Form DA-1 (Nomination Form)

Nomination under section 45ZA of the Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules, 1985 in respect of bank deposits

I/ We
Nomination Serial No.
nominate the following person to whom in the event of my/our/minor's death the amount of the deposit, particulars whereof are given below, may be returned by
State Bank of India,

(Name and address of branch/ office in which the deposit is held)

Details of Deposits

Type of deposit: Account number

Additional details, if any:

Details of the Nominee

Name:

Relationship with the depositor: Age: Date of birth of nominee:

Address:

City: PIN: State:

CIF No. of Nominee (to be filled byLCPC):

As the nominee is a minor on this date, I/We appoint Shri/Smt./ age: years

Address:

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.

Date:
Please Sign in black ink only.

Signature(s) / Thumb impressions(s) of depositor(s)

Place:

Signature(s) / Thumb impressions(s) of 1st witness ** Signature(s) / Thumb impressions(s) of 1st witness **

Name: Name:

Address: Address:

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

** Thumb impression(s) shall be attested by two persons.

Page No. 1 of 7
 Branch Teller: in CBS, go to - Customer Management -> Create Personal Customer (to
create new CIF) / Amend -> Customer Details (to issue Welcome Kit, put the printed a/c
Account Opening Form: Part-I
number here and transmit); Input TCRN in "Reference No." field and click "Get Details" To be separately filled by each applicant (new customers
only)

TCRN : AC24375860

(For office use only) CIF No. Date:

Branch to affix rubber stamp of
name and code no.
Account No.

Sole/First Applicant
1. Please fill up in BLOCK letters only and use black ink for signature. Please leave one box blank between two words. Tick (✓) the appropriate boxes.
2. Fields marked asterix (*) are not mandatory
3. Please affix a passport size photograph in the box provided. Also enclose another photograph for affixing in the pass book
4. For opening account of minors, where proof of identity/address is not available, the same will be provided by Father/Mother and Natural Guardian
5. In case of illiterate customers, Left Thumb Impression (LTI) to be affixed and verified.
Personal Details
Customer Type: Public Staff Senior Citizen: Yes Minor: Yes PF No.

Name: Mr Ms Mrs Other

SUSHMA GUDAPATI
Name of Father/ Husband/ Mr Ms Mrs
Guardian: Other

V V NARASIMHA RAO

Date of Birth: 25/06/1989 Gender: Male Female Nationality: INDIAN

Mother's Maiden Name: G KUMARI Marital Status: Married Unmarried Others

UID: UID of Father/Mother (in case applicant is a minor): Unique Identification Number
Correspondence Address (Current Residential/Office)
259/11,GRD FLR,5TH MAIN,VYALIKAVAL,

MALLESWARAM,

Landmark/ Street: BANGALORE

District: BANGALORE

City: BANGALORE PIN: 560003 State: KARNATAKA

Telephone no. Mobile no. 8867232660 Mobile no. will be used for sending SMS alerts
Permanent Address
Same as Correspondence Address
9/124,NANDIVADA,JANARDHANAPURAM

JANARDHANAPURAM

Landmark/ Street: JANARDHANAPURAM

District: KRISHNA

City: GUDIVADA PIN: 521321 State: ANDHRA PRADESH

Telephone no. Fax no.

Email Address: sushma.vana@gmail.com E-mail address is required for alerts and e-statements
Additional Details (wherever applicable)
Income: Upto INR 20,000 Monthly Annually Assets (approximate value):

*Religion: Hindu Muslim Christian Sikh Others

*Category: General OBC SC ST
Educational
Qualification: Non-Graduate Graduate Post-Graduate Others
Occupation Salaried Self-employed Business
Type: Retired Student Others Housewives

Organization's Name: *Designation/Profession:

Passport no. *Others Voters ID/ Driving Licence/ Govt. / Defence ID Card No.

