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Dist. No........
FORM DA-1 : NOMINATION
Nomination under Section 45ZA of Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination) Rules
1985 in respect of Bank Deposits,
l/ We @ Name(s);
Nominate the following person to whom in the event of myiourl minor's death, the amount of deposit in the account may be returned
by Punjab National Bank, B.O.
DEPOSIT NOMINEE
Nature Account No. Additional Name Address Relationship Age lf nominee is
of Details, if with depositor, minor his/her
Account anv if anv Date of birth
* As
the nominee is minor on this date, l/we appoint MriMs
Age
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.
Place:
Name
Signature: Signature:
Address: Address:
Place:
Date: Date:
#Thumb impression(s) shall be attested by two witnesses; otherwise it shall be attested by one witness.
NOMINATION REGISTERED
The Manager,
Branch Office
\ccount No.
(16 diqits)
1. FULL NAME, in GAPITAL Lettels (teaving a space between first, middte & tast name) 2. Gustomer lD No.
i
ii
ilt
3. lAA/e request you to open/renew the following account. l/we agree to be bound by the bank's
rules in force from time to time. (-Tick the relevant box on right side).
* Recurring Deposit Flexi-Recurri ng Deposit
TERM DEPOSIT Monthly Installment Rs........ Monthly core amount Rs........
#. Fixed Deposit (Specify)
No. of installments.........@ . No. of installments.........@ ...
Sign
*Standinq instructions : Kindlv debit monthlv instalment from account no. on --------------------of everu month
lnterest payment On maturiW Annually Half Yearlv Quarterly Monthly Credit Interest to SF/CA/ CC/OD
frequency Account No.
(Pl. tick in the Credit maturity proceeds to SF/CA/
appropriate box) cc/oD
Account No.
Instruction for Auto Renewal on maturity of Renew for Renew for Period for which Auto renewal required.
deposit (Tick the relevant column) Principal& Principalonly No. of times...
lnterest
3.