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    SB - Financial Inclusion Ekyc Account Opening Form (BC Point-System Generated) Ref - No. Date of Account Opening

    Uploaded by

    Kaushal Kumar
    - The document is an eKYC account opening form generated by the BC POINT system for opening a savings bank account under the financial inclusion scheme. - It provides details of the applicant such as name, address, contact details, identity details like Aadhaar and PAN, demographic information and asset/income details. - The applicant declares that he does not have any other bank account under the basic savings bank deposit scheme and agrees to the terms and conditions for opening and operating the account.

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    SB - Financial Inclusion Ekyc Account Opening Form (BC Point-System Generated) Ref - No. Date of Account Opening

    Uploaded by

    Kaushal Kumar
    620 views2 pages
    - The document is an eKYC account opening form generated by the BC POINT system for opening a savings bank account under the financial inclusion scheme. - It provides details of the applicant such as name, address, contact details, identity details like Aadhaar and PAN, demographic information and asset/income details. - The applicant declares that he does not have any other bank account under the basic savings bank deposit scheme and agrees to the terms and conditions for opening and operating the account.

    Original Title

    bob.ngm-fi.com_customeradditionaldetails.do_method=ACCO

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    - The document is an eKYC account opening form generated by the BC POINT system for opening a savings bank account under the financial inclusion scheme. - It provides details of the applicant such as name, address, contact details, identity details like Aadhaar and PAN, demographic information and asset/income details. - The applicant declares that he does not have any other bank account under the basic savings bank deposit scheme and agrees to the terms and conditions for opening and operating the account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    620 views2 pages

    SB - Financial Inclusion Ekyc Account Opening Form (BC Point-System Generated) Ref - No. Date of Account Opening

    Uploaded by

    Kaushal Kumar
    - The document is an eKYC account opening form generated by the BC POINT system for opening a savings bank account under the financial inclusion scheme. - It provides details of the applicant such as name, address, contact details, identity details like Aadhaar and PAN, demographic information and asset/income details. - The applicant declares that he does not have any other bank account under the basic savings bank deposit scheme and agrees to the terms and conditions for opening and operating the account.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    eKYC ACCOUNT OPENING FORM (BC POINT-System Generated) Page 1 of 2

    SB - FINANCIAL INCLUSION
    eKYC ACCOUNT OPENING FORM (BC POINT-System Generated)
    Ref.No. 195301593152 Date of account opening : 08-09-2021

    Name of the Branch MAIDANGARHI SOLID 8850


    Village/Town/City DELHI Sub District/Block Name/District SOUTH DELHI
    District SOUTH DELHI State DELHI
    SSA Code/Ward No.
    Village Code/Town Code (as per Name of Village/Town (as per census
    800441 DMCU
    census 2011) 2011)

    Applicant Details:

    A/C Number 88508100002596 CUST ID XXXXX6368


    A/C Type SB-FINANCIAL INCLUSION Scheme Code SB150
    Full Name MR Kaushal Kumar
    Marital Status UNMARRIED Gender Male
    Name of Father MR Dilip Kumar
    Name of Mother SHAKUNTLLA DEVI
    Name of Spouse
    Permanent Address
    House No 8-A, Hanuman Mandir Road Molarband E Badarpur South Delhi Delhi 110044
    (As per Aadhaar)
    Declaration for Local Address when Address as per Aadhaar is different from current address: Declare that I submitted below Aadhaar as proof of Identity & Address for the purpose of account opening.
    However, I hereby declare that my current address is as under
    Current Address
    (Self-declared)
    Residing Since
    Pin Code 110044
    Telephone No XXXXXX4124 Date Of Birth 13-11-1997
    Mobile No XXXXXX4124
    Aadhaar XXXX XXXX 1085 Pan Number EHWPK9883E
    Nationality INDIAN Religion HINDU
    Category
    Disability
    Education
    Occupation/
    SERVICES
    Profession
    Monthly Income Rs.0 Net Worth Rs.0
    No. of Dependents
    Details Of Assets:
    Owning House Owning Farm
    No. of Animals owned Any other
    Existing Bank A/C of family
    members/ household
    Kisan Credit Card
     I request you to issue me a RuPay Card (PMJDY) in my name given above
    I request you to enroll me under Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY)
    I request you to enroll me under Pradhan Mantri Suraksha Bima Yojana (PMSBY)
    Declaration cum undertaking

