Preferred Home Branch *Employee Code
FOR BANK USE ONLY
Branch Code *Corporate Code Ticket ID
*** Principal A/c Number
*If you have availed Corporate Salary Account/Kotak Staff
***Applicable in case of Family Savings account
Please tick to
Please open my Account - More than one type of account can be opened if all the applicants, including the primary applicant, remain the same select. Details
to be filled by
Savings : Product Name Code: Current: Product Name Code: Bank.
To know more
Product Name about various
TD : Code: Investment product types
please contact
Mode of Operation Singly Either or survivor Jointly Others Bank official
DETAILS * Fields are Mandatory
Name(s) of the Applicant (s) Customer Relationship Number#
4.
Preferred Mailing Address
Flat Number / Building Street / Block
Area Landmark Mobile number
will be used for
SMS Banking
*City *Pin Code State registration for
eligible
Telephone No. Mobile Number accounts.
e-mail address
required for
Email Address Alerts and
e-newsletters
#If not available, please fill customer relationship form, each applicant, representative / guardian of the applicant
(Debit Card/PIN/Password mailers will be sent to the preferred mailing address of each applicant. Account Statement/Cheque Book will be sent to preferred mailing address of the first applicant only)
Activ
ActivMoney (not available if linked account has an overdraft facility attached) Money
NOTE: The
ActivMoney is a facility of automatically sweeping out funds above a pre-specified threshold from your Current/Savings Account to a Term Deposit (TD) Account for 181 days. In sweepout
threshold limit
case of balance below threshold level in current/savings account, the TD will be broken prematurely and the required amount will be transferred to Current/Savings Account. specified
cannot be
ActivMoney facility required Yes No If Yes, please specify sweep out threshold Rs.___________________ . If No value specified, below twice the
the default sweep threshold will be twice the product AQB requirement product AQB
The nomination registered for Current / Savings account will apply for the TDs created through ActivMoney
SMS BANKING & ALERT FACILITY (Refer GSFC for charges applicable ) SMS Banking
facility is
Alerts facility enables you to receive alerts on your Email and/or Mobile regarding large debit, large credit, SI failure, balance below AQB and balance update. New alerts may be added from time to time. available to all
I/We hereby expressly consent and authorize the Bank to make telephone calls and send SMSs or/emails to inform me/us on any information or updates relating to the Bank's existing / new products/services. The said account
consent given is valid till such time I/We withdraw the same in writing. holders for all
products. Alerts
v for Primary
Alert Type Balance update frequency Trigger Amount Account Holder
v
v
SMS Daily Weekly Large Debit Rs. Ace Account Only only.
Large Creditv
v
E-mail Daily Weekly Rs. Ace Account Only
v
These alerts will be applicable for all your selected accounts. To make changes for any one account, please fill up Modify Alerts and SMS Banking form.
v
v
In case of no value specification or accounts other than ACE account, default values for Current Account will be set at Rs. 50000/- and for Savings Account will be set at Rs. 10000/-
The mobile number and E-mail address mentioned in this form will be used for all alerts sent by the Bank. The Bank will also use these details for sending out transaction related information and updates about products and
services. Incase you do not wish to receive information / updates; you can register yourself for Do Not Call on the Bank’s website www.kotak.com
CHANNEL ACCESS REQUEST
I wish to apply for access to the following Channels Deposit
v
Access to Payment Gateway will give automatic access to
1st APPLICANT 2nd APPLICANT Net Banking, Direct Pay, Online Shopping and all other
Accounts
include Current
PB NB DC PG PB NB DC PG Gateway services that may be introduced by the Bank as per
/ Savings / Term
regulatory guidelines from time to time.
Deposit Account(s) v v Deposits
# Mandate in favour of Bank to be executed to avail
Investment Account(s)# transaction facility on Net Banking and Phone Banking for
Insurance Investment Account(s).
PB - Phone Banking; NB-Net Banking; DC - Debit Card; PG - Payment Gateway (Net Banking includes Mobile Banking and Mobile payment services)
ACCOUNT STATEMENT OPTIONS (Kindly refer to General Schedule of Features and Charges for any frequency selected)
Email (Monthly) OR Physical Copy (Quarterly) OR Both
INITIAL PAYMENT DETAILS
Amount (in figures) (in words)
Mode of Payment : Cash (Please deposit only at Bank counters) Debit my/our Account Number
Cheque Number Dated D D M M Y Y Y Y Drawn on Bank’s Name
Branch
Cheques issued by the customer from his/her existing bank account and payable to Kotak Mahindra Bank Ltd. A/c < customer name > will only be accepted.
