Form 60: Verification
Form 60: Verification
Form 60: Verification
Form of declaration to be filled by a person who does not have either a Permanent Account Number or General Index Registration Number
and who makes payment in cash in respect of transaction specified in clause (a) to (h) of rule 114B
Full name and address of declarant
Ms.MALATHI A
19 THIRUMALAI PALANIYAMMAL ILLAM,THIYAGI BALU 1ST STREET SELLUR,MADURAI NORTH TALLAKULAM
MADURAI,MADURAI,TAMILNADU,625002
Amount of transaction
Are you assessed to tax?
account(s)
0
yes
No
If yes,
i) Details of Ward/Circle/Range where the last return of income was filled
ii) Reason for not having permanent account number/General Index Register Number
Verification
do hereby declare that what is stated above is true to the best of my
day of
20
Place :
MADURAI
Page No. 1 of 8
MALATHI A
nominate the following person to whom in the event of my/our/minor's death the amount of the deposit, particulars whereof are given below, may be returned by
State Bank of India,
SAVINGS ACCOUNT
Account number
GNANAVALLI A
MOTHER
Age:
37
16/03/1979
PIN: 625002
State: TAMILNADU
age:
years
Address:
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.
Date:
Place: MADURAI
Name:
Name:
Address:
Address:
* Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act on entitled to act on behalf of the minor.
Page No. 2 of 8
Branch Teller: in CBS, go to - Customer Management -> Create Personal Customer (to
create new CIF) / Amend -> Customer Details (to issue Welcome Kit, put the printed a/c
number here and transmit); Input TCRN in "Reference No." field and click "Get Details"
TCRN : AC64898600
Date:
Account No.
Sole/First Applicant
1. Please fill up in BLOCK letters only and use black ink for signature. Please leave one box blank between two words. Tick () the appropriate boxes.
2. Fields marked asterix (*) are not mandatory
3. Please affix a passport size photograph in the box provided. Also enclose another photograph for affixing in the pass book
4. For opening account of minors, where proof of identity/address is not available, the same will be provided by Father/Mother and Natural Guardian
5. In case of illiterate customers, Left Thumb Impression (LTI) to be affixed and verified.
Personal Details
Public
Staff
Yes
Customer Type:
Senior Citizen:
Name:
MALATHI A
Name of Father/ Husband/
Guardian:
Minor:
Yes
Mr
Ms
Mrs
Other
Mr
Ms
Mrs
Other
PF No.
ARUMUGAM N
Date of Birth:
16/07/2001
Gender:
Male
GNANAVALLI A
Marital Status:
Female Nationality:
Married
Unmarried
INDIAN
Others
UID:
Correspondence Address (Current Residential/Office)
19 THIRUMALAI PALANIYAMMAL ILLAM
THIYAGI BALU 1ST STREET SELLUR
Landmark/ Street: MADURAI NORTH TALLAKULAM
District: MADURAI
Sub District:
City: MADURAI
PIN: 625002
Telephone no.
State: TAMILNADU
Mobile no. will be used for sending SMS alerts
Email Address:
Permanent Address
Same as Correspondence Address
19 THIRUMALAI PALANIYAMMAL ILLAM
THIYAGI BALU 1ST STREET SELLUR
Landmark/ Street: MADURAI NORTH TALLAKULAM
District: MADURAI
Sub District:
City: MADURAI
PIN: 625002
Telephone no.
Fax no.
Additional Details (wherever applicable)
Monthly Income:
Upto INR 20,000
*Religion:
Hindu
Christian
Sikh
*Category:
General
OBC
SC
Educational Qualification:
Non-Graduate
Graduate
Occupation Type:
Salaried
Employer Name:
I.T. PAN:
OR Form 60/61
Muslim
State: TAMILNADU
Self-employed
Business
PostGraduate
Retired
Others
ST
Others
Student
Others
*Designation/Profession:
If PAN is not available please fill-up form 60/61
Nature of Business:
Page No. 3 of 8
TCRN : AC64898600
Identification Details
Identity Card issued by Public Authority is the same as the Correspondence Address mentioned on the first page of this form.
No.: XB
Issue Date
08-Jul-2015
OR
Any one document from each of the undernoted two columns for a photo-identity and proof of address (Please tick the appropriate box and give details below):
Proof of identity
Proof of address (of Correspondence Address)
A) Passport
A) Credit Card Statement (not more than 3 months old)
B) Voter ID Card
B) Salary Slip
C) PAN Card
C) Income/ Wealth Tax Assessment Order
D) Government/ Defence ID Card
D) Electricity Bill (not more than 6 months old)
E) ID Card of Reputed Employer
E) Telephone Bill (not more than 3 months old)
Please attach
F) Driving License
F) Bank Account Statement
one selfG) Pension Payment Order*
G) Letter from Reputed Employer
attested
H) Photo ID Card Issued by Post Office
H) Letter from Public Authority*
photocopy of
I) Photo ID Card Issued by University*
I) Ration Card
Identity proof
J) Photo ID Card Issued by Public Authority*
J) Voter ID Card (only if it contains the current address)
and Address
K) Aadhaar Letter / Card
K) Pension Payment Order*
proof each.
