FORM A
APPLICATION FOR OPENING
PUBLIC PROVIDENT FUND ACCOUNT
UNDER THE PPF SCHEME 1968
Date: From Type A/c No.:
PPF
For Office Use : A/c. to be opened at Branch Code Ledger No.
A/c. Label 1 SE Code A/c Manager
Please open my PPF Account. Please fill the form in BLOCK LETTERS only. Fields marked (star) are MANDATORY.
FULL NAME Please leave one space between words e.g.
PAN Number*** (Please)
or FORM 60/61 attached
# If Senior Citizen, please provide proof of Date of Birth ** If Minor, please fill-up minor declaration section below ***If PAN No. is not available, please attach form 60 or 61
OCCUPATION Salaried Self Employed Business Retired Student Housewife Others (Please Specify)
Existing Customer If Yes, Cust. ID
or A/c No.:
B) MINOR DECLARATION
Type of Guardian: Father Mother Court Appointed
Full Name of Guardian: Mr. Ms.
I hereby declare that the date of birth of the minor who is my is / / and I am his/her natural and lawful guardian/guardian appointed
by court order, dated / / (copy enclosed). I shall represent the said minor in all future transactions of any description in the above account until the said minor attains
majority. I indemnify the Bank against the claim of the above minor for any withdrawal/transactions made by me in his/her account.
Date: Signature of Guardian
C) (Please provide complete communication address for faster courier deliveries)
LANDMARK/POST OFFICE ( )
CITY ( )
STATE COUNTRY PIN CODE
Permanent Address Same as communication address Please note the address as below
Please provide
complete address
LANDMARK/POST OFFICE ( )
for faster courier
deliveries. CITY ( )
STATE COUNTRY PIN CODE
STD Code Tel. No. (Office) Ext. No. Tel. No. (Residence)
APPLICANT
Mobile Number Fax No. Preferred Communication Language
APPLICANT
*Other than English
E-mail Address (e.g.
[email protected])
APPLICANT
D) INITIAL SUBSCRIPTION DETAILS
Payment by
Cash Cheque No. Date: Drawn on Bank Branch
Debit my/our existing account. Account No. Initial amount Rs.
E) KNOW YOUR CUSTOMER (KYC) DETAILS
Provide KYC document (Attach photocopies of the following documents and produce the original copies of these documents for verification.)
Document for proof of Identity Document Identification No. Issuing Authority Place of issue
Document for proof of Address Document Identification No. Issuing Authority Place of issue
I agree to abide by the provisions of the Public Provident Fund Scheme, 1968 and amendments issued thereto from time to time.
DECLARATION
I I hereby declare that I am not maintaining any other Public Provident Fund Account
ii. I hereby declare that I am not maintaining any other Public Provident Fund Account, except an account on behalf of a minor.
iii. I hereby declare that the details of other Public Provident Fund accounts opened earlier by me are as under
Sr. No. Description Name and address of the Bank/Post office and account no.
iv. I also declare that I shall adhere to the ceiling on deposits as provided for by Central Government from time to time which is `1,00,000/- in a financial year at
present in each of the following types of Public Provident Fund Account, Individual Self Account and Account(s) on behalf of minor(s) of whom I am the guardian.
In case, at any time the said declaration is found untrue/false, no interest shall be payable to me/the subscriber on the amount of deposit found in excess of the
prescribed limit.
Signature or Thumb impression of Subscriber/guardian
Date: Additional specimen signatures
The Account may please be set up in Finacle/GBM.
FOR THE USE OF BRANCH
The account has been opened on with ` under Public Provident Fund Account No.
Customer ID:
Date: Accounts Officer
