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PUNJAB NATIONAL BANK

ACCOUNT OPENING FORM (All BRANCHES) FOR RESIDENTINDIVIDUALS (SINGLE/JOINT) ACCOUNTS The Manager,Branch Office..Dist. No. ( FOR OFFICE USE ONLY) Customer ID No:(Sole/first A/c holderonly)

Account No. (16 digits) 1 . I/we request you to open the following account. I/we agree to be bound by the banks rules in forcefrom time to time. (Tick the relevant box on right side). (To be filled in Block Letters)

(A) Savings Fund Account (B) PNB Prudent Sweep SF (Sweep In and Out Facility Requiredfordays )(C) Current Account $(D) PNB Smart RoamerCurrent Account $ (Sweep In and Out FacilityRequired fordays

)(E) Overdraft/Cash Credit $ (F) PNB SpectrumFixedDeposit@(G) Recurring Deposit Monthly Instalment RsNo. of instalmentsInterest rate .% (H) Flexi-Recurring Deposit Monthly Core amount RsNo. of instalments Interest rate .% (I) Tax Saver FD@ (Separate declarationannexed) (J) Flexible RateDeposit@(K) OTHERS (specify):@Amount Rs . Period:

Year..Months...Days..

Interest Rate:

..%

On maturity Annually Half Yearly Quarterly Monthly Credit Interest to SF/CA/ CC/OD Account No.________________

Interest paymentfrequency (Pl. tick in theappropriate box) Credit maturity proceeds to SF/CA/ CC/ODAccount No.__________________ TDS DETAILS TDS, if applicable: Yes/No If no, exemption reference No.______________________

If Yes,

Whether Form 15 G/H* submitted : YES NO Instruction for Auto Renewal on maturity ofdeposit (Tick the relevant column) Renew forPrincipal &InterestRenew forPrincipal onlyPeriod for which Auto renewal required:No. of times 2. Name of sole/first account holder (in block letters)Mr./Ms. First Name

Middle Name

Last Name

$ I /We am/are not availing any credit facility with any other Bank(s)/branch(es) of your Bank and I/We undertake to informyou, in writing, as soon as any credit facility is availed by me /us from any other Bank/branch of your Bank. OR I/We am/areavailing credit facilities with other bank(s)/branch(es) of your bank, as per details given in the enclosed sheet

* Form 15G for General Category & Form 15 H for Senior Citizens PNB 1084 A

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3. Names of the joint account holders (If applicable) (in block letters)i. Mr./Ms. First NameMiddle NameLast Name ii. Mr./Ms. First NameMiddle NameLast Name 4 . Mode of operation (tick whichever is applicable ) Self Either or Survivor Former or Survivor Any one of us orSurvivor(s)Jointly Any Other #

# Specify__________________________ 5. Nomination required : YES NO If Yes, please fill form DA-1.6. ATM/DEBIT CARD: I/we may please be issued ATM Card/ATM cum Debit Card as per following details.I/we have read the terms and conditions governing the use of ATM/DEBIT card. Name of I st Card holderName of 2nd Card holderName of 3rd Card holder 7. Account numbers of the customer on which ATM-cum-Debit card services are required (in case thecustomer has more than one account with Bank) Main Account No.2 nd Account No.3 rd Account No. 8.

Nomination for ATM/DEBIT CARD Holder (ACCIDENTAL INSURANCE): (delete whichever is not applicable)i) I/We_________________________________________________ hereby nominate Mr./Ms. s/d/w/o ___________________________________r/o ____ aged___________years to receive themoney payable by the Insurance Company in the event of my/our death. I further declare that his/her receipt shall be sufficient discharge tothe bank.(ii) As the nominee is minor on this date, I appoint Mr./Ms.__________________________________________________________________ s/d/w/o r/o ____ aged___________years toreceive the money on behalf of nominee during the minority of nominee. 9. Internet Banking

: I/we may please be allowed Internet Banking as per the following details. I/we have read the terms and conditionsgoverning the use of Internet Banking. i)

Name of the account holder (s) authorized for using internet banking services :a.________________________________________________________ b.__________________________________________________ ii) Account numbers on which internet banking services are required (in case the customer has more than one account with Bank) Main Account No.2 nd Account No.3 rd Account No. 10. Request: i ) Please issue Pass Book:

OR

Statement of account: (at my residence/Office /e-mail address (Any one))ii. I wish to avail Met-life insurance facility Y Niii. I wish to avail Medi-claim insurance facility Y Niv. I wish to avail Locker facility Y Nv. I wish to avail

on-line Trading facility Y Nvi. I wish to avail cheque book facility Y Nvii. I wish to avail Credit Card facility Y Nviii. Y N Date:

Customers Signature / : 1. _______________________________________

Thumb Impression2. ___________________________________ Place:... 3. ___________________________________ Cheque Book issued bearing No. From:__________________ to _______________ SIGNATURE OF AUTHORISED OFFICIAL

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Photograph: Pleasepaste recent PassportSize photograph.

Photograph: Pleasepaste recent PassportSize photograph.

PUNJAB NATIONAL BANK Branch Office.. Dist. No..

