Wau ere For Bank use ony Reco BRANCH CODE wasps EE CoM Ue) Customer 10 Dae omnino(aTs[o 1311 Tal2]t Lolo lol [Lg gg FINANCIAL INCLUSION : [APPLICATION FOR BASIC SB NO FRILLACCOUNT [Name in Full RIAD MAR io) [Fathers Name [OTE I Fe Dwi Je Ja J= Tala Nit [Motners name [7 1A [ ml vIn] [Name of tw Spouse [Tut |e (tess THivk Iai (va —_ lee telal (Mandai7Tenst 1 C]e, |e [eel = [Diswet EL-_Imi (sae [ PL xe | tls A [Profession ¢ [Annual income [RS. 1.0 pcre. Details of Nomination - — ikem ‘Name ot the Relationship te of Bith | Porson authorised to recive tho ‘Nominee grease of Minor) | amount inte oven of my minors daath during minor of nominge Puld [rere [Boloudred | nt Declraion [hereby apply for opening of #801 Financial Inclusion Scheme No Fral Account ATM Card or (Business Correspondent) Smart Card ‘Account. Ihave read the terms and conditions applicable to this account and BOI SB No Fill Account and also | agree tothe terms and conditions as may bein force form time to tie, lwo dectare thal the balances in all our accounts put together wil nos not likely to ‘exceed Rs 50,0001- (Rs. Fifty thousand ony a any point of ime and the turn over inthe account wil nots nt ikely to exceed RS. 1 lac (Rs. One Ine only) n year. le amlare aware that and assure the bank that whenever myfour account exceeds the above mentioned ‘nancia imi wo wi comply nd abe by the KYC norms ofthe Bank. Laccop that BOs enti atts cisretion o accept or reject ts application without assigning any reason whatsoever. | declare that the information provided by me inthis application form s true and correct retphone wo, BBY BAVA FE Date : \¢-0%- 202} 4\\ Signature /LHTI of applicant ine Details of itrocucton [Name ofthe personinroduced [Zia TV] \ [nA [> (a Tu fatet: lotr 1\ [ofol ofe [é Tal iCThinka TET SL ch [TTT TTS | know the above person forthe past — years ) JL. L TT] raha Kone introducer not avaliable cine ew idee? 1. Tenany one of the following dently pr oofisto be obtained suchas Election ID Card / Govt. IO Card /Driving License? Employer's ID Gard/ 10 Card issue by SchoolCollae along wih document for address proof such as Electricity Bil/ Ration Card 2. Inrodutionby tow neighbors whe have proper documents for identical 3. Anyother evidence forthe saisaction a the Bank, Signature of Vorlying OfficatBank of India ub For Bank use only BRANCH CODE Customer 10 FINANCIAL INCLUSION 10 \\22NCSA 14s, APPLICATION FOR BASIC SB NO FRILL ACCOUNT (Nanein Fal ETI Dale [Famersname | PJelAl ea el [Pla MA. Moners Name [C aT [Name ofthe Spouse [Address Tal [Wee lelae Mandal / Teh Tela LL Distiet Sate JET TTT [Sex_[ | Ave Dato of Bint Profession | Ag %pClnae ob [.Bolonas 6 (Annual income [Rs.[,< aro [GIRIPANNe. DRA PPAG Sor Dotais of Nomination — oo a SBA‘cNo. | Nameatite | —Relaonship [Age | Dato of in | _ Poon authorod io esa he Nominoe (incase tino) | amount in the even of my mnor Goat ang mor of rominee 1 2 3 _raveas [Er | Jerledmre] ly for opening of @ BO! Financial Inclusion Scheme No Fil Account /ATM Card or (Business Correspondent) Smart Card ve read the terms and condition applicable to his account and BOI SB No FrilAccount and also | ree to the terms and Coraitions as may bein force form tna to tina. Uwe dociare that the balances in all our accounts put togethor wil nots not likely to ‘exceed Rs. 50,000)- (Rs. Fifty thousand ony at any point of time and the tum over inthe account will novi no Tikely to exceed Rs. 1 lac (Rs. One lac ony) n year. We amlare aware that and assure the