Branch...............................

TO, Space Space

The Manager,
For For
TGMC Bank Ltd.,
Senior Citizen Yes No (Proof of Age to be furnished) Photo Photo

Customer ID
Membership No
Account No

Nature of Account
Savings Account Current Account

CONSTITUTION
Individual Joint Account Proprietorship Partnership Trust Private Limited Co.
Public Limited Co. Co – Operative society Others

INDIVIDUAL / JOINT ACCOUNTS / HUF ACCOUNT

1. Mr./Ms./M/s.........................................................
S/o, D/o, W/o ...................................................
Date Of Birth - -
Address (Office)..................................................
Address (Res)........................................................
..........................................................................
.............................................................................
City......................................Pin
City...........................................Pin
Designation.......................................................
Tel Mob
Tel Mob
PAN No. Form 60
K Y C Norms Complied Yes No

2. Mr./Ms./M/s.........................................................
S/o, D/o, W/o ...................................................
Date Of Birth - -
Address (Office)..................................................
Address (Res)........................................................
..........................................................................
.............................................................................
City......................................Pin
City...........................................Pin
Designation.......................................................
Tel Mob
Tel Mob
PAN No. Form 60
K Y C Norms Complied Yes No

3. Mr./Ms./M/s.........................................................
S/o, D/o, W/o ...................................................
Date Of Birth - -
Address (Office)..................................................
Address (Res)........................................................
..........................................................................
.............................................................................
City......................................Pin
City...........................................Pin
Designation.......................................................
Tel Mob
Tel Mob
PAN No. Form 60
K Y C Norms Complied Yes No

OPERATIONAL INSTRUCTIONS
SINGLE JOINTLY EITHER or SURVIVOR Others if Others Specify..........................................

Signatures:1..................................... 2............................................... 3.............................................

1. 2. 3.
a.______________________________ a.______________________________ a.______________________________
Signatures

b.______________________________ b.______________________________ b.______________________________

Specimen

c.______________________________ c.______________________________ c.______________________________

Administrative Office, B. H. Road, TUMKUR – 572103

 MINOR ACCOUNTS
Minor’s Date Of Birth* Name & Address of the Guardian...................................
Relationship: Mother Father Any Other Specify.................................................................................
* Copy of Birth Certificate should be enclosed

__________________________
Signature of the Guardian

Current Accounts:-

PROPRIETORSHIP FIRM PARTNERSHIP COMPANY TRUST ACCOUNTS SOCIETY

Name Of the Concern ......................................................................................Date of Regn.

Name of the Proprietor/Partner/Authorized Signatories....................................................................................

....................................................................................
Address (Regd)........................................................
............................................................................. Address
City...........................................Pin (Correspondence)..................................................
Tel Mob ..........................................................................
PAN No. Form 60 City......................................Pin
Designation.......................................................
OPERATIONAL INSTRUCTIONS: Tel Mob
Any One Jointly Specify ....................
Nationality.........................................................
KYC Norms Complied Yes No
Nature of Business ..................................................................................................................................
(Please attach Annexure/Letter of Authority, HUF Letter on Letter Head detailing the personal details of Partners/Directors such as
Designation, Husband’s /Father’s Name Date of Birth, Residential Address, Details of PAN Card, 2 Recent Passport size Photos of the
Partners/Directors/Trustees)

Space Space Space Space

for for for for

Photo Photo Photo Photo

Name............................ Name............................ Name............................ Name............................

Signature Signature Signature Signature

1. Latter of prop
2. Partnership letter
3. Draft of board resolution to be submit by ltd company

AUTHORIZATION & DECLARATION

The Bank based on this application from the authorized Signatories, mentioned under 'Operation', in its absolute discretion a nd subject to such
terms and conditions as the Bank may stipulate, can make payment of the process of the Deposit at the time of closure of the Account.

