New Form for opening of Account in POs
POST OFFICE SAVINGS BANK
ACCOUNT OPENING/PURCHASE OF NSC APPLICATION FORM FOR INDIVIDUALS
For Office Use
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Post Office Mumbai GPO Date SOL ID -40000100
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Account/Registration
NO.
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CIF ID (2)
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CIF ID (3)
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For Applicant(s)
*1 I/We request you to open /issue account/certificate in my/our name (please tick √ the empty box) :-
Savings Account
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TD A/C 2 Years
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Sr, Citizen Savings Scheme A/C
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Basic Savings Account
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TD A/C 3 Years
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PPF A/C
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RD Account
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TD A/C 5 Years
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NSC VIIIth Issue
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TD A/C 1 Year
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Monthly Income A/C
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NSC IXth Issue
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*2 Operation Instruction (please tick √ the empty box) :-
Single/Self
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Either or Survivor (Joint-B)
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Jointly (Joint-A)
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Through lierate agent
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*3 Full Name of applicant, in CAPITAL letter (Leave a space between words)
Mr./Mrs./Ms./Other First Name Middle Name Last Name Gender (M/F)
1.
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2.
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3.
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*4 Full name of father/husband/Mother, in CAPITAL letters (Leave a space between words)
Mr./Mrs./Ms./Other First Name Middle Name Last Name Gender (M/F)
1.
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2.
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3.
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*5 Residential Address
First Applicant
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2nd Applicant
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3rd Applicant
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Flat No./Bldg. Name
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Street/Road/Locality/Village
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Tehsil/Post Office
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City and District
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State
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Pin Code
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Tel./Mobile No. (optional)
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Email (optional)
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*6 Applicant Date of Birth (DD/MM/YY) PAN (If Not available, Attach form 60/61) CIF ID (If already exists)
1.
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2.
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3.
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7 Please chose from the following (Tick √ any one)
Minor through Guardian
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Lunatic Through Guardian
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Blind/physically Handicapped/llliterate through agent
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Pensioner
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BPL
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Beneficiary of any welfare Scheme
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Sanchayaka
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orther
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8 in case of minor/ lunatic Account, Please fill the following :-
Name of Guardian
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Residential Address
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Relationship with minor
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9 in case of other than Minor/Lunatic, please fill the following :-
Name of Sachayika /Government Welfare Scheme
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PPO/BPL/Registration/Enrollment No.
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10 Details about AADHAR :-
UIDAI Aadhaar Number
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UIDAI Aadhaar Number of Guardian (in case of Minor/lunatic account)
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1
*11 Detail of Know Your Customer (KYC) Documents Submitted :-
Photo ID
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Address Proof
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Applicant
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Applicant
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1st
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2nd
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3rd
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1st
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2nd
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3rd
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Types of Document
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Document No.
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Valid Up to (if any)
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*12 Detail of First deposit:-
Mode of deposit (Tick √ any one)
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Amount RS. (figures) (Words)
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Cash
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Cheque /DD
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Cheque /DD No.
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Date of Issue
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Name of the Bank/ Post Office
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Transfer
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Transfer Account No.
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CIF ID
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Name of the Bank/ Post office
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SBMO
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Postal Orders
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*13 Amount of Monthly Installment (in case of RD Account)
Rs. (in figures) (in words)
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14 in case of Certificates :- Please issue certificates as detailed below :-
Denomination (RS.)
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No. of Certificates
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Detail of Certificates issued (to be entered by Post Office)
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100
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500
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1000
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5000
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10000
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15 In case services of SAS/PPF/MPKBY Agent are taken
I/We are using the services of SAS/PPF/MPKBY Agent (Name) ……………………………………………………………………………………………………
Authority No. …………………………………………………………Valid up to …………………………………………………..
Received Passbook/Certificates on behalf of depositor
Signature of Agent with date ………………………………………………………………………………………………………………………………………………………
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16 Standing Instructions
Please credit my Monthly/ Quarterly/Yearly interest into following account (in case of MIS/SCSS/TD accounts) :-
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Savings Account No. ……………………………………………………….Standing at ……………………………………………………..PO / Bank.
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Please debit my following account for credit my RD installment Monthly/Half yearly/ yearly :-
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Savings Account No ……………………………………………………….. Standing at …………………………………………………… PO/ Bank.
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17 Nomination
I/We nominate the person (S) named below under Section 4 of the Government Savings Bank Act, 1873 (5 of 1873 to be the
Sole recipient(s) of the amount standing at the credit of the account in the even of my/our death.
Name & Address of nominee(S)
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Date of Birth
(in case of minor)
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Share of Nomination
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Name & Address of Person who may receive the said amount during the minority of the nominee(s)
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Signature of witness in case depositor wish to make nomination
………………………………………………………………………………………………..