I.T. PAN: OR Form 60/61 BJVPG1813Q If PAN is not available please fill-up form 60/61

Vehicle: Car Two-wheeler Other

Life Insurance Value: Upto 2 lakhs Upto 5 lakhs Above 5 lakhs
Life Insurance: SBI Life Other
Existing Loans: Car Loan House Loan Personal Loan Education Loan Business/Agriculture
House: Ancestral Owned Rented Employers
Mutual Funds: SBIMF Other No investments
Credit Card: SBI Card Others

Page No. 2 of 7
 TCRN : AC24375860
Identification Details
Aadhar Card where the address on the Aadhar Card is the same as the Correspondence Address mentioned on the first page of this form.
No.: 575778383376 Issued at: GUDIVADA Issue Date 19-Oct-2011
OR
Any one document from each of the undernoted two columns for a photo-identity and proof of address (Please tick the appropriate box and give details below):
Proof of identity Proof of address (of Correspondence Address)
A) Passport A) Credit Card Statement (not more than 3 months old)
B) Voter ID Card B) Salary Slip
C) PAN Card C) Income/ Wealth Tax Assessment Order
D) Government/ Defence ID Card D) Electricity Bill (not more than 6 months old)
E) ID Card of Reputed Employer E) Telephone Bill (not more than 3 months old)
Please attach
F) Driving License F) Bank Account Statement
one self-
G) Pension Payment Order* G) Letter from Reputed Employer
attested
H) Photo ID Card Issued by Post Office H) Letter from Public Authority* photocopy of
I) Photo ID Card Issued by University* I) Ration Card Identity proof
J) Photo ID Card Issued by Public Authority* J) Voter ID Card (only if it contains the current address) and Address
K) Aadhaar Letter / Card K) Pension Payment Order* proof each.
L) NREGA Card L) Lease Deed/Sale Deed* Originals
M) Proof of Residence Issued by University* thereof will
N) Address Proof of Relatives (for students)* have to be
O) Address Proof of Close Relatives* produced for
P) Address Proof of Gazetted/ Senior PSU Officers* verification
No.: No.:

Issued at: Issued at:

Issue date: Issue date:

* Refer to the Savings Bank rules
Introduction Details
I having CIF no. confirm that I am
Required for small
an holder of account number of State Bank of India for the past months and account only. Not
required if complete KYC
personally know the applicant(s) for more than months and confirm his/her/their identity and address as stated requirements are fulfilled
above.

Date

Signature of the Introducer Sign verified by (Sign, SS No. & stamp)

With State Bank of India agreeing to open my Small Deposit account under liberalized KYC norms specified by RBI, I undertake to submit the required
KYC documents as and when the balance or total annual transaction in my account exceed the stipulated limits in this regard. In the event of non
compliance the Bank is within its rights to stop operations in account after advance notification as per RBI instructions

Signature of the Applicant

Detail of other Accounts
Please give the details of your other accounts in our#/other Bank #mandatory

Bank Branch Type of Account/Facility(ies) Account Number

Date
Please Sign
in black ink
Place BANGALORE only.
Signature/ Thumb impressions of depositor

FOR OFFICE USE

Details of one or two identification marks, if any, such as a mole or scar (mandatory for illiterate applicant)

Verifying Officer/Open CIF Generated CIF

Signature:

Name: SS No.: (Authorised signatory)

Designation: Date: Date: SS No.:

Page No. 3 of 7
 Account Opening Form: Part-II

Branch to affix rubber

stamp of name and code no.
Date: (For office use only) Account No.

Type of Account

Savings Bank Account (with cheque book) Recurring Deposit

Please tick the type
Savings Bank Account (without cheque book) Term Deposit
of account to be
No-frills Account Savings Special Term Deposit opened. To know
more about various
Saving Plus Account Multi Option Deposit Scheme linked with schemes please
Premium Savings Account Savings Bank Current Account contact Bank
officials.
Current Account Others (please specify)

Details of Applicant(s)
CIF no. (to be filled
Sole/First Holder Name:
in by branch/LCPC):
SUSHMA GUDAPATI
CIF no. (to be filled
Second Holder Name:
in by branch/LCPC):

CIF no. (to be filled

Third Holder Name:
in by branch/LCPC):

Account Name
Account name as would appear on passbook/account statement
SUSHMA GUDAPATI

Services Required
1. ATM-CUM-DEBIT CARD: (for International card and its variants, separate application is to be submitted)
Applicant no. Card Type Name as would appear on the card