CREDIT FACILITIES (Only for Current Account)
Please attach
I/We declare that I/We do not enjoy credit facilities with other bank(s). the NOC and
details of such
I/We enjoy credit facility/have current accounts with other bank(s). facilities
separately as
per format
available with
the branch
DECLARATION
The particulars contained herein shall be valid for all accounts opened by me/us or to be opened by me/us hereafter either singly or with other(s) and/or by me/us in any representative capacity
with the Bank unless informed to you otherwise. I/We have read/obtained and understood the Terms and Conditions and citizen charter governing the opening of an account with Kotak
Mahindra Bank Ltd. (the Bank), and those relating to various Services including but not limited to (a) ATMs (b) Phone Banking (c) Debit Card (d) Net Banking (e) Payment Gateway (f) Kotak
BillPay (g) SMS Banking (h) Alerts Service (I) Opening of an Investment Account. I/We understand that the Bank may at it absolute discretion, discontinue any of the Services completely or
partially without any notice to me/us. I/We agree that the Bank may debit my account for service charges as applicable from time to time. I/We understand that investment products are not bank
objects or other obligations of or guaranteed or insured by Kotak Mahindra Bank Ltd. or their affiliates. They are subject to risk and possible loss of principal. Past Performance is not indicative of
future performance. I/We hereby declare the above information is true to the best of my/our knowledge. I/We shall advise the Bank immediately in the manner as agreed by me/us and acceptable
to the Bank, in case of any change in the above details and information given by me/us. To refer to the terms and conditions please visit our web-site www. kotak.com or collect a copy of the Term
and Conditions from any of our branches. Mandate for Investment Accounts : I/We hereby authorize you to transfer funds in any form and manner including but not limited to by way of
debit/credit of my/our account(s) and issue pay-orders/demand drafts/bankers cheques from my/our account for the purchase, redemption, switch receipt of dividends or any such acts for
Mutual Fund unit in pursuance of the instruction given by me/us or my Attorney from time to time. I/We hereby state that all the Acts, deeds and things done by you based on such instruction shall
be binding on me/us. This mandate by me/us to be adhered to by the Bank in respect of all actions permitted by the RBI and/or relevant regulations applicable from time to time.
SIGNATURE
1st Applicant 2nd Applicant
Please sign in
Black ink only
CRN CRN
3rd Applicant 4th Applicant
Please sign in
Black ink only
CRN CRN
FOR BANK USE ONLY
Parent ID Category: P A B C S T G
Source Code Risk Profile H M L
Lead Generator Code Group Co. Code Group Co. Emp Code
Lead Convertor Code Customer Segment: RL WM CB
RM Code Insta Kit Yes No
NMC Waiver Yes No IP Waiver Yes No
Approved by: Sales Official Branch Official
(Sign & Code) (Sign & Code)
DesignationX Designation
Opportunity ID Section
Savings Current
Investment TD
Preferably for
NOMINATION (FORM DA1) Single Account
Nomination under Section 45-ZA of the Banking Regulation Act, 1949, and rule 2 (1) of the Banking Companies (Nomination) Rules, 1985, in respect of bank desposits. holder
I/We__________________________________________________________Name(s) & Address (es) ________________________________________________________________________
_________________________________________________________________________________________________ nominate the following person to whom in the event of my / ours
/minor’s death the amount of the deposit, particulars whereof are given below, may be returned by ________________________________________________________________________________
Deposits Nominee
Nature of ______________________________________________________________ Name____________________________________________________________________________
Distinguishing No._______________________________________________________ Address__________________________________________________________________________
Additional Details, if any___________________________________________________ (name and address of branch/office in which deposit is held)
Relationship with depositor, if any_______________________________________________________
Age______________ If nominee is a minor, date of birth D D M M Y Y Y Y
As the nominee is a minor on this date, I/We appoint Shri / Smt / Kum*________________________________________________________________
Address ____________________________________________________________________________________________________________ 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. In case I / We am / are seeking the benefit of the ActivMoney
facility. I/We agree and instruct the Bank to treat this nomination, made by me / us for all sweep TD created pursuant to the said ActivMoney facility.
Date: D D M M Y Y Y Y Place:_________________
Signature(s) / Thumb Impression (s)** First Holder / Depositor Second Holder / Depositor
Signature of First Witness*** Signature of Second Witness***
Name _______________________________________________________________ Name____________________________________________________________________________
Address______________________________________________________________ Address__________________________________________________________________________
____________________________________________________________________ ________________________________________________________________________________
Applicable, if no nomination is provided in a Single Holder A/c FOR BANK USE ONLY
The Bank, through its authorized representative had explained to me the advantages of nomination facility
I have clearly explained to the customer the advantages of nomination facility and inspite of the same
as per the extant guidelines of RBI. However, I hereby decline to presently nominate any individual and
he/she still does not want to nominate and he/she also refused to provide a specific letter to the effect
understand the risks and consequences of my failure to give nomination and am fully aware of the hardships
that he/she does not want to make a nomination
my legal heirs would face in the event of my death without nomination registered in your Bank records.
Customers Signature Employees Signature & Code
* Strike out if nominee is not a minor
** Where deposit is made in the name of a minor, the variation of nomination should be signed by person lawfully entitled to act on behalf of the minor
*** Thumb impression (s) shall be attested by two witnesses and signature will be attested by one witness
Please obtain separate DA1 Form with each account
FORM 60
[See third proviso to rule 114B]
Form of declaration to be filed by a person who does not have either a permanent account number or General Index Registration Number and who makes payment in cash in
respect of transaction specified in clauses (a) to (h) of rule 114B
1. Full name and address of the declarant
2. Particulars of transaction - Opening of accounts(s)
3. Amount of transaction
4. Are you assessed to tax ? Yes No
5. If yes,
i) Details of Ward/Circle/Range where the last return of income was filed?
ii) Reasons for not having permanent account number/General Index Register Number?
6. Detail of documents being produced in support of address in column (1)
Verification
I, , do hereby declare that what is stated above is true to the best of my knowledge and belief.
Verified today, the day of 20
Signature of the Declarant Place
