
Cheque Book
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Welcome
Kit
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Documents
attached (Tick
√ relevant columns)
Age proof
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Photo ID
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Address
Proof
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Source
of funds
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Form 60
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Form 61
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Form 15G
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Form 15H
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Facilities
required (Tick
√ relevant columns)
Internet
Banking
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Viewing
rights
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Applicant
(1)
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Applicant
(2)
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Applicant
(3)
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Transaction
rights
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Applicant
(1)
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Applicant
(2)
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Applicant
(3)
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Tick √ relevant Box
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ATM cum Debit Card
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Mobile Banking
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SMS Alerts
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For
Mobile Banking/ SMS Alerts.
For Statement
Mobile
No.
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Email
ID
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Signature or Thumb impression
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Recent Photograph
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Applicant (1)
Or
Guardian
(in case of Minor or Lunatic
Account)
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Applicant (2)
Or
Operation agent
(in case of Blind/ Physically Handicapped/illiterate
depositors operation through agent
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Applicant (3)
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3
Declarations (Tick √ the relevant bullet )
·
I/We hereby
declare that I/We have clearly understood POSB General Rules 1981 and Post
Office Savings Account Rule
1981/Post office Recurring Deposit Rules 1981/Post
Office Time Deposit Rules 1981/Monthly Income Account Rules 1987/Senior
Citizens Savings Scheme Rules, 2004 (amended for time to time) governing the
accounts under this scheme and to Abide by such rules framed by the Central
Government as may be applicable to the account from time to time. I/We will not
open more than one savings account in one post office. I/We will furnish on
demand from the Post Office Savings Bank, particulars of all such accounts
irrespective of the location of post office where these accounts are/were
opened.
·
I/We also declare
that I/We have not exceeded the prescribed maximum limit of investment for an
individual while investing in Various MIA/SCSS accounts in different post
offices.
Note :- For the purpose
of maximum limit in MIA, the depositor’s share in the balance of a joint
account shall be taken as one half or one third of such balance according as
the account is held by two or three adults.
·
I/We shall adhere
to the ceiling on deposits, taking the deposits in all the accounts opened by
me/us together, as specified in rule 4 and amended from time to time. In case,
at any time, any excess deposit is found, such excess deposit will be refunded
to me/us after recovery of excess interest paid if any under the rules.
·
For any
transaction occurred through my cheque-book/passbook/ATM cum Debit
card/Internet/Mobile Banking, I/we shall be fully responsible.
·
I/we am/are legal
guardian of the minor/lunatic and copy of the orders of the competent court is
attached.
For PPF:-
·
I hereby declare
that I/we have clearly understood the PPF Scheme Rules, 1968 governing the
accounts under the said scheme, as amended from time to time (hereinafter
referred to as the said rules and shall abide by such rules framed by the
Central Government as may be applicable to the account from time to time.*
·
I hereby declared
that I am not maintaining any other Public Provident Fund Account.
·
H hereby declared
that I am not maintaining any other Public Provident Fund Account except an
account on behalf of a minor.
·
I also declare
that I shall adhere to the ceiling on deposits as provided for by Central
Government from time to time, which is Rs. 1,50,000/- in a financial year at
present, in my individual self account and accounts opened on behalf of
minor(s) of whom I am a guardian. In case, at any time, the above said
declaration is found untrue/false, no interest shall be payable to me/ the
subscriber on the amount of deposits found in excess of the prescribed limit.
For NSC
·
I/We hereby agree
to abide by National Savings Certificates (VIII Issue) Rules, 1989 or (IX Issue
) Rule 2011. (amended from time to time.
Authorization
·
I/We authorize
Agent (name) ………………………………………………………………………………………………………………………. to receive
Passbook/Certificate on my/our behalf.
Signature/Thumb
Impression:- 1st Applicant 2nd
Applicant 3rd
Applicant
For office Use Only
Certified
that I have verified the documents submitted with this application form and
confirm that KYC norms are fully complied with
Signature of BPM Signature
of SPM Signature
of Postmaster
………………………………Please
Cut from here and past in Register (only for literate Customers
)……………………………………………………….
Date of Opening of Account (to be filled by Applicant
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Account/Registration No. (to be filled by Post
Office)
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Sr. No.
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Specimen Signature (to be filled by the applicant (s)
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1
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2
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3
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