bank that whenever mylour account exceeds the above mentioned nano imi we wilcomply and abide by the KY noc ofthe Bank. accept that BOs ented a Its csroton to acceptor reject ts ‘application without assigning any reason whatsoever, I deca vided by me inthis application form is rue and correct. Telopone No. 224 SOS] ) 4 Q Pace: Chhatri pate: |Z O82, Details of introduction CI [Branch TT TT | know the above person forthe past Mintroducor isnot available “Then any one ofthe following klenly prooTistobe obtained suchas Election ID Card / Gov. 1D Card/ Driving License Employor's 10 Gara! 1b Card issuo by SchoclCollege along wih document for address proof suchas Electricity Bil/ Raton Card Introduction by iow neighbors wo have proper documents foridntication, ‘ay oher evidence forthe satisfaction ofthe Bank, Signature of Vortying Officatyeh PR Reo ~ar For Bank use only BRANCH CODE Customer 10 W221 BEA AM (DoT Ts 1973] Carol IS 1p 1g 1p [6 4e") ET Co are) Account No.[ 4] 319 [3 [1] 8] 2[1 Lolo [a FINANCIAL INCLUSION APPLICATION FOR BASIC SB NO FRILLACCOUNT Declaration NameinFul TPIT TST TAB TAT “I TTI [FatersNone [Vande il [Bfesalal | jy yy yt tT J Motors ware [STATIN [yTAL [isle 1e [esl Name ofthe Spouse [xi A |. |_| | |_| TTL _| [Address tials Ie IA IeicIeiAl_ | IwisiR ist [Mol ts vige EF [RTT ET TI =e i} [ease ints en ns] i [| eet ta] [Distt CELE Perr) ‘State ] Sex [PL Ave : d le loly D mM VY y¥ Profession [Se ——[setongsto | OBC] ec | sc | ST] Gon Tad : [Annual income LS Gre _ |GIRIPAN No. — Details of Nomination SBACNo. | Nameotthe | Relafonship [Age] Date of Binh | Porson authorised to racoive tho Nominee encase iron | amen ert ty rina SAB THIN Acer - | [poreby apply for opening of a BOI Financial Inclusion Scheme No Fill Account /ATM Card or (Business Correspondent) Smart Card ‘Account have read the terms and conditions applicable to this account and BOI SB No FrilAccount and aso | agree to the terms and ‘concitons as may be in force form te to tne, Uwe dactare thatthe balances in all our accounts pu together wll nots not likely to ‘exceed Rs. 50,000 (Rs. Fifty thousand only a any point of time and te turn over inthe account wil nots not Ikely to exceed RS. 1 lac (Rs, One lac only) in year We amiare aware that and assure the bank that whenever myour account exceeds the above mentioned ‘inancla imi wo wil comply and bide by tho KYC norms ofthe Bank. | acco hat BO Is entiled ats csoreton to acceptor reject this application without assigning any reason whatsoever. | declare that the infomation provided by me inthis application form is tue and earect. Telephone Ne. ASZASLIVR« Place: Chhatri Dae: |Q-o8-23 Details of introduction [[Nome ofthe person invoaucod | [| | 11] (aeno TT [PTT ETE ttt - (sanen TT TTT TTT TP PTT reret Vow the above person forthe past years introducer isnot available Signature ofthe introducer 1 2 3 “Then any one ofthe folowing kent prooTis tobe obtained suchas Eoction ID Card / Govt. 1D Card/ Driving Licensed Employer's ID Card/1D Card isaueby SchoolColle along with document for addross proot such as Elect Bil/ Raton Card Introduction by tw neighbors who haw proper documents foridentitcation. ‘Any olher evidence forthe satisfaction of the Bank, Signature of Vorlying OfficatLaannqye or Bank use only RICE (0 orancncooe eee =U Come) Customer 1d Cia hictoTa2ret a) cco o(4]]91 3111 s21t Lola el fare) FINANCIAL INCLUSION APPLICATION FOR BASIC SB NO FRILLACCOUNT (Ranenrar ——FFTATPTALS]_IeTUret ale! [Plats [Famersname [KT Alm) AIL