1st
Domestic Gold International
2nd Domestic Gold International

3rd Domestic Gold International

Please mention any other account desired to be linked

Account Type Account Number Name

Account Type Account Number Name

Viewing rights Limited Transaction rights : Full Transaction rights :
2. INTERNET BANKING:
1st 2nd 3rd applicant 1st 2nd 3rd applicant 1st 2nd 3rd applicant
3. MOBILE BANKING: Mobile Banking Service to be enabled on this no. 8867232660
4. SMS ALERTS: SMS Alerts at mobile number as mentioned in Part-I: Required Not required
5. CHEQUE BOOK: Type of Cheque Book: Ordinary Multicity* Both * Charges applicable for Multicity cheques
6. STATEMENT FREQUENCY: Monthly Quarterly Half-yearly
(for current account)
e-Statement to be sent to e-mail id as mentioned in Part-I: Required Not required

Mode of Operation

Self only Either or Survivor Former or Survivor Any one or Survivor Jointly Other

Specimen Signature(s)

Paste a passport size photograph inside this box Paste a passport size photograph inside this box Paste a passport size photograph inside this box

1st Applicant 2nd Applicant 3rd Applicant

Please
Sign in
black
ink
only.

Signature(s) / Thumb impressions(s) Sole/First Holder Signature, SS No and name of verifying officer

Signature(s) / Thumb impressions(s) Sole/First Holder Signature, SS No and name of verifying officer

Signature(s) / Thumb impressions(s) Sole/First Holder Signature, SS No and name of verifying officer

Page No. 4 of 7
1. TERM DEPOSIT / SPECIAL TERM DEPOSIT

Amount: Rs. (in words) Period:

year(s) month(s) days. In case of Term Deposit, interest payable: Monthly Quarterly
Maturity instruction: Payment instruction (Maturity Proceeds/Residual)
Auto renew* principal Auto renew for period: By credit to my bank account no.
Auto renew* principal & interest
year(s) month(s) day(s)
Auto renew* Rs. By Banker’s Cheque / Demand Draft

Pay principal & interest Pay principal

* Renewal will be done at the then prevailing interest rate
2. MULTI-OPTION DEPOSIT SCHEME
I/We hereby give consent for debiting my/ our account for recovering service charges as normally applicable to Savings Bank and Current Account.

Linked Saving Bank/Current Account No.

3. RECURRING DEPOSIT

Monthly installment: Rs. Standing instruction (if any) Debit account no.

Period: year(s) month(s) On Maturity, credit proceeds to account no.

4. SAVINGS PLUS / PREMIUM SAVINGS ACCOUNT

Auto-sweep facility links Savings/Current Account with Term Deposit Account. Your Savings Plus/Premium Savings Account balance above a threshold value, for a
minimum amount of Rs.10,000 and in multiple of Rs.1000 in any one instance, is transferred to a Multi Option Deposit (MOD) and earns interest as applicable to the MOD.

Threshold Amount* :Rs.

Minimum balance required:
Sweep time: day (example Monday, Tuesday) of every week (only for Savings Plus Account) Savings Plus Account: Rs. 5000
Premium Savings Account: Rs. 25000
OR (example 1st,2nd) of every month beginning

