eon cd Back Office: Dear Madam/Sir with Cust. Id. ‘with Branch Office: ... Dist. No. Reg: Your Saving A/c No. .. We thankfully recognize your patronage for starting relationship with Punjab National Bank family. The details of accounts basic information provided by you are given hereunder for your kind information and record. Discrepancy, if any, be kindly brought to the notice of concerned branch by quoting the Account No. within three days. sl. Details First Second No applicant applicant a Full Name %2, Spouse Name 73. Father's Name “4. Mother's Name 5. Guardian Name, if minor *6. Date of birth 7, Place of Birth *8. Residential Address 79, ‘Address Proof Type/No FIO. Tdentity Proof Details ‘Type/No sr ‘Aadhar No #12. PAN No TS, Passport No. 14. ‘Tax Residency TS. TIN/other equivalent (for tax residency other than India) 716.i)| Nature of account co) Mode of operation “17. Nomination Details *18. Mobile No. 719, | Email iD Assuring you of our best services, We are confident that our relationship will grow further in times to come. With regards! For Punjab National Bank ‘This is a computer generate statement,ware FATCA/ CRS SELF CERTIFICATION / DECLARATION FOR INDIVIDUALS: ‘Are you a tax resident of any country other than India? Ity , please fill the details below & Sign: If No, please sign the declaration Certification below: (Please indicate all countries in which you are resident for tax purposes and associated details) (ve T.Countyy | 1803166 | Tax Identification | Residence Tadress Type: (ies) of Tax | Country Identification | Type (TIN or | Address for Tax residency # |code of | Number (TIN)* | Other’ panpeeel 1 Residential jurisdiction | or Equivalent | please flacinding City or otiraisence specify) State, Country Business, T= Applicant a Applicant Place/City of Birth 1303166 County code of birth T Applicant nt Applicant «To also inchide USA, where the individual is a citizen] green card holder of USA % In case Tax Identification Number is not available, kindly provide functional equivalent’ Certification: Under penalty of perjury, I/we certify that: I understand that Punjab National Bank is relying on this information for the purpose of determining the status of the account holder named above in compliance with FATCA/CRS, Punjab National Bank is not able to oller any tax advice on FATCA or CRS or ite impact on the account holder. | shall seele advice from professional tax advisor for any tax questions. agree to submit a new form within 30 days if any information or certification on this form becomes incorrect. I agree that as may be required by domestic regulators/tax authorities, Punjab National Bank may also be required to report, reportable details to CBDT or other authorities agencies or close or suspend my account, as appropriate. [have understood the information requirements of this Form (read along with the FATCA/CRS Instructions} and hereby confirm that the information provided by me on this Form including the taxpayer identification number is true, correct, ‘and complete, | also confirm that I have read and understood the FATCA/CRS Terms and Conditions and hereby accept the same. Signatures 2. Photo with Cross (st Applicant) [Hind Applicant) (ist Applicant) (ind Applicant) Riguatars ‘Account Number. ibliielicetthnual dial Raaeiasdatasaaadaaa ‘Name 1* applicant 27 applicant Cust 1D TPT tT tt ttt ‘Specimen Signature Mode of operation For Office | 1 Signature Verified Name: Use only | 2.In person verification done & KYC Date: Signature with verified from original document GBPA/PF No 3,Account opening authorizedAnnexure. ‘TERMS & CONDITIONS |/we confirm that details entered in the tablet for opening my account have been seen by me & found correct. I have given following KYC documents as a proof of identity and address: 1, PAN No. 2. COLT TTT TTT) Passport no/priving ticence No lee epeteya] 3. Any other (Please specify) i i, I/we further confirm having received, read and understood (a)the accounts rules and hereby agree to be bound by the terms & conditions outlined in these rules which governs the account(s) which I/we am/are opening/will open with Punjab National Bank and (b) amendments to the rules made from time to time and those relating to various services availed by me/us when displayed by the bank on its notice board or on its website and those relating to various services offered by the Bank including but not limited to Debit card, Credit card, Internet banking, Mobile Banking, SMS alerts ‘and other facilities listed in this form. I/We are aware that the usage of these facilities is governed by the terms and conditions which are contained in the brochures of the Bank issued from time to time/ displayed on the website ‘www,pnbindia.in, the site maintained by Punjab National bank and I/we have reviewed the contents of the