AIK) Pvsia| [Pip [i [MottersNane AlN TT PLANT [PTA ATe [Name ofthe spouse [RE Tu TCT TA INTDIAT ie [raerous TAIL LA TWinieint ilo Ty igs Teiatelel_| LCE Mand Toeh Ieiclelel 1 2 a [et [else 1 ed [sao Wl 16 (Sox [7 [Ase | [[ oaeeroien Tr Profession | 51 P Ofehoth | |= L__d _ ae “enualcona [Rs J2GO0— [aR CT PP S28 | otal of Nomination : Name ot the ‘Nominee (iacase of Mince) } amount inthe event of my minor's Relationship [Age | Date of Bith | Porson authorised i receive the ‘death during minority of nominee Spovde | lofoslisq7 Declaration 7 ane I hereby apply for opening of a BOI Financia Inclusion Scheme No Fil Account / ATM Card or (Business Correspondent) Smart Card ‘Account. have read the terms and conditions applicable to this account and BO! SB No Fri Account and also | agree to the trms and conditions as may be in frce form ime to tre. Wwe declare tha the balances in all our accounts put together wil nos not kal to ‘exceed Rs. 60,000 (Rs. Fit thousand only at any point of time andthe turn over in the account wil nots notlkely to exceed Rs. 1 lac (Rs, One lac only} in year. We anvace aware that and assure the bank that whenever myfour account exceeds the above mentioned financiat Hint we wi comply and abide by the KC norms ofthe Bank. | accept that BOs ented a ts csroton to acceptor reject tis application without assigning any reason whatsoover. | dacare thal the information provided by me inthis application forms rue and correct z Tephone Wo, Z1\ 6 3OORS2 TAP OL Kumar Fa) gril Paco: Chari pate: (-0@-“2OTS Signature /LHTI of applicant Dotais of introduction [srnch I | know the above person forthe past a bv ds introducer is not available. Signature ofthe introducer 4. Themany one ofthe following identity prootis tobe obiained such as Election ID Card Govt. 1D Card/Driving License! Employer's, 0 Gard 10 Card issue by SchoolCollage along wih document for address proof suchas Electric Bil/ Ration Card 2. Inroductionby tow neighbors who have proper documents or dentate. 3. Anyolherevidence forthe satstactionoftoBank, Signature of Vorlying OfficatWr 1OB AUG we For Bank use only eo RANCH CODE Maen eon Customer 1D FINANCIAL INCLUSION APPLICATION FOR BASIC $8 NO FRILLACCOUNT TTA 1 Al | I | [Name in Fut i [Faners Name [| [Mothers Name [Name of he Sp [arene [vitage Mandal Ted (Bester State : I 7 (sx F [Aol [ [baeoreim (Jjal alt D MM. D [Profession [ST oon ~_[ Belongs to | OBC ——[eiRIPANNe | ae iz inl iG FIP] OOOO Details of Nomination: ee a ‘SB Alc No, Name otthe | Relationship [Age | Date of Bith Parson authorised to receive the Nominee (incase of Minor) | amount in the event of my minor's __| |_| death dwing rinonty ofrominse, Declaration - Ee | hereby apply for opening of a BOI Financial Inclusion Scheme No Fil Account /ATM Card or (Business Correspondent) Smart Card ‘Account ave read the terms and conditions applicable to this account and BO! SB No FrilAccount and es | agree to the terms and conaltions as may be in force frm time to tiene. Me decare thatthe balances in all our accounts put togethor wil nots not likly to ‘exceed Rs. 50,000 (Rs Fifty thousand ony at any point of ime and the tun over inthe account wil nots not ikely to exceed RS. 1 lac (Rs. One lac only) n year. We amare aware that and assure the bank that whenever mylour account exceeds the above mentioned Financia iit we wl comply ana abide by the KYC norms of" ~ “++ enitlad at its dlscrtion to accopt or rooct his >vided by me inthis application form is rue and application without assigning any reason whatsoever. | doc correct. raion. 