Under reverse sweep facility for breaking the MOD, the MOD to be broken by: Last in first out First in first out
5. NO-FRILLS ACCOUNT
I declare that my present gross monthly income is not more than Rs.5,000. I shall inform you whenever it exceeds Rs.5,000. I understand that if the value of my business
connection, including other liability products like Recurring Deposit or Term Deposit,exceed Rs.10,000/-,this account will cease to be a ' No-frills' account. The account will
then be treated as a normal Savings Bank account, governed by the terms and conditions applicable to such accounts. I shall abide by the ' Know Your Customer' norms as
stipulated from time to time.
6. FOR JOINT ACCOUNTS WITH 'EITHER OR SURVIVOR' OR 'ANYONE OR SURVIVOR' MODE OF OPERATION
We have to advise that State Bank of India may pay to anyone of us, any day either before or on due date, on or after due date and where no due date is fixed, on demand, the
principal alongwith interest. Payment to any one of us is discharge to the Bank from all of us, until you receive a notice contrary to it from both/ all of us. In case of death of
any one, amount is to be paid to the survivor(s).
I/We have read and understood the rules and regulations of the product(s)/ service(s) opted for and agree to abide by the terms and conditions relating to the conduct thereof
as also any changes brought about therein from time to time.A copy of the Savings Bank rules and regulations has been made available to me by the mode of a tear off.
Further,I/we understand that I/we have the option to operate this account through my mobile handset using MPIN as per Terms and Conditions displayed on Bank' s website
www.sbi.co.in. Further,I/we have read and understood the provisions contained in the "Terms of Service document" of "OnlineSBI" on the Bank' s website www.sbi.co.in and
accept them.I/we agree that the transaction executed over "OnlineSBI" under my Username and Password will be binding. The Bank is entitled to amend the "Terms of
Service document" of "OnlineSBI" from time to time.

Please Sign in
black ink only.
Signature of 1st Applicant Signature of 2nd Applicant Signature of 3rd Applicant
Nomination
Nomination, if required fill Form DA-1 on page no. 2, otherwise sign below
I/We do not want to nominate any person in this account
Please Sign in
black ink only.

FOR OFFICE USE

Certified that the implications and conditions for the operation of the account have been explained to the depositor (only in case of illiterate applicant)

Open account: Account number generated:

Date: (Authorised signatory) Date: (Authorised signatory)

i) Internet Banking (INB) Kit No. : Initials

ii) INB Viewing Transaction rights vii) Account sourced by Business Correspondent/ Business Facilitator - Yes/ No
Initials
given on : If yes, Name/ Designation:
iii) Mobile Banking MPIN given on Initials Code no. of BC/BF Initials

iv) ATM Card data transmitted on Initials viii) Account transferred / Home branch
Initials
changed on:

