AOF FOR OPENING/RENEWAL OF TERM DEPOSIT

The Branch Head,

Branch Office…………………………………

1. FULL NAME, in CAPITAL Letters (leaving a space between first, middle & last name) 2. Customer ID No.
i
i. CKYCR No.
ii
ii. CKYCR No.
iii
iii. CKYCR No.
3. Repayment account/Credit Maturity/renewal/Interest/Other Proceeds to Account No.____________________
4. TYPE OF TERM DEPOSIT REQUIRED (Tick the appropriate box)
FD RD
Fixed Deposit PNB Tax Saver FD Non-Callable Recurring Deposit: Flexi-Recurring Deposit
(Please Specify Palash (No premature Deposit Monthly Instalment Monthly core amount
FD Scheme) Green Withdrawal (No premature Rs……………………… Rs……….……...........
_____________ deposit allowed under Withdrawal allowed No. of Instalments No. of Instalments
the scheme) under the scheme) …….…... @........ …….…... @........
5. Interest Payment Frequency 6.Auto Closure/Renewal-Tick the appropriate box 6.1 Instructions for Amount at auto
(tick the appropriate box) Auto Closure Auto Renewal at maturity for period renewal on maturity of FD, please
at maturity renew for (tick the appropriate box):
On Ann Half Quart Mon Y/N Same period on Different period on Matur Principal Fixed Others
Mat ually Yearly erly thly maturity for maturity (please ity Only Amt. (please
urity ____ times specify the period). Amt. specify)
Period_____ for
______times

7.Mode of Operation (Tick the appropriate box)

Self Eith Former Any Jointly Self In case of Mode of operation is “Either or Survivor” or “Former or Survivor”
er or or one or Any or “Any one of us or Survivor/s”: - We hereby authorise/undertake that in
Surv Survivor Surviv Other case of death of any of us payment of our fixed deposit/recurring deposit
ivor or (specify)
proceeds can be paid to the Survivor/s without obtaining the concurrence of
Legal heir/s of deceased depositor/s amongst us. Such authority will be
applicable on or after maturity and pre-mature payment (both cases)

8.TDS DETAILS - Applicable: Yes/No. PAN No.

TDS if not applicable, exemption Reference No.___________. If Yes, Whether Form 15 G/H^ submitted: Yes___ No___
Form 15G for General Category & 15H for Senior Citizen
I/We request you to open/renew FD/RD for Amount Rs.________________ Debit Account No.___________________ for
Period: Years___Months____Days_______. I/we have understood and agree to be bound by the bank’s rules in force
from time-to-time.
Standing Instructions for RD/FRD- Kindly debit monthly instalment from Account No. ____________________ on _____
of every month.
Customers’ Signature(s)/ 1. ________________________
Place: ___________ Thumb Impression(s) 2. ________________________
Date: ____________ 3. _________________________

Term Deposit Account No.

(for office use only)
(Verified by)
PNB-1177R2 /ENGLISH/LOT NO.01/FEB25/100/OMSAI (Signature of authorized official with GBPA No.)
 Branch Office………………………………………….
Dist. No………………………………………………….
NOMINATION
Nomi- YES Fill the form DA-1 below Name of nominee to be YES
nation NO-The benefits of Nomination Facility have been explained to me/us. printed on FDR or RD NO
Required However, I/we do not want to nominate any person in this account. Passbook
FORM DA-1: NOMINATION
Nomination under Section 45 ZA of Banking Regulation Act, 1949 and Rule 2(1) of the Banking Companies (Nomination)
Rules 1985 in respect of Bank Deposits,
I/We @ Name(s): _______________________________________________________________________________________________
R/O___________________________________________________________________________________________________________
Nominate the following person to whom in the event of my/our/minor’s death, the amount of deposit in the account may be returned
by Punjab National Bank, B.O.____________________________
DEPOSIT NOMINEE
If nominee is
Account Relationship minor,
Nature of No. Additional Name Mobile No. Address with depositor, Age his/her Date
Account Details, if any (Optional) if any of birth

As the nominee is minor on this date, I/We appoint Mr./Ms.__________________________________________________

Age_________Address__________________________________________________________________
Mobile No. (Optional) _________________ 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: ___________________
Date: ___________________ Signature(s) /Thumb impression(s) of depositor(s)

Where the deposit is made in the name of minor, the nomination is to be signed by natural/legal guardian of the minor to
act on behalf of the minor. (Strike out if nominee is not a minor)
WITNESSES
Name & Signature of the first witness Name & Signature of second witness
Name_____________________________________ Name____________________________________
Signature: _________________________________ Signature: ________________________________
Address: __________________________________ Address: _________________________________

Place: ____________________________________ Place: ___________________________________

Date: _____________________________________ Date: ____________________________________
Telephone No. _____________________________ Telephone No. ____________________________

Thumb impression(s) shall be attested by two witnesses; otherwise, it is not required.

…………………………………………………………………………………………………………………………………………………………………….
NOMINATION REGISTERED
The above-mentioned nomination is registered at Serial No. _______________in respect of (Type of Account)
_________Deposit Account No. ___________________Date _________.

For Punjab National Bank

(Authorised Official)
PNB-1177R2 /ENGLISH/LOT NO.01/FEB25/100/OMSAI
(GBPA)