7674.25 094-8 Place: Chhatri Date paneer [Mane ote penonmeoaced [72 AKT aIAISICI AlsTAl a weve TUizfalaplaottioliolultfelt-} _ (eee IcIblaleleR TEE EPP ttre rrr on / a Resseacebinbod ee 1 know the above person forthe past —_ Employers ID Gard ID Cardissue by SchoolCollege along with document foraddress proof such as Electr Bil/ Ration Card. 2, Inrodictionby tow neighbors who have proper documents or identiication, 3. Anyother evidence forthe satisfaction ofthe Bank, Signatur of Vortying Offical~ 144 oo” \\TAeWUNF Vg For Bank use only runes! Cove (Ole Ts 1913] =o Caalel pccount No. [4131913111 8] 211 L010 [0] FINANCIAL INCLUSION FOR BASIC SB NO FRILL APPLI [Nanenrun (RUS teteteral 7 TRIN atrlulAy TT TT TTT) [Famers Name [ST Xe [isl | LETTE rT yr rire) [Reteratene TT LI EE LEC 1 Narre ofthe spouse | ULed_| | ieee ose ||) [ns Telecel ELCEEEe rrr) [vitooe Chabchvle | =CEEELELECEL [Mandai7teret JEL 1211 | i tT TiETiTttT4 [District lel Im 1 PP ttTiri ti I jase TTT) alo lle YY YY Be | sc | St] Gen | Date of Birth “Person authorised to receive the (nvease of Minor) | amount in the event of my minor's [ sBAreNo. Name otthe | Relationship | Aas | ‘Nominee ‘oath during minoniy of rominge L Dedaration Troreby apply for opening of a 8OI Financial Intusion Scheme No Fil Account ATM Card or (Business Correspondent) Smart Card ipecount {have read the terms and conditions applicable to this account and BO! SB No Frill Account and also agree to the terms and cenaons as may ba in force form me to time. lie dectare that the balances in all our accounts put together wil nos not key to cxeoed Fs, 50,000) (Rs. ity thousand ony at any point of me and the tum over inthe account will otis not ikoy to exceed Rs. 1 la: (fs. One lac ony) in year. UWe amare aware tha and assure the bank that whenever mylour account exceeds the above mentoned {fnancicl iit wo wil comply and abe by the KYC norms ofthe Bank. | accept hat BO! is ented tits discretion to accept or rect his pplication wihout assigning any reason whtsoever.| declare that the information provided by me inthis application form s true and correct. - rebephene no. FEE EAVOSEP | : Rh ei ~~ Signature / LHTI of applicant Place: Chhatri ate ne ee = [Kane dvepoom read [Calvi idee Telabal CPP T 4 (xene. TUlzTols [olalo ate) : tomer inaltiob FTP? 1 ttt tit tttittit tit neem a 5 Lg Wintroducer fs not availabe: ‘Siar or tac Te ect ong ty prointab candice Garton Ct DLs Empovers issu School Colge lng wih document or adress pot such as Elect Bi/ Raion Cad 2. letroductionby tow neighbors who have proper documents foridentficalion, 3. Anyolher evidencetor he satisfaction ofthe Bank ‘Signature of Vertying OffctalW22USSNAS i Fer bah be oly CCS BRANCH Cope opera ps1 aps Ee mute Customer 1b Ole Account No.(4] 3/9] 11] 81 2]1 [elo lo /ICP Ae LS FINANCIAL INCLUSION APPLICATION FOR ‘$B NO FRILL, [Renee SETS OL ISAS ([Fainer’s Name eee Belplal Tl - : [Mother's Name [Name one Spouse | [Annual income [Rs. 50,77 |GIRPANNe. TAS Detals of Nominaion: ‘SBAcNo. | Nameaithe | Relaionstip [Age | Date of ih ‘Nominee (incase of Mine) ae * pouse oor laphage| aiaion "Thereby apply for opening of a BOI Financial Inclusion Scheme No Fril Account / ATM Card or (Business Correspondent) Smart Card ‘Account. have read the tems and condions applicable this account and 801 SB No Fil Account and also! agree tothe terms and conditions as may be in fore form time to time. live deciare thatthe