    • I hereby apply for opening of a BSBD Bank Account. I declare that I do not have any other Bank account in Bank of Baroda and another BSBD account with any other bank. The terms and
    conditions applicable have been read over and explained to me and have understood the same. I shall abide by all the terms and conditions as may be in force from time to time.
    • I hereby declare that I have submitted the Aadhaar Card issued by UIDAI voluntarily for identification and address proof towards the compliance of KYC norms under the PMLA, 2002. I hereby
    consent that the Bank may verify the same with UIDAI and authorise the UIDAI expressly to release the identity and address through biometric authentication.
    • I hereby consent that my Aadhaar number shall be seeded in my Bank Account for receipt of DBT benefits.
    • I declare that my Aadhaar is not seeded with any other Bank for receiving DBT benefits (I understand that NPCI will reject mapping request, if my Aadhaar number is already mapped to any other
    Bank). OR my Aadhaar is currently seeded with ___________________________________ (name of bank) and request you to change DBT mapping at NPCI from my account with that bank to my
    account with Bank of Baroda. (I understand that my NPCI mapping for receiving DBT benefit will not be changed from previous bank in the event of my PMJDY overdraft continuing to be
    outstanding in that bank)
    • I understand that I am eligible for an Overdraft (under PMJDY scheme) after satisfactory operation of my account after 6 months of opening my account with a maximum limit of Rs. 10,000/-
    (Rupees ten thousand only) and fulfilling other terms and conditions of the scheme, for meeting my emergency/ family needs subject to the condition that only one member from the household will be
    eligible for overdraft facility. I declare that I have not availed any Overdraft or Credit facility from any other bank. I shall abide by the terms and conditions stipulated by the Bank in this regard.
    • I declare that at the time of account opening, I have requested for issue of RuPay card (PMJDY) and I have submitted my request for enrolment under the following micro insurance schemes

    https://bob.ngm-fi.com/customeradditionaldetails.do?method=ACCOUNTOPENFORM 08-Sep-21
    eKYC ACCOUNT OPENING FORM (BC POINT-System Generated) Page 2 of 2

    PMJJBY (Pradhan Mantri Jeevan Jyoti Bima Yojana


    PMSBY (Pradhan Mantri Suraksha Bima Yojana
    • FATCA Declaration: I declare that I am a citizen of India by birth and resident in India as well as resident for tax purposes in India and not of any other country other than India
    • I declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform the Bank of any charges therein, immediately. In case any of the above
    information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
    • I agree that my personal KYC details may be shared with Central KYC registry or any other competent authority. I hereby give consent to receive information from the Bank / Central KYC Registry /
    GOI / RBI or any other authority through SMS / e-mail on my registered mobile number / e-mail address. I also agree that the non-receipt of any such SMS / e-mail shall not make the Bank liable for
    any loss or damage whatsoever in nature.

    Form No 60 (If PAN is not provided)

    I do not have PAN and details of my income for the year is given below:

    a) Agricultural Income NA
    b) Other than agricultural income NA

    I do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I do not have a Permanent Account Number and my estimated total income (including
    income of spouse, minor child etc., as per section 64 of Income Tax Act, 1961) computed in accordance with the provisions of Income Tax Act, 1961 for the financial year will be less than the maximum
    amount not chargeable to tax.
    Place: ___________________________
    Date: 08-09-2021
    (Signature / LTI of applicant)
    Nomination From-DA1:
    I do not want to nominate anybody in this account
     I want to nominate the following person to whom in the event of my death the amount of this deposit particulars of which given above may be returned by Bank of Baroda
     I want the name of the nominee to be printed on the passbook

    Person authorized to receive the amount in case of minor death


    Name of Nominee Relationship Age Date of Birth,in case of minor
    during the minority of the nominee
    DILIP KUMAR FATHER 46 01-09-1975

    Obtain latest
    photograph not
    older than six month

    Place:DMCU

    Date:08-09-2021 (Signature / LTI of applicant)

    Witnessed by -
    Name of BC agent:MAHENDRA KUMAR PANDEY KOID:19530159

    Address of BC agent:SANGAM VIHAR, HAMDARD NAGAR SANGAM VIHAR, HAMDARD NAGAR DL DELHI 110068
    Signature of BC agent
    Enclosed: Self attested copy of Aadhaar.
    FOR OFFICE USE AT BC / CSP LEVEL
    Name of BC agent: MAHENDRA KUMAR PANDEY KOID 19530159
    Date of submission to link
    Date of enrolment:
    branch:

    Date
    Signature of BC agent:

    For office use at link Branch


    Particulars of a/c opened
    Received on:
    tallied with a/c opening form:
    Account No: 88508100002596 CUSTID: XXXXX6368
    A/c unfreeze in FREEREC Photo & Signature uploaded
    on: on:
    Date
    Signature of BM at Link Branch

    https://bob.ngm-fi.com/customeradditionaldetails.do?method=ACCOUNTOPENFORM 08-Sep-21

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