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Aonexure-SZ

9 . Phone No.
10. Mobile No.

1 1 . Emal 1D

made available later, on a Yes No


12. Do you want to subscribe to SMS Alerts (To be

13. Subscribers Bank Details:


You want to change Bank details of:
Tler1Tler I
Tier I Account Savings Curent

Bank Alc Number

Bank Name

Bank Branch

Bank Address

Pin Code

Bank MICR Code

IFS code (Wherever appllcable)

Tier 1I Account: If same as above for Tier I


else,
Savings Ae Curent AWc
Bank Alc Number

Bank Name

Bank Branch

Bank Address

Pin Code

Bank MICR Code

IFScode(Wherever applicable)

Section B - Subscriber's Noination Details


You want to change Momination details
Ther Tler 1
Tier I Account
1. Name of the Nominee:

1st Nominee 2nd Nominee 3rd Nominee

First Name First Name


First Name
ADHA

Middle Name Middle Name Middle Name

LSITARAM
Last Name Last Name Last Name

SAKHARMADE

2. Date of Birth' (Only in case of a minor):

1st Nominee 2nd Nominee 3rd Nominee


20/04/19822

3. Relatonship with the Nominee:

1st Nominee 2nd Nominee 3rd Nominee

S1STE

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