Name & Address of witness …………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………….
*Mandatory Fields to be filled by customer.
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18 Other information
Monthly Income (Rs.) (Tick √ any one)
Up to 5000/-
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5001-10000
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10001-20000
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20001-50000
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50001-1 lac
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Above one lac
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Occupation (Tick √ any one)
Salaried
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Self employed
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Business
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Retired
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Student
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Pensioner
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Agriculture
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Others
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Account Open mode (Tick √ any one)
Normal
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Without Cheque Book
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With Cheque Book
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Welcome Kit
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Documents attached (Tick √ relevant columns)
Age proof
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Photo ID
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Address Proof
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Source of funds
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Form 60
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Form 61
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Form 15G
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Form 15H
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Facilities required (Tick √ relevant columns)
Internet Banking
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Viewing rights
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Applicant (1)
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Applicant (2)
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Applicant (3)
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Transaction rights
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Applicant (1)
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Applicant (2)
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Applicant (3)
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Tick √ relevant Box
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ATM cum Debit Card
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Mobile Banking
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SMS Alerts
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For Mobile Banking/ SMS Alerts. For Statement
Mobile No.
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Email ID
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Signature or Thumb impression
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Recent Photograph
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Applicant (1)
Or
Guardian
(in case of Minor or Lunatic
Account)
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Applicant (2)
Or
Operation agent
(in case of Blind/ Physically Handicapped/illiterate depositors operation through agent
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Applicant (3)
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3
Declarations (Tick √ the relevant bullet )
· I/We hereby declare that I/We have clearly understood POSB General Rules 1981 and Post Office Savings Account Rule
1981/Post office Recurring Deposit Rules 1981/Post Office Time Deposit Rules 1981/Monthly Income Account Rules 1987/Senior Citizens Savings Scheme Rules, 2004 (amended for time to time) governing the accounts under this scheme and to Abide by such rules framed by the Central Government as may be applicable to the account from time to time. I/We will not open more than one savings account in one post office. I/We will furnish on demand from the Post Office Savings Bank, particulars of all such accounts irrespective of the location of post office where these accounts are/were opened.
· I/We also declare that I/We have not exceeded the prescribed maximum limit of investment for an individual while investing in Various MIA/SCSS accounts in different post offices.
Note :- For the purpose of maximum limit in MIA, the depositor’s share in the balance of a joint account shall be taken as one half or one third of such balance according as the account is held by two or three adults.
· I/We shall adhere to the ceiling on deposits, taking the deposits in all the accounts opened by me/us together, as specified in rule 4 and amended from time to time. In case, at any time, any excess deposit is found, such excess deposit will be refunded to me/us after recovery of excess interest paid if any under the rules.
· For any transaction occurred through my cheque-book/passbook/ATM cum Debit card/Internet/Mobile Banking, I/we shall be fully responsible.
· I/we am/are legal guardian of the minor/lunatic and copy of the orders of the competent court is attached.
For PPF:-
· I hereby declare that I/we have clearly understood the PPF Scheme Rules, 1968 governing the accounts under the said scheme, as amended from time to time (hereinafter referred to as the said rules and shall abide by such rules framed by the Central Government as may be applicable to the account from time to time.*
· I hereby declared that I am not maintaining any other Public Provident Fund Account.
· H hereby declared that I am not maintaining any other Public Provident Fund Account except an account on behalf of a minor.
· I also declare that I shall adhere to the ceiling on deposits as provided for by Central Government from time to time, which is Rs. 1,50,000/- in a financial year at present, in my individual self account and accounts opened on behalf of minor(s) of whom I am a guardian. In case, at any time, the above said declaration is found untrue/false, no interest shall be payable to me/ the subscriber on the amount of deposits found in excess of the prescribed limit.
For NSC
· I/We hereby agree to abide by National Savings Certificates (VIII Issue) Rules, 1989 or (IX Issue ) Rule 2011. (amended from time to time.
Authorization
· I/We authorize Agent (name) ………………………………………………………………………………………………………………………. to receive Passbook/Certificate on my/our behalf.
Signature/Thumb Impression:- 1st Applicant 2nd Applicant 3rd Applicant
For office Use Only
Certified that I have verified the documents submitted with this application form and confirm that KYC norms are fully complied with
Signature of BPM Signature of SPM Signature of Postmaster
………………………………Please Cut from here and past in Register (only for literate Customers )……………………………………………………….
Date of Opening of Account (to be filled by Applicant )
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Account/Registration No. (to be filled by Post Office)
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Sr. No.
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Specimen Signature (to be filled by the applicant (s)
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1
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2
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3
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