v) Nomination serial no.: Initials ix) Account closed on: Initials

vi) Threshold (KYC) limit: Rs. Initials

Page No. 5 of 7
 SAVINGS BANK RULES
To be torn off and given to the customer

‘Know Your Customer’ Guidelines

Any person fulfilling account opening requirements may, upon agreeing to comply with the prescribed rules, open a Savings Bank Account,
provided she/he furnishes proof of identity and proof of address as required by the Bank. (Rule No. 1)
PROOF OF IDENTITY PROOF OF ADDRESS
1. Passport 1. Credit Card Statement (not more than 3 months old)
2. Voter ID Card 2. Salary Slip
3. PAN Card 3. Income/ Wealth Tax Assessment Order
4. Government/ Defence ID Card 4. Electricity Bill (not more than 6 months old)
5. ID Card of Reputed Employer 5. Telephone Bill (not more than 3 months old)
6. Driving License 6. Bank Account Statement
7. Pension Payment Order* 7. Letter from Reputed Employer
8. Photo ID Card Issued by Post Office 8. Letter from Public Authority*
9. Photo ID Card Issued by University* 9. Ration Card
10. Photo ID Card Issued by Public Authority* 10. Voter ID Card (only if it contains the current address)
11. Pension Payment Order*
12. Lease Deed/Sale Deed*
13. Proof of Residence Issued by University*
14. Address Proof of Relatives (for students)*
15. Address Proof of Close Relatives*
16. Address Proof of Gazetted/ Senior PSU Officers*
Nomination & Survivorship Facility
The nomination facility is available on Savings Bank Accounts and the account holders are advised to avail of this facility for smooth settlement
of claim by legal heirs in unforeseen circumstances. Nomination can be made in favour of only one nominee. In case they do not wish to make
a nomination, the fact should be recorded on the account opening form under their full signature. Joint account with survivorship benefit can be
operated by the survivor, in such circumstances. (Rule Nos. 10, 2)
Types Of Accounts, Balance Stipulation & Service Charges
The applicants can open an account either with chequebook facility or without chequebook. The current minimum quarterly average balances
prescribed for these account types and the charges prescribed for non-maintenance of minimum balance, are available at the Bank’s website
www.statebankofindia.com. The information can also be obtained from Branches. There is no ceiling on maximum balance in Savings Bank
account, except for Minor’s account. (Rule Nos. 11, 12).
Minor’s Accounts
Minors who can adhere to uniform signature and are not less than ten yearsold can open accounts in their single name and maintain therein a
maximum balance of Rs.200,000/- (Rs. Two lacs only). Minors may open joint accounts with their guardians. (Rule No.3)
How To Open An Account?
In ordinary course, applicant(s) should attend the Bank personally for completion of formalities for opening the account. They will duly fill in and
sign the prescribed application form. Applicant(s) should submit two copies of his/ her/ their recently taken passport size photographs. Account
holder’s signatures must be legible and well formed. Signatures should not be in capital or block letters. Each account will be given a distinctive
account number. While dealing with the Bank, this number should be invariably quoted by the account holder(s). The account holders, in their
self-interest, are expected to adhere to uniform signature as per specimen recorded with the Bank while operating the accounts and addressing
any correspondence to the Bank. (Rule Nos. 7, 8, 9, 13)
Pass Book
The pass book and cheque book supplied to the account holder should be kept in a safe place. The Bank will not be responsible for any loss or
incorrect payment attributable to the account holder’s neglect in this regard.(Rule Nos. 18, 29). For withdrawing cash by means of a withdrawal
form, the pass book must be presented. Withdrawals using cheque forms and Debit card can be effected without pass book. Deposits may be
made without production of the pass book. (Rule No. 15) Pass book should be got updated regularly. The pass book will be returned to the
accountholder immediately after completionof the transaction duly updated. In case it is not collected within a week’s time, it will be returned to
them by Registered A.D. post/ Courier at their cost. (Rule No. 16) The account holders should carefully examine the entries in their pass books
and draw the Bank’s attention to errors or omissions, if any. (Rule No. 17) Duplicate in lieu of the lost or mutilated pass book may be issued on
receipt of a written request from the account holder after necessary enquiries, completion of formalities and recovery of prescribed charges. The
current charges prescribed for this are available at the Bank’s website www.statebankofindia.com. This information can also be obtained from
Branches.(Rule No. 20)
Change in Rules
The Bank reserves the right to alter, delete or add to any of these Rules and service charges for which the customer will be duly notified through
Bank's website and/ or branch notice board.(Rule Nos. 39, 46)
Cheque Book
The Bank will issue the first cheque book after completion of all formalities with regard to opening of the account. No charge will be recovered for
issue of twenty five cheque leaves in a year (both MICR and non MICR). Thereafter, service charge will be charged to the customer’s account.
The current charges prescribed for this are available at the Bank’s website www.statebankofindia.com.This information can also be obtained
from Branches. The account holders must use only the cheques from the cheque books issued to them by the Bank. The Bank reserves the right
to refuse payment of any cheques drawn otherwise. Ordinarily, Bank will not issue more than one cheque book at a time or before exhausting
all or nearly all cheque leaves issued previously.(Rule No. 27)Cheques must be written legibly and any alterations or cuttings should be
authenticated under full signature which must conform to the specimen recorded with the Bank. (Rule No. 28) Stop payment instructions in
respect of cheques issued or lost can be registered with the Bank on payment of a prescribed service charge. The current charges prescribed for
this are available at the Bank’s websitewww.statebankofindia.com.This information can also be obtained from Branches. (Rule No. 32)

