ER Raweduacaton rn coer ‘AO FOR OPENING/RENEWAL OF TERM DEPOSIT The Branch Head, Branch Office... FULL NAME, in CAPITAL Letters (leaving a space between frst, middle & last name) 2. Customer ID No. CKYCR No. ii cxver oy i IT] i CKVCR No. 3, Repayment account/Credit Maturity/renewal/Interest/Other Proceeds to Account No.. 4. TYPE OF TERM DEPOSIT REQUIRED (Tick the appropriate box) FD RD Fixed Deposit | PNB | TaxSaverfD | Non-Callable Recurring Deposit: Flexi-Recurring Deposit (Please Specify | Palash | (No premature | Deposit Monthly Instalment | Monthly core amount FD Scheme} | Green| Withdrawal | (No premature Rs, Rs. deposit | allowed under | Withdrawalallowed | No. of instalments No. of Instalments the scheme) _| under the scheme) @ @ 5. Interest Payment Frequency | 6.Auto Closure/Renewal Tick the appropriate box | 6.1 Instructions for Amount at auto {tick the appropriate box) ‘Auto Closure | Auta Renewal at maturity far peried renewal on maturity of FD, please at maturity renew for (tick the appropriate box): Gn Ann [Waly [Guar [Mon] WN | Sameperiodon | Differentperiodon | Matur | Principal | Fixed | Others Mat | ually | Yearly | erly | thly maturity for maturity (please | ty | Only | Amt. | (please wunty times specify the period). | Amt specify) Perlod___ for 7.Mode of Operation (Tick the appropriate box) Self [Eth [Former [Any | Jointy | Seif | tn case of Mode of operation is “Either or Survivor” or “Former or Survivor” erar ot fone or Any | or “Any one of us or Survivor/s": - We hereby authorise/undertake that in ‘Surv | Survivor | Surviv ae case of death of any of us payment of our fixed deposit/recurring deposit vor or specify) proceeds can be paid to the Survivor/s without obtaining the concurrence of Legal hei/s of deceased depositor/s amongst us. Such authority will be applicable on or after maturity and pre-mature payment (both cases) 8.TDS DETAILS - Applicable: Yes/No. panno. [| | | TDS ifnot applicable, exemption Reference No. Te ¥es, Whether Form 15 G/B? submitted: Ves__ No Form 15G for General Category & 15H for Senior citizen /We request you to open/renew FD/RD for Amount Rs Debit Account No. for Period: Years__Months__Days. Viwe have understood and agree to be bound by the bank's rules in force from time-to-time. ‘Standing Instructions for RD/FRD- Kindly debit monthly instalment from Account No. onset of every month Customers’ Signature(s)/ 1. Place: Thumb Impression(s) 2 Date: 3 (weamwwccan TTT TTT TTT TTT See PNB H77RE ENGLSWLOT NOCYFERDSNOGOMEAL (Signature of authorized official with GBPA No.)eeu Rae dusuas ton a coer Branch Office... NOMINATION Nomi [YES Filthe form DAI below Name of naminge to be [ YES ration | NO-The benefits of Nomination Facility have been explained to me/us. printed on FOR or RD | NO Requiced _ However, /we do not want ta nominate any person inthis account. Passbook FORM DA-1: NOMINATION Nomination under Section 45 ZA of Banking Regulation Act, 1949 and Rule 2{2) of the Banking Companies (Nomination) Rules 1985 in respect of Bank Deposits, We @ Name(s): R/O. "Nominave the folowing person to whom inthe event of my/our/minors death, the amount of deposit Inthe account may be returned by Punjab National Bank, 8.0, DEPOSIT NOMINEE ifrominee | Account | Relationship minor, natureot | No. | Additional Name MobileNo. | Address | with depositer, | age | his/her Date Account Details, ifany (Optional ifany cof bith {As the nominee is minor on this date, /We appoint Mrs, Age, Address, ‘Mobile No. (Optional) _ to receive the amount of the deposit on behalf of the nominee in the event of my/our/minar's death during the minority of the nominee. Place: Date: 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 of the minor. (Strike out if nominee is not a minor) WITNESSES Name & Signature of the first witness _ Name & Signature of second witness Name___ Name. Signature: Signature Address Address: Place: Place: Date: Date: Telephone No. Telephone No. ‘Thumb irpression() shal be aitested by wo witnesses; otherwise, isnot required NOMINATION REGISTERED The above-mentioned nomination is registered at Serial No. In respect of (Type of Account) Deposit Account No. Date For Punjab National Bank (Authorised Official) (G8Pa}