Customer IDAccount No. SPECIMEN SIGNATURES/THUMB IMPRESSIONS

3. Names of the Account Holder(s) (In block letters)

i. Mr. Ms.ii. Mr. Ms.iii. Mr. Ms. Mode of operationSignature(s) verified by: (With GBPA No. & Date) FOR BRANCH USE ONLY SIGNATURE GBPA/SPA /PF NUMBER DATE 1. Information entered in the system by2. Entered Information Verified by ATM-cum-Debit Card no. Date of issue Issued by (Signature withGBPA/SPA no.)Internet issued(Mention User ID)Date of issue Issued by (Signature withGBPA/SPA no.)

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PUNJAB NATIONAL BANK

Branch Office.Dist. No.

FORM DA-1: NOMINATION Nomination under Section 45 ZA of Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules 1985 inrespect of Bank Deposits,I/ We @ Name(s) ________________________________________________________________________________ ________________ R/o_____________________________________________________________________________ ________________________________ Nominate the following person to whom in the event of my/our/ minors death, the amount of deposit in the account may be returned by PunjabNational Bank, B.O.______________ DEPOSIT

NOMINEE Nature ofAccountAccountNo.AdditionalDetails, if anyName Address Relationshipwith depositor,if anyAge If nominee is minorhis/her Date of birth* As the nominee is minor on this date, I/we appoint Mr/Ms_______________________________________________________ Age________ Address_________________________________________________________________________ _____________ ________________________________________________________________________________ _________________________ to receive the amount of the 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 depositors

@ Where the deposit is made in the name of minor, the nomination is to be signed by natural/legal guardian of the minor to act on behalf ofthe minor.*Strike out if nominee is not a minor WITNESSES #

Name & Signature of the first witnesses Name & Signature of second witnesses Name___________________________ Signature:________________________ Address:_________________________ Place:___________________________ Date:____________________________ Telephone No._____________________ Name___________________________ Signature:________________________ Address:_________________________ Place:___________________________ Date:____________________________ Telephone No._____________________ # Thumb impression(s) shall be attested by two witnesses, otherwise it shall be attested by one witness.. A C K N O W L E D G E M E N T Received on ________________nomination form no. DA 1 for making Nomination from (Name of deposit Holder(s))___________________________ in respect of (Type of Account.) _________________ Deposit AccountNo.________________ ___________________________ Date_____________________.

For Punjab National Bank(Authorised Official)(GBPA NO )

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( ALL BRANCHES) PUNJAB NATIONAL BANK Branch Office...Dist. No..

CUSTOMER MASTER FORM ( To be filled in separately by every individual) (To be filled by bank) 1. Customer ID No.

(Tick the appropriate boxes, wherever required) Photograph: Pleasepaste recent PassportSize photograph. 1. Name of Account Holder (In block letters)Mr./Ms. First Name

Middle Name

Last Name

2. Father/HusbandsName

3. Gender Male Female 4. Place ofBirth

5. Date of birth (DD/MM/YYYY)6. Nationality7. Religion HINDU / MUSLIM / SIKH / CHRISTIAN /OTHERS8. Category GENERAL/ OBC / SC / ST 9. Status Illiterate Blind Pardanashin Phy.Hand. OTHERS 10. Identification mark__________________________________________________________________ 11. Address : (a) Present Residence Owned Parental RentalEmployer provided

AddressCity (State) PINTelephone No. (with STD Code)E-mail

Mobile No. (b)Permanent Residence Owned Parental RentalEmployer provided

Address City (State) PINOffice / BusinessAddressCity (State) PINTelephone No. (with STD Code) 12. minor: YES NO If yes, furnish details of guardian a. Relationship with MinorFather Mother Guardianb. Name of Guardian: Mr./Ms.c. Address of Guardian 13. Whether staff member : YES NO If yes, PF account no._____________

14. Occupation : Salaried-Govt./PSUsectorSalaried-othersRetired -Govt./PSUsectorRetired-OthersStudent Housewife SelfemployedOthers- NotworkingMedical Legal CA/CS Business-TradingBusiness-Industry/Mfg.Agriculture Other (specify) PNB 1084 B

(function() { var pageParams = {"origHeight": 1167, "origWidth": 902, "fonts": [10, 4, 1, 8, 9, 7, 5], "pageNum": 5}; pageParams.containerElem = document.getElementById("outer_page_5"); pageParams.contentUrl = "http://html3.scribdassets.com/2af48duq0w1ccb1u/pages/5-991cac312c.jsonp"; var page = docManager.addPage(pageParams); })(); Scribd.Ads.addBetweenPageUnit(5);

15. Marital status

: Married Single

16. Educational qualification : Up to SSC

Graduate Post Graduate Other (specify)_______________ 17. Total annual income (individual) ; Up to Rs.50000 Rs. 50000 - Rs. 1.5lakh Rs.1.5 lakh - Rs 5 lakh Above Rs.5 lakh 18. Annual turnover (in case occupation is business ) __________________________ Nature of business (Commodity type)________________________________________________ Whether documentary proof in support of item no. 17 & 18 provided : YES NOIf yes, type of Proof : Balance Sheet Income-tax ReturnSales Tax Return Excise Return Other (specify) _______________ 19. Whether Income Tax Assessee? YES NO IF Yes, furnish PAN/GIR NUMBER (If PAN/GIR No. is not applicable, submit Form No. 60/61) PAN/GIR Number 20. Proof of identity : Passport PAN Card Voter ID Card Govt. /Defence ID CardDriving license Others (specify)_________________

21. Proof of address : Electricity Bill Telephone Bill Passport Ration CardDriving Licence Govt / Defence ID Card

Others ( Specify)__________________ 22. Name of spouse (In block letters) Mr./Ms.

