FORM DA -1 amabrégr tq - sear aeet For Making Nomination - Deposits yray/grench es ora ced ae Mert sae, 1949 Wh re 45 wes ate Hove aie TRF) rem 2(1) Bani RET ‘Nomination under section 452A of the Banking Regulation Act, 1949 and Rule 21) of the Banking Companies (Nomination) Rules, 1985 in respoct of bank deposits eta her We. “a at (Name(s) and address refs eae wh aPaete wea wea feat tem sree A ay AT aT, eee re Fen A feet et | ‘nominate the following person to Whom in the event of my / our / minor's deat the amount ofthe deposit, particulars whereof are given below may by returned ‘tertesio eet by Central Bank OF Tadia ‘ere eae er th ar rt a aft eg Branch (Name and addzess of branch Jace in which deposits held) ser eR [Nature of Deposits ges ie Distinguishing No. tice a afew ‘Additional detail any =i wae ot wa Nominee Name and adress weds ‘ate erate wore sath 5 Name ‘Adress weet |oq| salsrate Relationship | Age] If nominee With gepaster same ifany hiséate of ith ate fa a ort wi reel arrest, Hie, aap [At Ue nominee is a minor on this date VWe apoitt Shri’Sm/Kum aa, cae 31g ‘Name, address and age. Bit sremes yg a a9 aad a sree hes a she 8 ooh eS fe ger TE to receive the amount of the deposit on behalf of the nominee in the event of my.ourminor’s death during the minority of the nomine. rat Place ‘ite /Date and Caf) were rene at IE ee Name (3) signature(s) and address(es) of witness(es) of depositor (s) ar of are enh ae ate fe OH a a wee Ber atc rae wate Band we & fe is ae ‘Where depesit is made inthe nme of a nor, the nomination should be signed by a pesoa law fully ened to act on beba ofthe minor, ‘akc rubited sears x8 ER Z| Strike out if nominee is not a minor igh ae afi a ats | Thumb impression(s shall be atested by two witnesses, tradt /Acknowledgement wrarrta et gtieete stage inrespect of S BIC D/FD/RD Alc. No. For Tae erthente wid om Cane. Received nomination from No, DAI From Shit ‘rat wwe Branch Manager smite Oste: re Branch FAP-08-2020