Public Provident Fund - Digital Form

APPLICANT INFORMATION

Name of Applicant Date of Birth

HARENDER KUMAR YADAV 1976-06-26
First Name Middle Name Last Name YYYY-MM-DD

PAN Aadhaar ID Mobile Number Email ID

ACGPY9030L XXXXXXXX2972 00918800560185 hkyadav76@yahoo.co.in

Address PIN Code State

YADAV NIWAS,RZ - 154/A, STREET NO. 9-B,KAILAS,H PURI
110045 DELHI
EXT.,,NEW DELHI

PAYMENT DETAILS

Initial Deposit Amt Savings A/C No SI Required? SI Frequency

5000 007010100236720 N -

SI Amount SI Start Date SI End Date

- - -
DD/MM/YYYY DD/MM/YYYY

Carry Fwd Required? No of Carry Fwd Attempts

- 0

NOMINEE DETAILS

Nominee Name Relationship Date of Birth

Sharda Yadav WIFE 19/04/1979
DD/MM/YYYY

DECLARATION:
● I hereby declare that I have not opened a Public Provident Fund Account in the name of myself/minor in any of the Post offices/Banks in the country.

● I further declare that I will abide by the ceiling of maximum deposit in the accounts opened in my name and in the name of minor and any deposit in

excess of the ceiling will be treated as in contravention to the Scheme.

● I further declare that I and/or the nominee both are resident citizens of India and undertake to inform the Bank of any change in our

residency/citizenship status in future.

● I hereby undertake to abide by the scheme provisions and Government Savings Promotion rules-2018 applicable on the Scheme and amendments

issued thereto from time to time.

Note - Access your account statement by logging into Internet banking > Investments > PPF