Mode of Deposit - Cash/Cheque/DD
Cash Rs. __________________ (_________________________only)
Cheque/DD No. ______dt.
________drawn on __________
Bank _________Branch
for Rs. __________________
Transfer from Savings/Current
Account No. ________
Mandate for Account
Operations
Single
Jointly by All
Anyone or Survivor
Either
or Survivor
Former or Survivor
Others
Maturity Details
Schemes(FD/RIP/RD/Others)
Maturity Value
Maturity Date
Renewed/Closed
Renewal Instructions
Deposit Renewal Instructions:
I/We authorize the bank to automatically renew
the
matured term deposit
with/ without accrued interest
for________
period at the prevailing rate of
nterest unless otherwise instructed by
me/us.
I/We authorize the bank to automatically
convert
the matured recurring
deposit with/ without accrued i
nterest
for________ period to FD/ RIP A/c at
the
prevailing rate of interest
unless otherwise instructed
by me/us.
Payment Instructions
Interest Payment Instructions:
Monthly
Quarterly
(Please tick (a)
the
type of Account)
P.O / D.D to the mailing address
Transfer to SB/CA/CC/LN No:
Others (Please specify)
Payment Instructions on Maturity: (Please
fill in only if the interest is not to be renewed with the
Principal) (Tick (a)
appropriate box)
P.O / D.D to the mailing address
Transfer to SB/CA/CC/LN No.
Others (Please specify)
TDS
To be deducted PAN
No______________________
Not to be deducted (Form 15H, etc to be submitted every
financial year)
Nomination required
Yes (Please execute the nomination form DA 1 printed overleaf)
No
Please do not indicate the nomination on the
passbook / deposit receipt
Standing Instruction
Please debit monthly instalment of RD A/c_______ from my/our
SB/CA/CC
account no_________________
Agreement
I/We agree to be bound by the Bank's rules and regulations
governing
_______________account from time to time.
I/We will
maintain minimum balance
in the account and in
the event of fall
in the minimum balance the Bank may
realize the appropriate service charge.
Nomination under Section 45 ZA of Banking Regulation
Act, 1949 and Rule 2(1) of the Banking
(Nomination Rules
1985 in respect of Bank deposits)
I / We __________________________________________nominate the following
person to
whom in the event
of my / our / minor's death the amount of deposit in the above account,
may
be returned by United Bank of India____________________________Branch
(Name
and address of the branch / office in which deposit is held)
Particulars of Nominee
Name
Address
Relationship with
Depositor, if any
Age
If nominee is minor,
his / her date of birth
* As the nominee is a minor on this date, I / We
appoint Shri / Smt /Km …….………………
……………………………………………….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 the
depositor(s)
