BC CODE: -
(Business Correspondent – State Bank of India)
APPLICATION FORM FOR CSP (CUSTOMER SERVICE POINT) UNDER BUSSINESS CORRESPONDENT
1. Nearest SBI Branch
2. Name (In Block Letters) ________________________________________________________
3. Father’s /Husband’s Name ________________________________________________________
4. Date of Birth DD___________MM____________YY_______________________
5. Gender (Please Tick) Male Female
6. Marital Status (Please Tick) Married Unmarried
7. Education (Please Tick) Class XII
Graduate Postgraduate or above
8. Permanent Address ________________________________________________________
P.O.__________ Tehsil__________District_____________________
State_________________________Pin________________________
9. Present /Communication Address
________________________________________________________
P.O.__________ Tehsil__________District_____________________
State_________________________Pin________________________
10. Contact No. Residence__________________Mobile________________________
11. E-mail ID ________________________________________________________
12. Currently Banking with bank name ________________________________________________________
13. Bank Account Number, if any ________________________________________________________
14. Cheque Facility (Please Tick) Available Not Available
15. Proof of Name (Please Tick) Voter ID Driving License
Pan Card Passport Bank Passbook
Aadhar Card
16. (A) Proof of Address Electricity Bill (Latest) Telephone Bill (Latest)
House Tax Receipt (Latest) Water Bill (Latest)
Registry of Property (Latest)
(B) PAN No. __________________________________________________________
17. Present Business __________________________________________________________
17.a) If yes, nature of business ___________________________________________________________
18. Computer Literacy ___________________________________________________________
18.a) If yes, nature of qualification ___________________________________________________________
19. Total income ___________________________________________________________
Less than Rs. 5000/- Rs. 5000 – Rs. 10000/-
Rs. 10000 – Rs. 20000/- Rs. 20000 – Rs. 30000/-
More than Rs. 30000/-
20.Do you have any Experience ____________________________________________________________?
21.Languages known ____________________________________________________________
Say Yes /No
Read Write Speak
English
Hindi
Any other
22.No. of years of stay In the Town /village In Town in Town in Village
23.Do you have any police records? If any, give details _________________________________________________
24.Name, address, and occupation of two persons to whom reference can be made
(A) First Person ___________________________________________________________
___________________________________________________________
___________________________________________________________
(B) Second Person ___________________________________________________________
___________________________________________________________
___________________________________________________________
25.Defaulter (if any) to banks/financial institutions _______________________________________________________
26.Infrastructure Available Office Owned Rented Area
Location Computer Internet
27.Name of Department / Office from which retired
___________________________________________________________
28.Position at the time of retirement. (Please give brief of various assignments held and role)
_____________________________
29.Any disciplinary action taken against you while in service (if yes, please give details, please enclose a Certificate of
conduct from last the employer)
_______________________________________________________________________________________________
30.Particular of Liabilities _________________________________________________________________________
31.Particular of movable property and investment ______________________________________________________
32.Particulars of immovable Property (A) Land: Village Construction (Property exacts should be attached)
Date: __________________ Signature of the applicant
Place: __________________ Full Name in Capital Lett
Mobile No. _____________
