Membership No. Rega No. 3608 Date 0603-1983 THE STATE BANK EMPLOYEES’ CO-OPERATIVE CREDIT SOCIETY LTD., 1st Floor, State Bank of India, Mysore Bank Circle Branch, Avenue Road, Bengaluru - 560 009, Ph : 080-2234 0814, E-mail : [email protected] & [email protected] APPLICATION FOR MEMBERSHIP To, ‘The Chief Executive Officer, Affix Latest State Bank Employees’ Co-operative Credit Society Lid., Paseport 1st Floor, State Bank of India, Photograph Mysore Bank Circle Branch, ‘Avenue Road, Bengaluru - 560 009, Enclose 2 Paseport Dear Sir, ‘Size Photographs lam applying for membership and that | may be adrrited as a member of your Society and be alloted 5 shares of ,000/- each, 01. Name ofthe Employee (inBlockLotters) 02, Nameof Branch a 03, Branch Code, RBO & AO : & 04, PF Index Number & Designation & 05, Age&DateofBirth Nears _. J L 06. Date of Appointment, Basic Pay & Gross Salary J I zg z 07. Father/HusbandName 08, ResidentialAddress 09, Telephone Number Res. No Br/Off. No 10. Mobile Number & E-mail IO 11, Aadhaar Number & PAN Number 12, BankAccount Number SI. No. Particulars ‘Amount @) 1_| Admission Fee 00 2_| Share Fee EW '3__| Subscription to 5 shares 5,000 4 | One month's advance subscription to CSF 200 5__| One month’s advance subscription to DCR Fund 200 6 | Initial contribution to DCR Fund 7,500) Total 7,050 13, Details of Remittance : D.D. No Date___/_/20_ for 7,050/- favouring State Bank Employees’ Co-operative Credit Society Ltd., payable at SBI Mysore Bank Circle Branch (40007). 14, I declare that Iam not a member of any other Primary Co-operative Credit Society and that | will not join any ‘Society without express sanction from the Society / Registrar of Co-operative Societies. 15, Ihave read and understood the bye-laws ofthe Society, | agree to abide by the same. | herewith solemnly declare that allthe information given above are true. 16. Documents required: 1. Latest Salary Slip, 2. Aadhar Card Xerox, 3. PAN Card Xerox, 4. Bank ID Card Xerox, 5.3 Passport Size Photos Place Date Jt. ‘Signature of Applicant Introduction by Members Signature Signature Name Name Membership No. Membership No. PF Index Number| PF Index Number of BranchiChief Manager with FOR OFFICE USE Admitted and or allotted Shares as per Board resolution dated ft CHIEF EXECUTIVE OFFICER PRESIDENTNomination No. NOMINATION FORM To, The Chief Executive Officer, State Bank Employees’ Co-operative Credit Society Lid. Place 1st Floor, State Bank of India, Mysore Bank Circle Branch, Date ! / ‘Avenue Road, Bengaluru - 560 009. Dear Sir, Nomination I hereby nominate the persons mentioned here below to receive the balance at creditinmy-a) Share Account, b) Compulsory Savings Fund Account, c) Death Relief Benefit under the Death-cum-Retirement Benefit, fundand d) Anyotheramounts due to me by the Society in the event of my death and in accordance with the rules of the Society. 3 ‘Age & ‘Share Payable to each & Name of the Nominees Relationship Nominee 1 2 The nomination made herein invalidates my previous nomination/s, it any, and shall bein force until revoked by me in writing or varied by subsequent nomination communicated to you and acknowledged by you further agree that payment to the nominee/s in accordance with the directions contained in this letter of nomination shall be valid discharge and it shall be binding on me and my heirs and representatives, | am aware that any disposition under my will contrary to this nomination will not cancel the nomination. Witness : 1. Signature Yours Faitfully, Name (in Block Letters) _— Branch Name Signature of the Member Membership Number PF Index Number E-mail ID Mobile Number Name {in Block Letters) Branch Name Membership Number Telephone Res No, Br/Oft No. PF Index Number Residential Address E-mail 1D Mobile Number Telephone Res No, BriOff No. 2 Signature Residential Address Name (in Block Letters) Branch Name Membership Number PF Index Number For State Bank Employees’ Co-op, Credit Society Ltd,, E-mail ID Mobile Number Telephone Res No, Br/Off No. Residential Address Chief Executive OfficerFrom Place ShrifSmt,__— HRMS ID State Bank of India, Date ! J To ‘The Chief / Branch Manager, State Bank of India, Through the Chief Executive Officer, State Bank Employees’ Co-operative Credit Society Ltd., Bengaluru Dear SirfMadam, I, has applied for admission as a member of the State Bank Employees’ Co-operative Credit Society Lid., Bengaluru and | hereby authorize you to recover from out of my monthly salary and pay such sum or sums to the said Society in payment of all or any instalments of share capital, loan or loans, monthly contributions towards compulsory savings fund, death-cum-retirement benefit fund and all other sums that may be decided by the Society from time to time and at any time become due and payable by me to the said Society towards the instalment or instalments of share capital, compulsory savings fund, death-cum-retirement benefit fund, loan or loans or other sums that may be due and payable by me to the Society. | agree to accept as sufficient evidence as my liability a demand from an officer of the Society certified by him to be correct. | agree that you make recoveries from my salary in the manner above mentioned so long as | continue to be a member of the Society. | shall not at any time ask for the suspension of the recoveries except with the express consent of the Board of Directors of the Society. If Lam transferred to any other Branch, | request and authorize yourself and the society to communicate to my pay disbursing officer a copy of this agreement and request and authorize him to make the recoveries. There upon the disbursing officer shall effect recoveries according to the demand lst sentto him by the Society. Yours faithfully, ‘Signature of Member Forwarded to ‘The Chief / Branch Manager State Bank of India ‘Admitted as Member at the Board meeting held on. and Membership Number is Chief Executive Officer To Date ! J ShviSmt State Bank of india, Dear Sir/Madam, Your Application for Membership With reference to your application for membership in the Society, you are hereby informed that you have been admitted as ‘member of the Society and your Membership Number is You are requested to quote the Membership Numberin all your corraspondence with the sociaty. Please also find herewith enclosed your Share Certificate in support of your membership with the Sociaty. The acknowledgement duly signed by you for having received the Share Certificate, may please be retransmitted tous for our records. Yours faithfully, Chief Executive Officer ‘State Bank Employees’ Co-operative Credit Society Ltd, +" Foor, State Bank of India, Mysore Bank Cicle Branch, Avenue Road, Bengaluru - 560 009, ‘Acknowledgement To, The Chief Executive Officer, State Bank Employees’ Co-operative Credit Society Ltd., ‘st Floor, State Bank of India, Mysore Bank Circle Branch, Avenue Road, Bengaluru - 560 009. Dear Sir, Acknowledgement for Share Certificate | acknowledge receipt of your letter dated in support of my membership with the Society. Yours faithfully, enclosing the Share Certificate vide No. Signature of Member Name [Designation Branch Name PE Index Number Mobile NumberTear Here Nomination Certificate by the Society Certified that particulars ofthe nomination have been recorded in our books vide nomination form No, Name ofthe Member: ______________For State Bank Employees’ Co-op. Credit Society Ltd, Membership Number PF Index Number Name of the Branch Name of the Nomineels, Chief Executive Officer Place : Bengaluru Date