balances in all our accounts put together wil noVs not likly to ‘exceed Rs, 60,000/-(Rs. ity thousand ony at any pont of ime and the tun over inthe account will otis not ely to exceed Rs. 1 lac (Rs. One tac only) in year. We amare aware that and assure the bank that whenever mylour account exceeds the above mentioned financial iit we wil comply and abide by the KYC norms ofthe Bank. | accep thal BOs ented atts discretion to acceptor reject this ‘application without assigning any reason whatsoover. I declare thatthe information provided by me inthis application form is tue and correct. teephone No. BL SCQHAY S2 Pace : Chhatri pate: 108202 % Dats of rirodvcton [Name ofa 1. Tenany onecrthe folowing identity prootis tobe obtainod suchas Election ID Card/ Govt 1D Card/ Driving License Employer's 1D Gara ID Card issue by SchoolCollege along with document foraddres proof such as Electricity Bil/ Ration Card. 2, Introduction by tow neighbors whohave proper documents foridentiicalon. 3. Anyalherevidencefortha satisfaction ofthe Bank, Signature of Vertying Offical f1)2218891 5@! For Bank use only oo BRANCH CODE Gu Lem le Customer Account No.[4[3[9 [3 [1 FINANCIAL INCLUSION APPLICATI (NaneinFur——_TAINIZIMTE STH [DIE [ramersneme [a Tul TIA im [DIE [Mother's Name MAINS [A IN [Name ofthe spouse |Q[0 [1 [raross: TKIAIS [BAT [Vilage [Mondo Torat ——[E[o WIE] IB IN [ALL [sex_[Matal Age [Ds [ Date ofBitn lolet tol 9 (Profession [So] 2mdeyaodd | Belongs to ‘Annual Income [Rs._ GOO F-[GIRPANNe. Hx PPD Hl;02 Dotails of Nominetion SBA No, Namo atthe | Relationship [Age | Date of Bith Person authorisod to receive the Nominee. (iacate of Miner) ) amount inthe event of my minor's ‘death during minority of nominee: | Gautom | Fathon [50] oF01-1473 Decaraion | hereby apply for opening of a BO Financlal Inclusion Scheme No Frit Account /ATM Card or (Business Correspondent) Smart Card ‘Account. Ihave read the terms and conditions applicable to his account and BO! SB No Fill Account and also | agree to the terms and ‘coneitions as may bein force form time to tine. we dociare that the balances in all our accounts put together wil nos not likly to ‘exceed Rs. 50,000)-(Rs. ity thousand ony at any point otime and the tum overin the account wil nots not likely to exceed RS. 1 lac {(Rs. One lac ony) in year. We am/are aware that and assure the bank that whenever my/our account exceeds the above mentioned financial it we wil comply and abide by the KY norms ofthe Bank. accept that BOs ented at ts discretion to acceptor eect this application without assigning any reason whatsoever. | declare thal the information provided by me inthis applcation form i rue and comeet. reprone vo. 11513 2.60332 | | Anunesla De Date ~ Signature /LHTI of applicant Details of introduction q ! [[Name ofthe person introauced | R) AIVIT INIDIAIO| IAISINIAL imal Place: Chhatri (mero TTT TTT ti ttt tit 8 | know the above person for the past 2. years, amroune not oaks aaa tte ioducer +n per ay one og erty pons tbe cbised suche lecon 1 Carl/Govt 0 Carve noe Erol 1 Gard/1D Card issue by SchoolCollege along wih document for address proof suchas Electric Bil/ Ration Card 2. Iniroduction by tow neighdors who have proper documents for dentition. 3. Anyotherevidenceforthe satisfaction ofthe Bank Signature of Voriying Officat: CHP \\rPAKEUSR For Bank use only BRANCH CODE operas] Customer POLeILIZ Ist Account Wo.