Form - 1: Paste Photograph of Applicant/s

Download as pdf or txt
Download as pdf or txt
You are on page 1of 3

FORM -1

Application for opening an account


To
The Postmaster/Manager
…………………………………………………
………………………………………………… Paste photograph of
applicant/s

Sir,

I ………………………..(account holder/guardian) hereby apply for opening of an account


under Public Provident Fund Scheme. I tender herewith Rs……………......./(Rs In words
……………………………………………………….) in cash/Cheque/DD. No…………………
date……...…. as initial deposit. My particulars are as under:-

1. Name of account holder …………………………………………………………..............


Husband/Father/mother’s name ……………………………………………………………
Date of Birth……… ..…………..................…(DD / MM / YYYY )
(In words)…………………………........................

OR

2. Name of minor account holder ……………………………………………………………


Father /mother’s name or the guardian …………………………………………………
Date of Birth……… ..……… ………………(DD / MM / YYYY )
(In words)……………………………………………

3. Aadhar Number of account holder/guardian …..………………………………………....


4. Permanent Account Number (PAN) of account holder /guardian ......…………………..
5. Present Address
…………………………………….…………………………………………………………..

Permanent Address

………………………………………………………….………………………………………

6. Contact details

Telephone Number……………………………..

Mobile Number…………………………………..

Email ID…………………………………………..
7. Type of Account

Single or through Guardian for Minor or person of unsound mind or blind or


differently abled through authorized person.

8. (*)Details of date of birth proof …………………………………………………


(Applicable in case of minor account)

a) Certificate No. ………………………………………………………………..

b) Date of Issue………………………………………………………………….

c) Issuing authority……………………………………………………………...

9. (*) Name of Guardian (Natural/Legal) ………………………………………………(In


case the account is opened on behalf of a Minor/person of unsound mind)

10. Details of other KYC documents attached 1. Proof of identification


………………………………………………
2. Address proof
………………………………………………
11. (The following documents are accepted as officially 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 NREGA signed by the State Government officer 5. Letter
issued by the National Population Register containing details of name and
address);

1. The operation of the account will be:- (a) By the Guardian till the account holder
attains majority. (b) By the account holder on attaining majority,

12. Specimen Signatures


1………………………… 2……………………………. 3.,……………………………

(Name)…………………………………………………………..................................................

I hereby declare that I have not opened a Public Provident Fund Account in the name of the
myself/minor mentioned at serial number 1 in any of the Post office/Bank in the country.

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 paragraph 4 and any deposit in
excess of the ceiling will be treated as in contravention to the Scheme.

I further declare that I and the minor both are Resident citizen of India and undertake to
inform the account office of any change in our residency/citizenship status in future.

I 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.

Signature or thumb impression of account holder /guardian

Date:……………………
Nomination
13. I…………………………………………..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 at the time of my death would be payable.

S.No. Name(s) of Full address Aadhaar Date of Share of Nature of


the (s) number of birth of entitlement entitlement
nominee(s) nominee nominee in Trustee or
and (optional) case of owner
relationship minor

1
2

As the nominee(s) at Serial No.(s)…………………………………….specified above is/are


minor(s), I 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 death during the minority of the nominee(s).

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

Name & Address……………………………………………..

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

Name & Address……………………………………………..

Signature or thumb impression of account holder or guardian

Place:
Date:

For use of Post Office/Bank


The account has been opened in the name of…………………………………
on…………………….. with initial deposit of Rs………………………………………. with
Account No.__________________________ dated______________________________.

Customer identification Number……………………………….. Nomination has been registered


vide No……………………………………..dated………………………………………..

Signature and seal of competent authority.

You might also like