L) NREGA Card
L) Lease Deed/Sale Deed*
Originals
M) Proof of Residence Issued by University*
thereof will
N) Address Proof of Relatives (for students)*
have to be
O) Address Proof of Close Relatives*
produced for
P) Address Proof of Gazetted/ Senior PSU Officers*
verification
No.:
No.:
Issued at/by:
Issued at/by:
Issue date:
Issue date:
With State Bank of India agreeing to open my Small Deposit account under liberalized KYC norms specified by RBI, I undertake to submit the required
KYC documents as and when the balance or total annual transaction in my account exceed the stipulated limits in this regard. In the event of non
compliance the Bank is within its rights to stop operations in account after advance notification as per RBI instructions
#mandatory
Type of Account/Facility(ies)
Account number/CIF
Date
Please Sign
in black ink
only.
Place
MADURAI
Generated CIF
Signature:
Name:
SS No.:
(Authorised signatory)
Designation:
Date:
Date:
SS No.:
Page No. 4 of 8
Date:
Type of Account
Recurring Deposit
With Cheque Book and Debit Card
Term Deposit
Savings Bank
Current Account
Services Required
1. ATM-CUM-DEBIT CARD:
Applicant no.
1st
Domestic
Gold International
2nd
Domestic
Gold International
3. INTERNET BANKING:
1st
2nd
1st
3. MOBILE BANKING:
4. SMS ALERTS:
5. CHEQUE BOOK:
6. STATEMENT FREQUENCY:
(for current account)
Monthly
Ordinary
Quarterly
Multicity*
Yes
Not required
Half-yearly
7.TELEBANKING KIT:
Required
Both
2nd
Required
Not required
no
Mode of Operation
Self only
Either or Survivor
Former or Survivor
Jointly
Other
Specimen Signature(s)
DECLARATION:
I/we affirm and declare that I/we have read over and
understood the present rules and regulations of the
Bank, and those relating to various services offered by
the Bank including but not limiting to Debit
Card/Internet Banking/ SMS Banking/ Tele-banking and
other facilities. I/We agree to abide by the same as they
are in force now and also by those as would be
amended further from time to time through
Circulars/Notice Boards/Websites etc. I/We agree that
the transactions & request executed in above mentioned
account through internet, mobile & telebanking under
my/our User ID and Password will be legally binding
on me/us & I/we are responsible for maintenance of
secrecy and confidentiality of the information passed on
to me/us by the Bank through internet/mobile/email/telephone. I/We mandate from other joint holders
to view/enquire/operate the joint account mentioned
above. Further, I/we agree that Bank has got all the
rights to debit my/our account for any service charge or
discontinue my/our account without any notice to
me/us. I/We hereby undertake to inform the Bank on
any change in my/our communication address or
constitution, and I/we shall submit the address proof in
case of transfer of our account from one Branch to
other Branch. I/We hereby declare that I/We have
submitted the Aadhaar Card issued by UIDAI for
identification and/or address proof towards the
compliance of KYC norms under the PMLA, 2002.
I/We hereby agree that the Bank may verify the same
with the UIDAI, and authorize the UIDAI expressly to
release the identity and address through biometric
authentication to the Bank. (applicable only where
accounts are opened with Aadhaar).
Please
Sign in
black
ink
only.
Page No. 5 of 8
1. TERM DEPOSIT
Amount: Rs.
(in words)
year(s)
Period:
month(s)
Maturity instruction:
Monthly
Quarterly
year(s)
month(s)
day(s)
Pay principal
year(s)
month(s)
4. SAVINGS PLUS
/ PREMIUM SAVINGS ACCOUNT
Auto-sweep facility links Savings/Current Account with Term Deposit Account. Your Savings Plus/Premium Savings Account balance above a threshold value, for a
minimum amount of Rs.10,000 and in multiple of Rs.1000 in any one instance, is transferred to a Multi Option Deposit (MOD) and earns interest as applicable to the MOD.
Threshold Amount* :Rs.
Sweep time:
day (example Monday, Tuesday) of every week (only for Savings Plus Account)
Date:
Transaction
Date:
(Authorised signatory)
Initials
rights
Initials
Initials
Initials
Initials
Initials
Initials
Initials
Initials
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