First NameMiddle NameLast Name Telephone No. (with STD Code)

PIN CODE

E-mail

Mobile No.

Customer ID No. (if any)

Whether employed/self employed

N If yes, furnish office/Business address

Office/BusinessAddress

Telephone No. (with STD Code)

23. Whether dealing with any other bank, if yes, please give details Facilities/services being availedNAME OF THE BANK AND BRANCHSF CA OD TL OTH

24. Whether already dealing with PNB, if yes, please give detailsNature of Account Account No. Branch Office

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25. Loans availed: (tick whichever is applicable, if yes, mention name of financing institution/bank with amount) Sl.No. Type of Loan YES NO NAME OF INSTITUTION AMOUNT 1. CAR LOAN 2. CONSUMER LOAN 3. HOUSING LOAN 4. MORTGAGE LOAN

5. EDUCATION LOAN 6. ANY OTHER 7.8.9. 26. Assets (approximate value) Rs._________________ Details( * ) : Vehicle owned Car Two wheeler Others None Life policy for Upto Rs 1 lac Upto Rs 2 lacs Upto Rs 5 lacs Above Rs 5 lacs Pension policy Yes No If yes, give details______________ Medical Insurance Yes No If yes, give details______________ Other Assets :_______________________________________________________________________________ __ 27. Investments

(approximate value) Rs._________________

Details ( *) & Shares/NSCs/PPF, other deposits etc) (tick appropriately)(Stocks {

Nationalized Banks Pvt. Banks Foreign OthersCompany Deposits Mutual Funds Shares Bank Deposits

Investments Property Gold PPF Others Amount : up to Rs 1 lac Upto Rs. 2 lac up to Rs 5 lac Above Rs 5 lac 28. INTRODUCTION: I know Mr./Ms._____________________________for the past _______years _______months as a ____________________ (e.g.) friend , relative, neighbour etc. and confirm his/ her occupation as a ____________________ andconfirm address(s) as mentioned herein.a. Introducers Name_____________________________ b. Introducers address: ______________________________________ Phone ________________________ Signature of the Introducer :___________________________________

IntroducersCustomer IDNo.IntroducersAccount No.

29( * ). Spouses qualification : Up to SSC

Graduate Post Graduate Others (Specify)_______________ 30( * ).Details about your family members : Age Group Up to 10 yrs 11 to 20 yrs 21 to 45 yrs 46 to 60 yrs Above 60 yrs Total No. of Males + + + + =No. of Females + + + + = 31( * ). Any relative settled abroad? Yes No If Yes, please mention their names and addresses.Name Address 1.2.3.

How many times have you been abroad in last threeyears? Never 1 to 5times

Above5 times ( * ) Optional

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32. DECLARATION :

I have read (a) the Account Rules and hereby agree to be bound by the terms and conditions outlined in these rules which governthe account(s) which I am opening/will open with Punjab National Bank and (b) amendments to the rules made from time to time and thoserelating to various services availed by me. I understand that the bank may at its absolute discretion discontinue any of the services completelyor partially without any notice to me. I have also been made aware of the charges applicable on various services provided by the Bank. Iauthorise the bank to debit my account for recovery of service charges/incidental charges as applicable from time to time. I hereby declarethat the information furnished above is true and correct to the best of my knowledge. Date__________________ Place__________________ SIGNATURE/THUMB IMPRESSION OF

CUSTOMER 33. Declaration in case of a minor account : I

hereby declare that the date of birth of the minor is ____/____/_____ who is my (relationship) __________________ and I am his/her naturalguardian/lawful guardian appointed vide court order dated_________________(copy enclosed). I shall represent the said minor in all futuretransactions of any description in the above account until the said minor attains majority. I indemnify the Bank against the claim of the abovehis / her account.minor for any withdrawal/transactions made by me in

DATE _____________________ PLACE _____________________ . SIGNATURE/THUMB IMPRESSION OF GUARDIAN

FOR BRANCH USE Risk Category : High risk Medium risk Low risk Negligible risk

SIGNATUREGBPA/SPA/PF NUMBER DATE 1. Introducers signature verified by2.Creation of customer master authorized by3. Account opening Authorized, copies of documents obtained verified, Customersname checked with the barred list and Risk category verified by

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Punjab National Bank Account Opening Form Punjab National Bank (PNB) India Account Opening Form Download or Print 122 Reads Info and Rating

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Upload Date: 01/13/2012

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