[4] 319 [3 ]1 | 8] 2]1 | 010 [0] J [Nama ofthe Spouse at [aaaross Kal Sala ai G [Vilage FINANCIAL INCLUSION - APPLICAT ‘SB NO FRILLAGCOUNT [Name in Full Talc ralRi Ts IAIN LTT TTT as TTT) [Famersname Is wlalPlainl JOAINIA| | | | tt |} ttt yt yt) [Moners Name ot taiailal J] | fei Rial li AlRIDI- fatto |= TOT feel Ietal | | + - = [PIvikl [tae I [sex_[ P| Age. [2 5} ose oer |p [ tl Ui (Profession ae doe [GIRPAN No. VRP JOD 39, Det el J Mw. Y | oBc]_ Bc Name ot the Nominee ‘Age | Date of Birth Person authorised to recaive the | {incase of Minor) amount nthe event of my minor - - lath during minority of ominee Seat Yn] f0-01s 19Go | MSTHE R Dedaration | nereby apply for opening of @ 801 Financial Inclusion Scheme No Fil Account /ATM Card or (Business Correspondent) Smart Card ‘Account, Ihave read the terms and conditions applicable to his account and BOI SB No FillAccount and also | agree to the terms and Conaitions as may be in force form time to trne, Yo doctare thatthe balances in all our accounts put together wil nots not tly to ‘exceed Rs, 50,000/- (Rs. ity thousand ony at any pont o ime and the tun over inthe account wil novi not ikely to exceed Rs. 1 lac (fs. One lac ony) in year. We amare aware that and assure the bank that whenever my/our account exceeds the above mentioned Financial int we wi comply and abide bythe KY norms of ha Bank. ' accopt that BOs ented a ts cscreton to acceptor eect tis ‘application without assigning any reason whatsoever, | dec vided by me in this application form s true and correct. reprarere, FFISSUS (1D ace: Chhatri dae: 22 O82, ~Sogon 9 agin Yous ‘Signature / LHT! of applicant Dalai of introduction [Name ofthe nerson nioaueed TAL is [Nhl AAAL I J (weno. THIRlalal Tol lt lolole taylan tt [Branch [c hei rit TTT TTTETTTTrery ttt "anow the above person forthe past years - oe ws Kccicatlin, me lowing ident prootisto be obtained such as Election ID Card Govt. 1D Gard/Driving License 4. Thenany one Employer's 0 Gard/ 1D Card issue by SchoolCallce along with document for address proof such as Electricity Bil/ Ration Card 2, Introduction by tow neighbors whe have proper documents for dertication 3. Anyothereviencefrthe satisfaction of the Bank, Signature of Vorlying OfficiatFor Bank use only Roy BRANCH CODE OOS TS TITS ET emt) (Customer 10 _ (oT secant No (4739 [S111 812]1 Lol0T0Fy [41] FINANCIAL INCLUSION APPLICATION FOR BASIC SB NO FRILL ACCOUNT [Naneinrut [TAT [mat INT ERR [Fratner's Name [S.J yz ielub Aly J J | overs Name |e [A Lore Ww. ~Tele lL [amore sows Ty) [STAID I MeL TE TE [address IAL SIO TLS Tou ie | | vilage eto. 1 [Mandel Tetet___ [EIA sa | |] a [Dewar Ja] [state Iw el LTT TTT ‘Sex | Age \ DD MM YY YY Profession | Move Dee Belongsto | OBC] BC] SC | ST| Gen ([Anoual income TRSJQ050 | Const name Te Ig000 | SBA No. | Narwotthe | Relaionsip [Age | Dato of Btn | _ Porson authorised to rocove he ‘Nominee (easect in) | amet inthe oven of my minor doeth during miner of naminee er Seo vse fe Declaration | hereby apply for opening of @ B01 Financial Inclusion Scheme No Frill Account ATM Cart or (Business Correspondent) Smart Card ‘Account. [have read the terms and conditions applicable to this account and BOI SB No Fl Account and also | agree to the terms and ‘coraltions as may be in fore form time to tina. wo dacare that tho balancos in all our accounts put together wil nots nt hikly to ‘exceed Rs, 60,000)- (Rs. Fy thousanel only at any point otime and the tun over inthe account wil nots not Ikely to exceed Rs. 1 ac (Rs. One lac only) in year. lWe anvare aware that and assure the bank that whenever mylour