Page No. 6 of 7
OPERATIONS IN THE ACCOUNT

General
Savings Bank account is essentially a facility to build up savings and hence must not be used as a Current Account. Bank may close an account
should it have any reason to believe that the account holder has used her/his account for a purpose for which it is not allowed. (Rule No. 5)
Deposits
There is no restriction on number of deposits that can be made into the account. No deposit in cash for less than Rs 10/- will be accepted.
Cheques, drafts or other instruments drawn only in favour of the account holder will be accepted for credit of the account. Third party
instruments endorsed in favour of the account holder will NOT be accepted. No drawings against accepted instruments will be normally
permitted until these are realized. In satisfactorily conducted accounts, immediate credit will be afforded for outstation instruments deposited up
to Rs 20000/-, which may change from time to time. The normal collection and out of pocket charges will be recovered. The current limit and
charges prescribed for this are available at the Bank’s website www.statebankofindia.com. This information can also be obtained from Branches.
Overdue interest will be recovered for instruments subsequently returned unpaid. (Rule Nos. 21, 22, 23)
Withdrawals
The accountholder can withdraw money personally from her/ his ordinary Savings Bank Account by using Bank’s standard withdrawal form.
The pass book must accompany the withdrawal form. The withdrawal form can be used only for receiving payments by the accountholder
himself/ herself. ATM cum Debit card can also be used in ATMs for cash withdrawal. The accountholder cannot withdraw an amount less than
Rs. 50/-. All withdrawals must be in round Rupees only Third party payments through withdrawal forms are not permitted. A letter of authority
as per the prescribed format, along with the pass book should be sent to the Bank through an authorized representative to receive payment in
case the account holder is unable to attend personally to withdraw cash from her/his account. (Rule Nos. 24, 25, 26) The minimum drawing
permitted per cheque form is limited to Rs. 50/-. There is no ceiling on the maximum amount that can be drawn through a single cheque. (Rule
No. 30) The maximum number of debit entries permitted in an account is 30 per half year or as decided by the Bank from time to time,
excluding transactions through alternate channels like State Bank ATMs and Internet Banking. Cash withdrawal at ATMs of other banks will be
counted as a debit entry in the account for the above purpose and are not to be treated as transactions made through alternate channels.
Charges prescribed for exceeding this limit are available at the Bank’s website www.statebankofindia.com. This information can also be obtained
from Branches. (Rule No. 35) Cash withdrawal can be made from the accounts of the sick, old or incapacitated account holders who are unable
to attend the Bank and/or also not able to put their signature or thumb impression for withdrawing cash by completing the laid down
formalities. (Rule No. 33)
Overdrafts

Overdrafts in Savings Bank accounts may be permitted under exceptional circumstances with prior arrangements only. Cheques drawn in
excess of the balance in the account will be returned unpaid. Service charge will be recovered each time a cheque is returned unpaid for want of
sufficient funds. Charges prescribed for this are available at the Bank’s website www.statebankofindia.com. This information can also be
obtained from Branches. (Rule No. 31)

Inoperative Accounts Account holders are advised to operate their accounts regularly. Accounts not operated are classified as Inoperative after the
stipulated time period of 24 months since last operation. Inoperative accounts having less than the stipulated minimum balance will be charged
a service charge at the end of the first year after the account is identified as inoperative and thereafter every year, if the account remains
inoperative. If the balance in the account is equal to or less than the service charge, the account will be closed under advice to the account holder.
The current prescribed charges in this regard are available at the Bank’s website www.statebankofindia.com. This information can also be
obtained from Branches. (Rule Nos. 36, 37)

Standing Instructions
The account holder can request the Bank for effecting periodical payment of insurance premium, membership fees etc. by debit to her/ his
account on payment of service charges. The current prescribed charges for Standing Instruction are available at the Bank’s website
www.statebankofindia.com. This information can also be obtained from Branches. (Rule No. 40)
Payment of Interest
Interest at the prescribed rate will be calculated on a daily product basis and will be credited to the account half yearly on 30th June and 31st
December. Interest will be paid If it works out to be Rs. 1/- or more and will be rounded off to the nearest rupee. The Payment of interest on
Saving Bank Account is subjected to RBI directives and any change therein may be notified through advertisement in the newspapers,(Rule Nos,
41,42)
Transfer & Closure Of Account
Accounts may be transferred between branches of the Bank at the request of the account holder(s). Request for closure of account should state
the reason for closure. The pass book, unused cheque leaves and the ATM cum Debit card (after cutting into two pieces across the magnetic
strip) must accompany such request. Joint accounts can be closed only at the request of all such joint signatories. Service charge at prescribed
rate will be recovered if an account is closed prior to twelve months of its opening. The current charges prescribed for this are available at the
Bank’s website www.statebankofindia.com. This information can also be obtained from Branches. (Rule Nos. 43, 44, 45)
Detailed rules available on the banks website www.sbi.co.in or on request at all branches.

Page No. 7 of 7