same. I/we understand that the bank may at its 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 «1/We declare that the transactions in the account will be made from legitimate sources only and the account will not be ‘used for any purpose contrary to law. I/we also agree to maintain the minimum/quarterly average balance which the Bank may prescribe as the minimum/quarterly average balance to be maintained to avail the facilities and agree to pay the charges if ‘minimum quarterly average balance not maintained and any other charges stipulated by the Bank. 1/We understand that any change in this respect will be notified by the Bank on its website www.pnbindia.in and also will be displayed on the notice board of the branches one month in advance. 1/We undertake to make good the losses to the bank, suffered ‘consequent to crediting in the account proceeds of cheque drawn on other customers’ accounts in bank or make good any overdraft created in our account on account of service charges or debit card withdrawal or through any other transaction. I/we also undertake to update identity and address proof and submit latest photograph on the periodic interval. 1/We give our consent to receive information by usual means of communications including phone banking about PNB's products and/or services or promotional offers introduced by the bank from time to time and also authorize the bank to Use my/our personal information for marketing purposes. All communications will be sent on provided registered mobile no, & registered E-mail id/ by post. My personal / KYC details may be shared with Central KYC Registry. I hereby consent to receiving information from Central KYC Registry through SMS/Email on my registered number /email address NOMINATION: (Please Tick) Nomination required | Yes] | No Th _YES......-..-nplease fill in the following particulars 1/we, nominate the following person particulars whereof are given below to whom in the event of my /our death ‘the amount of the deposit in the account opened with this AOF may be returned by the bank, Nominee Name Address Relationship | Age | If nominee with isa minor As the nominee is a minor on this date, I/ we appoint Shri I'Smt/.... ete aaa name, address and age) to receive the amount of the deposit on behalf of the nominee in the event of my/ our/ minor's death during theminority ofthenominee. Name of nominee to be printed on Passbook & Statement Y [—] oO » Signatures (Uist Applicant) (lind Applicant)yaeticourldec.¢ Fests Pe rd Pda Bada Bank Dated: The Branch Head, Punjab National Bank, 80 Respected Sir, Reg: Declaration in regard to communication address and Income proof for opening bank account in your branch With reference to the above I hereby declare and confirm that presently 1 am residing locally at d I will submit my OVD of present address within three months from the date of opening of the account, f bank will be free to restrict operation in my bank account. I further declares that 1 am by profession and my annual Income is Rs. approx. Hence, | do not file any Income Tax return. You are requested to open my account. Thank You Name: Mother Name: Mobile No: Signature The Chief Manager CASA Back Office Chandigarh/Panchkula sir, ‘We hereby declare that we have verified KYC documents with original at ours. Branch ManagerFORM 60 [See thi provision to of Rule 148] Form of Declaration to be filed by a person who does no have either permanent account number of general index Register Number and who makes payment in respect of transaction specified in clauses (¢) to (fof rule 114B of the income Tax Act. 1982. 1, Full Name and Address ofthe declarant one 2. Particulars of transaction ‘Account Type Number nn 3. Amount of the transaction Rs. 4. Are you assessed to tax ? Yes / No 5. Ifyes, i) Details of Ward / Circle / Range where te last return of income wa fle. ii) Reasons for not having permanent account number / General Index Register Number 6. Details of document being produced in support of address in column (1) Verification r do hereby declare that what is stated above is rue tothe best of my knowledge and belief. Date. Place ee ‘Signature ofthe declarant Instructions: Documents which can be produced in support of the address are: (a) Ration Card (b) Passport (©) Driving License (a) Identity Card issued by any intitation (6) Copy of Electricity bill or Telephone bill showing residential address. (0) Any document of communication issued by authority of Central Government oF focal bodies showing residential address. (g) Any other documentary evidence in support of his address given i the declaration. Note: Amendment with effect from 1 November, 1998 as per Income Tax Act, 1962 Rule 114 B: para (¢) A time deposit exceeding Rs, 50,000/- with a banking company : para (0) opening an account with a Banking Company.