account exceeds the above mentioned financial fini we wil comply and abide bythe KYC norms ofthe Bank. accopt that BOs ented a ts clserotion to acceptor reject ts ‘application without assigning any reason whatsoever, | declare thal the information provided by me inthis application form is true and correct. Tlophona No. ZY 6 FLO PF S13 oe 1 Datalso itrocuction [[Name ofthe person introduced RIA aeno. fololul fal ati lo LMT [Benet [CTH Wl Bet I LI | know the above person for the past 2 years [uty SINDIeTAT ate Minrodicar ot vale 1. Then any nef flowing ently pools tobe obtained suchas Elacton 1D Cad Gov. 1D Ca Ding Lense Empoyers [0 Gard cardisoueby ScootColage long wih documento ares prot sich a Elect Bil Raton Card 2. Invotuctonby tom nghbor wove proper docimenstorierteston 3. Anyoterawnceteresatstacton othe Sank Signature of Veryag OftaZOS SPOR) aa \2D1BAIS4 For Bank use only OY BRANCH CODE Ay Toa [31913] } CustomerID Account No.[4[3[9 [3 ie 1 olaley) FINANCIAL INCLUSION APPLICATION FOR BASIC SB NO FRILL ACCOUNT {Name in Fut Paoli le Imial TKMTAD fol a Fateroname —[SJZ) Imo [Kim | | | EET | Cor J [Monersneme_ [AlBlElZIAL TaD] I [Name ofthe spouse [NAL | [| [1 | 1 i [dares Valh tol Tethwh airy ttt i J I TT tI {itt [Viteoe BE Hol Ts Talolmo ie LL _L_) [Mandal Toba t at ETT TTT ] (oar +4 CoC [state [ L [eal LETT!) Sen en fa 4 7 chile Patel [Stale Taran” fa we | So] ST] Gen ([GanuatTnoome [Rs 10,0779 [SIRUPAN Ne Betalsof Nomination = - — ‘SB Alc No, Name ot the ij Relationship | Age | _ Date of Birth Person authorised to receive the Nominee (race) | amount in te oven of my minor ee po) | deat uring monty of folase Sobers OLED | mother -| tal shace ‘Declaration = — {thereby apply for opering of a BOI Financial Incksion Scheme No Frill Account /ATM Card or (Business Correspondent) Smart Card ‘Account. Ihave read the terms and conditions applicable to his account and BOI SB No ll Account and also | agree tothe terms and ‘oncions as may be in fore form time to tie, Me dectare that the balances in all our accounts pul together wil nots not lily to ‘excood Rs, 50,000)- (Re. Fy thousand only at any pont o ime and the tum overin the account will novi not likely to exceed RS. 1 lac (Rs. One lac only) in year. We anvare aware that and assure the bank that whenever my/our account exceeds the above mentioned ‘nancial tnt we will comply and abide by the KYC norms ofthe Bank. accept that BOs enilled at its dlscreton to acceptor reject this ‘application without assigning any reason whatsoever, | deck ‘ide by me in his appllcation form is rue and correc. reapnone No, FES SUESO 3 a Mock K lal Date: 24 ~ C23 Signature / LHTI of applicant Data of notion [ Name ofthe person irvosuced [ia (sene. THz To Taf fof UN lo [Benen Te Taf hfe Fst TT ‘know the above person forthe past 2 yeere | T ye vVicINDIgIAL RIA fT TTT Tritt as (wn moka, fore vate sigh fhe reducer te coring Wnty pros tobe obec as leon 1) Crow. 1D Gar DvingLcenee! mployer's TD ard ID Cardissueby Schoo¥Collexe along with document or address proofsuch as Elect Bil/ Raton Card 2, Introduction by tw neighbors who have proper documents foridenifcaion 3. Anyather evidence forthe satisfaction ofthe Bank. Signature of Vertying Offical~ Av jae FAl SS For Bank use only BRANCH CODE [Name in Fu 0 [Fathers Name TP [Mother's Name [2 ee ~ Tele ES oo Ein] asian Tul AL [se_TF [Ase] | Fase [Tae SIS Loam | at [Ranatincome [7 gpm [SRM TAT PSS QIOm 1] Datos of Nomination SBAcNo, | Nao ihe | Rantings] Sage) Feson arin