SB- AOF POST OFFICE SAVINGS BANK APPLICATION FOR

SB- AOF POST OFFICE SAVINGS BANK

APPLICATION FOR OPENING OF ACCOUNT/PURCHASE OF CERTIFICATE

FOR USE OF POST OFFICE

Post Office

Tran-ID

SOL ID

Date of Maturity

Account Number

CIF-ID (1)

CIF-ID (2)

CIF-ID (3)

Instructions:i.Please tick (√) the appropriate box,ii) Use CAPITAL LETTERS only while filling in the application form iii) Submit the self-attested copies of the Documents.

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The Postmaster

…………………………………………………

Madam/Sir,

I/We …………………………………………………………………………………..….(Applicant/guardian) hereby apply for opening of an account under

……………………(Savings/RD/ 1,2,3,5 Years TD/MIS/SCSS/PPF/SSA/KVP/NSC VIII

Issue)scheme in your Post office in my/our name(s)/in

the name of minor or person of unsound mind.

(ii) Account Holder Type: - Self Minor through Guardian Person of unsound mind through guardian.

(iii) Account Type: - Single Either or Survivor (Joint B) All or Survivor(s) (Joint A)

1. In case of account opened in the name Minor/ Person of unsound mind.

Name of Minor/ Person of unsound mind

Date of Birth(DD/MM /YYYY) in words

Gender

(M/F/O)

Name of Guardian, Relationship and

status – Natural or Legal

Details of proof of age of minor along with

its date of Issue and Issuing Authority

(In case of SSA A/c Birth Certificate is mandatory)

2. I/We tender herewith Rs………………../-(Rs………………………………………………………………………………………………………………(In words) in

cash/DD/Cheque No………………… date……………. as initial deposit. My/Our particulars are as under:-

Particulars

Applicant

Name of the Applicant/ Guardian

Name of Husband/ Father/ Mother

Gender (M/F/O)

Date of Birth (DD/MM/YYYY)

and In words (mandatory)

Aadhaar Number

PAN Number*

CIF ID (existing A/Cs holders)

Present Address:-

House/Locality/Village & Post

Office/City/District/ State/Pin Code

Permanent Address:

House/Locality/Village &Post Office/ City/

District/ State/Pin Code

Telephone No./Mobile No.*

E-mail ID

ID Proof

(Document No./Date of Issue/ Issuing

Authority)

Address Proof

(Document No./Date of Issue/ Issuing

Authority)

For SCSS Account details of proof of age

(Doc. No.,issue Date and Issuing Authority)

(If Aadhaar Card/proof of enrolment of Aadhaar is not provided, any of the following documents can be accepted as valid documents for the purpose of identification

and address proof) :- 1. Passport 2.Driving license 3. Voter’s ID card 4. Job card issued by Mnregs signed by the State Government officer 5. Letter issued by the

National Population Register containing details of name and address.

Note:- As per PMLA Act-2002, if balance/investment in all accounts are 10 Lakh & above, customer has to submit copy of document showing source of receipt of

funds tendered for investment.

Specimen Signatures

1……………………………..1………………………………..1………………………………..

2……………………………..2………………………………..2………………………………..

3……………………………..3………………………………..3………………………………..

Name:-………………………………Name:-………………………………….Name:-……………………………………………

Paste photograph

of applicant/s

Paste photograph

of applicant/s

Paste photograph

of applicant/s

(i) Additional Facilities available (For Post Office Savings Account) (a) Cheque Book required:- , (b) IPPB A/C

(d) Insurance/Pension products: - PMSBY PMJJBY APY (Prescribed form to be enclosed)

3. Declarations

General:-(1) I/We hereby undertake to abide by the scheme provisions and Government Savings Promotion Rules, 2018 applicable

on the Scheme and amendments issued thereto from time to time.

(Details available at https://www.indiapost.gov.in/VAS/Pages/RTI/RTI-Manual-5.aspx)

(2) I/We further declare that I/We/Minor/person of unsound mind is/are Resident citizen of India and undertake to inform the

account office of any change in My/our residency/citizenship status in future.

(3) I hereby agree that account will be operated by me till account holder attained age of 18 years and thereafter, account holder will

operate the account. (In case of SSA and Minor Account opened through Guardian).

(4) In case services of SAS/MPKBY Agent are taken: -

Name of Agent …………………………………… Authority No…………………….Date of validity……………………………

(5) Standing Instruction (i.e. MIS to SB, SB to RD etc.) if any……………………………………………………………………………………………………

TD :- Extension/Renewal of account required after maturity :-

SSA :- I hereby declare that no other account has been opened under Sukanya Samriddhi Account in the name of the depositor in

any of the Post office/Bank in the country.

PPF :-(1) I hereby declare that no other account has been opened under Public Provident Fund Account in the name of the

myself/minor in any of the Post office/Bank in the country.

(2) I further declare that I will abide by the ceiling of maximum deposit in the accounts opened in my name and in the name of

minors as per provision of the scheme and any deposit in excess of the ceiling will be treated as in contravention to the Scheme

provisions.

MIS/SCSS :- I/We hereby declare details of my/Our existing accounts* as on today under “National Savings Monthly Income

Account/ Senior Citizen Savings Scheme” in any of the Post Office/Bank in the country.

Sl.No.

Name of Scheme

(MIS or SCSS)

Date of opening

of account

Amount

deposited

Customer Identification

Number (CIF No.)

Account

Number

Name of Post

Office/Bank

*If number of accounts is more, details of all accounts should be filled and attached as annexure duly signed.

Please tick (√) the appropriate box

Date:- Signature or thumb impression of Applicant(s)/Guardian

4. Nomination

I/We…………………………………………..hereby nominate the person(s) mentioned below to whom to the exclusion of all other persons in

the event of my death the amount standing to my credit in ……………………………………..(Name of Scheme) at the time of my death

would be payable.

S.No.

Name(s) of the

nominee(s) and

relationship

Full

address

(s)

Aadhaar number

of nominee

(optional)

Date of birth of nominee

in case of minor nominee

Share of

entitlement

Nature of

entitlement

Trustee or owner

As the nominee(s) at Serial No.(s)…………………………………….specified above is/are minor(s), I/We appoint

Shri/Smt/Kumari……………………………………………………………………S/o,D/o,W/o………………………………………………………………………………..

Address……………………………………………………………………………………………………………………………………………………………………………………to

receive the sum due under the said account in the event of my/Our death during the minority of the nominee(s).

(In case, applicant(s) is/are illiterate)

1. Signature of witness…………………………………………………………………………………………………………………………………………………………………

Name & Address…………………………………………………………………………………………………………………………………………………………………………..

2. Signature of witness…………………………………………………………………………………………………………………………………………………………………

Place:

Date: Signature or thumb impression of Applicant(s)/Guardian

FOR USE OF POST OFFICE

I have carefully examined this application and Identification as well as address proof documents submitted. Opening of account is

approved.

Account has been opened in the name of………………………………………………………..with Rs……………………on…………………….. (Date) under

……………..scheme vide A/c No. …………………………………………… dated ……………………………..

Nomination registration details:-

Date Stamp Signature of GDS Branch Post Master

Name Stamp of EDBO

Date Stamp Signature of Sub/Asst./Head Post Master

Designation stamp