I/We request and authorize you to honour all cheques or other orders drawn by me / us of bills of exchange and notes as also amounts of any
dishonoured bills, notes and cheques to this account, whether the account be for the time being in credit or overdrawn as per rules of the Bank in
force with or without any advice to me / us.

I / We hereby authorize the Bank to disclose any information contained in this form without my/our prior consent to Government agencies , credit
information companies or any other authorities deemed necessary by the Bank.

I the undersigned am, the sole proprietor of the above named firm and request you to honour only my signature or a person authorized by me in
writing

We, the undersigned, carrying on business as partners of the above named firm, request you to honour our signatures as partners, until you
receive notice from us to the contrary. We shall be liable to you jointly and severally for all the dealings of our firm with the Bank. Whenever any
change occurs in our partnership, we shall inform you of the same in writing under the signatures of all the partners and our individual
responsibility to the Bank will continue until all our liabilities to the Bank are discharged.

I / We confirm that the rules and regulations of the Bank and Reserve Bank of India in force for this scheme have been read to me / we and I / we
agree to abide by the rules and regulations which may be modified from time to time.

I /We agree to abide by the Banks rules relating to Current / S.B. Accounts proposed minimum balance of Rs............................

Signature of Depositor (1) Signature of Depositor (2) Signature of Depositor (3)

Documents for FIRMS/COMPANIES:
1. Copy of Certificate of Incorporation. 2. Board Resolution authorizing for opening and conducting of the account.
3. Copy of Certificate of Commencement of Business. 4. Copy of the Partnership Deed/Registration Certificate (if amy)
5. Copy of Memorandum and Articles of Association. 6. PAN Card Copy of Individual/ Partnership/ Company.

Documents for INDIVIDUALS:

Any one document from each of the undernoted 2 lists for a photo ID and a proof of residence (As per KYC Norms).
1. Copy of Passport 1. PAN Card
2. Voter's ID Card 2. Credit Card Statement
3. ID cards issued by reputed employers + 3. Salary Slip
Employer's letter + Salary slip 4. Electricity Bill
4. Driving License 5. Telephone Bill
6. Passport, if address is same
Copies verified with the originals 7. Income/ Wealth Tax assessment order
8. Mobile Bill
9. Life/ Medical Insurance Policy
Branch Manager 10. Municipal Tax / Water Tax Bill

INTRODUCED BY
Name ......................................................... S/o, D/o, W/o ...................................................
Account No. SB CA Address ..............................................................
I / We know the applicant for the last ..........................................................................
..............Months/Years and recommend them to the Bank
City......................................Pin
Tel Mob
Date:
Place:
Signature of the Introducer
NOMINATION

Nomination for DA-1

(To be filled by the depositor for this facility)

I / We Nominate the following person to whom in the event of My/ Our/Minor’s death, the amount of deposit, particulars
thereof are given below may be returned by the Bank.
Nature of Relationship If Nominee is a minor
Name Address Age
Deposit with depositor his/her Date of Birth

As the nominee is a minor on this date, I/We appoint Shri./Smt./ Kumari (Name, Address & Age )...................................
............................................................................................................................................................................to receive
the amount of the deposit on behalf of the nominee in the event of My/ Our/Minor’s death during the minority of the nominee.

Place : Signature(s)/Thumb Impression(s)

Date : of Depositor(s)

Witness for Thumb Impression(s) 1.)........................................................... 2.).............................................................

Address...................................................................................................................... .......................................................

Strike out if Nominee is not minor

Where the deposit made in the name of Minor, the nomination should be signed by a person lawfully entitled to act on
behalf of the minor.

Note. The Branch should comply by the provisions of the section 45 ZA of the Banking regulation act of 1949 and
Rule 2(1) of the Banking Companies (Nomination Rules) 1985 in respect of Bank Deposits:

For Bank Use KYC Norms Complied Yes No

Account Opened By .......................................... Date of Opening........................................

Account Opening Authorized By........................ Nomination Dated ....................................
Nomination Registration No...............................

Branch Manager