jose neessshiiney | amount the ov omy mins death during minonly of nominee g per orloz ny ia re Dedoration |Mhoreby apply for opening of a 01 Financia! Inclusion Schome No Fil Account / ATM Card or (Business Correspondent) Smart Card ‘Account, [have read the terms and conditions applicable to this account and BOI SB No Frit Account and aiso| agree tothe terms and Conditions as may be in force form time to time. Ve dectare thatthe balances in all our accounts put together wil noUs not tkely to ‘excaed Rs. 50,000/- (Rs. ity thousand only at any pinto time and the ttn over in the account wl nos not ikely to exceed RS. 1 lac (Rs. One lac only) n year. We amare aware that and assure the bank that whenaver mylour account exceeds the above mentioned financial mt we wilcomaly and abide by the KYC norms ofthe Bank. accept that BOs entiled atts discretion 1o acceptor reject this ‘application without assigning any reason whatsoever. | deck Qo 16634713" ‘olophona No. Paco: Chat pa: 22 “08-202. S Detaleofrivadveton [Name ofthe person Jo UB Irsl lel Miao (Bonen IC TELE Pl TooToo eres ee von ey , oes fase q Ce ee anne meet eee reeee) Employer's 10 Gard/ID Cardissue by Schoo¥College along with document tor address proof such as Electricy Bil/ Ration Card, 2, Inroduction by tow neighbors who have proper documents or identiicaion, 3. Anyolher evidence forthe saistaction ofthe Bank Signature of Vorying OfficalBV wrseleB ‘ For Bank use only a Coo BRANCH CODE (olorsTs Tors] Bank of India ‘Customer iO COEELLELL] Account No.4] 3[9 [3 [1] 8] 21 [ofofol] [uj zt] FINANCIAL INCLUSION CATION FOR BASIC SB NO FRILLACCOUNT Lal Teast TTT LTT [TTT] Chi a (Ramen Fa [Famers Name [Mothers Name [Namo ofthe Sp [pairess [Vilage [Mandal Tens [Diset [sta Sex [| foe. Date offiih [= [Profession (Roms [5.5 ms ‘Dotails of Nomination ‘SB Alc No. Dale afin] Porson arse wreck ho | (neateudtron | ancurtin te ever yma Soot aug inert feomvee _| | Declaration : | hereby apply for opening of «80! Financial Inclusion Scheme No Fil Account ATM Card or (Business Correspondent) Smart Card ‘Account. Ihave read the terms and conditions applicable to his account and BOI SB No Fill Account and also | aaree tothe torms and conditions as may be in force form tine to tiene, a dectare thatthe balances in all our accounts put together wil nots not tkely to ‘excaed Rs 50,000/- (Rs. ity thousand only at any point of time and te tun over inthe account wl nos not ikely to exceed RS. 1 lac (Rs. One tac only) n year We amfare aware that and aes the hank that whanever mylour account excoeds the above mentioned financial ink we wi comply and abide bythe KC norms ¢ ‘ont a ts escretion to accept or eect this ‘application without assigning any reason whatsoever. de ded by me inthis application form is true and correct. Telophone Ho. [TRA S SOV Bs 0) Proce: Chhatri — Dae: 04-04 2O2S, ~ Signature /LHTI of applicant -\°% Qso" Data oinrodution [Name ofthe person inoducod (weno. TOOT 2412 F [nha Tol T LLTTTT TI ‘know the above person forthe past 2. years a Wo oy ol ‘Signature of the intr AL TL introducer is not avaiable : reducer 1. Thenany ane! the following iently proofs tobe obtained such as Election ID Gard Govt. 1D Gard /Driving License/ Employer's 11 Card’ ID Gardiseue by School Colle;e along wth document or address proof suchas Electricity il/ Ration Card 2, Infroduction by tow neighbors wha have proper documents for identification 3. Anyolherevidence forthe satisfaction ofthe Bank. Signature of Vortying Offilal