Jamia Cooperative Bank
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Account Opening Form for Individuals

Type of Account

Account Category

Mode Of Operation

In case of MINOR ACCOUNT (Full details of minor)

Personal Detail of Account Holders

1st Applicant Mr./Mrs./Ms

Please Affix Passport size photograph

Signature

2nd Applicant Mr./Mrs./Ms

Please Affix Passport size photograph

Signature

3rd Applicant Mr./Mrs./Ms

Please Affix Passport size photograph

Signature

Detail of Account Holders

Detail of Account Holders 1

Detail of Account Holders 2

Detail of Account Holders 3

KYC Documents

Identity Proof(Any of the following)

KYC Documents For 1st Applicant

Address Proof (Any of the following)

Bank account statement or passbook

Latest Copy of LIC Insurance Premium receipt

Letter from employer certifying the current mailing address (only from private limited/ limited companies)

Existing valid registered lease agreement on stamp paper (in case of rented/ leased accommodation or shifting/transfer of residence)

KYC Documents For 2nd Applicant

Address Proof (Any of the following)

Bank account statement or passbook

Latest Copy of LIC Insurance Premium receipt

Letter from employer certifying the current mailing address (only from private limited/ limited companies)

Existing valid registered lease agreement on stamp paper (in case of rented/ leased accommodation or shifting/transfer of residence)

KYC Documents For 3rd Applicant

Address Proof (Any of the following)

Bank account statement or passbook

Latest Copy of LIC Insurance Premium receipt

Letter from employer certifying the current mailing address (only from private limited/ limited companies)

Existing valid registered lease agreement on stamp paper (in case of rented/ leased accommodation or shifting/transfer of residence)

Service / Business Details

Service / Business Details For 1st Applicant

Service / Business Details For 2nd Applicant

Service / Business Details For 3rd Applicant

Facilities

NOMINATION (DA1Form)

Nomination :

I have been explained about the benefits of the Nomination facility; however, I do not wish to provide Nomination for this Account

*Nomination under Section 45ZA of the Banking Regulation Act 1949, and rule 2(1) of the Co-operative Banks (Nomination) Rules, 1985, in respect of the Bank deposits. Whether nominator(s) agree(s) to have name of the nominee on pass book/Statement of Account

I/We, hereby nominate the following person to whom in the event of my/our/minor’s death, the amount of the deposit particulars of which are given below, may be paid by Jamia Co-operative Bank Ltd

to receive the amount of the deposit in the Account on behalf of the Nominee in the event of my/our/minor's death, during the minority of the Nominee. Witness detail (Two Witnesses in case of thumb Impression)

Witness No. 1
Witness No. 2

#Signature (s) /thumb Impression (s) of Depositor (s)

@ Please Put Tick in appropriate box wherever applicable.

# Where Deposit is made by minor, the Nomination should be signed by a person lawfully entitled to act on behalf of the minor

# Thumb Impression to be attested by two witnesses.

Declaration

I/We,hereby irrevocably agree and undertake toabide byKYC norms and furnish following Information along withdocumentary attedence tothe bank:

  • Copies of documents for KYC updation with original for verification
  • Immediately inform the Bank in writing of change in my/our residential/business address, Service/occupation/nature of business.
  • Any additional information as with reference to my/our Account and transaction.
  • Joint Account : I/We hereby authorize the Bank to make payment of deposit to the survivor without concurrence of the legal heir of the deceased account holders.
  • The Bank rules & regulations relating to accounts have been read& understood by me/us and I/we agree to abide by the said rules & regulations and any amendments made thereto from time, to time as displayed on bank’s Website/Notice Board and those relating to various services including but not limited to ATM Card, SMS Banking, Mobile Banking, Internet Banking etc.
  • I/We understand that the Bank may at its discretion discontinue any of the service completely or partially. I/We agree that the Bank may debit my/our account with service charges, as applicable, from time to time
  • I/We confirm that I/we am/are resident of India.
  • I/we am/are not availing any credit facility from any other bank OR I/we am/are availing following credit outstanding facilities as specified

I/We hereby declare that the information furnished above is true & correct to the best of my/our knowledge.
All the points in the above declaration have been well explained to me by the bank.

Yours Faithfully

Signature (s) / Thumb Impression (s)

Signature (s) / Thumb Impression (s)

Signature (s) / Thumb Impression (s)

Introducer Details

Other Information
Applicatnt 1

Residence

Religion

Caste

Marital Status

If married, date of Marriage

No. of Dependent (Spouse+Parents+ Children)

Annual Income

Profession/Occupation

Educational Qualification

Asset Ownership Details

Flat/House

Commercial Property

Car

Two Wheeler

Applicatnt 2

Residence

Religion

Caste

Marital Status

If married, date of Marriage

No. of Dependent (Spouse+Parents+ Children)

Annual Income

Profession/Occupation

Educational Qualification

Asset Ownership Details

Flat/House

Commercial Property

Car

Two Wheeler

Applicatnt 3

Residence

Religion

Caste

Marital Status

If married, date of Marriage

No. of Dependent (Spouse+Parents+ Children)

Annual Income

Profession/Occupation

Educational Qualification

Asset Ownership Details

Flat/House

Commercial Property

Car

Two Wheeler

Form No. 60

[See second proviso rule 114B]

Form of declaration to be filled by a person who does not have a permanent account number and who enters into any transaction specified in rule 114B

Are you assessed to Tax?

Form No. 61

[See second proviso to clause (a) of rule 114C (1)]

Form of declaration to be filled by a person who has agricultural income and is not in receipt of any other income chargeable to income-tax in respect of transactions specified in rule 144B

Are you assessed to Tax?