FD Form
FD Form
FD Form
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____________________________________ 2.________________________________
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_________________PIN _________________PIN
_________________PIN
DECLARATION
I/We hereby confirm that the Rules of Business have been read by me/us and/or explained to me/us.
I/We have understood and agreed to be bound by the Bank's Rules and Regulations governing such
Account from time to time. I/We confirm that I am /we are Indian National/s and resident/s of India.
I/We hereby declare that the above information is true and correct.
Yours faithfully,
1. (SPECIMEM SIGNATURE)
2. 1. _______________ 3. __________________
3. 2. _______________ 4. __________________
4.
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PERMITTED TO OPEN ACCOUNT
________________
____________________
Signature of Introducer
PARTICULARS OF RENEWALS
Deposit Nominee
Name : ______________________________ Address : _______________________________
Nature : _____________________________ _______________________________________
Distinguishing No : ____________________ Age : __________________________________
Additional details, if any : ______________ If nominee is a minor, his date of birth:
____________________________________ _______________________________________
____________________________________ ** As the nominee is a minor as on this date, I/We
appoint Sri/Smt/Ku. __________________
________________________________________
________________________________________
(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:______________________
Date: ______________________
Signature/s/Thumb impression/s of depositor/s
WITNESSES
Name : ______________________________ Name : ______________________________
Signature : __________________________ Signature : ___________________________
Address : ____________________________ Address : ____________________________
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Nomination accepted and registered vide Regn. No
Dated
For CANARA BANK
Supervisor : Office/Manager :
NOTE :
Where deposit is made in the name of minor, the nomination should be signed by a person
*
lawfully entitled to act on behalf of the minor.
* Strike out if nominee is not a minor
* Thumb impression/s shall be attested by two witnesses.