UNITED BANK OF INDIA

ACCOUNT OPENING FORM (Individual)

SAVINGS ACCOUNT
with Cheque Book
without Cheque Book
Please tick ( ) type of account
CURRENT DEPOSIT ACCOUNT
1
PAN/GIR No. or Form No. 60/61 /
RECURRING DEPOSIT
Date
Monthly Instalment Rs.
OTHER TERM DEPOSIT (specify)
Rs.
Period of Deposit/
Days / Months / Year
Residing at this address since (year)
3
2
Nationality
1
2
3
Office Address Residential Address
Branch
Account No.
Complete address with telephone number, fax and email of all the depositors
REINVESTMENT PLAN
FULL NAME OF DEPOSITORS IN BLOCK LETTERS
Amount of Deposit
DATE OF BIRTH
1
2
3
By me
By guardian on behalf of minor
By either/any one of us or survivor
Jointly by us By Former or Survivor of us

Other (Specify)
Address of Communication First Depositor Second Depositor Third Depositor
MODE OF OPERATION
In respect of Term Deposit please send the renewal notice do not send the renewal notice
Minimum balance to be maintained in the
SB Account Rs.
Amount of per unit of FD -- Rs.
Period of Term Deposit -- days
Please debit monthly instalment of RD account from my
savings bank account no.
Please credit monthly quarterly interest on Fixed Deposit to my
savings bank acount no.
In case the operation is by Either / Any One or Survivor
YES NO
The bank may, on receipt of a written application from either / any one or survivor of us, in its absolute discretion and subject to such terms and conditions as the Bank may stipulate, (a) grant loan /advance against the security of the term deposit receipt to be issued in our joint names or (b) make premature payment of the proceeds of the term deposit or (c) close the account without reference to the other depositors. The Bank will be fully discharged while closing the account in this manner.
Standing Instruction :
In case of United Bonanza
Savings Account :
Name of the Guardian & relationship
In case the operation is by Former or Survivor
YES NO
The bank may, on receipt of a written application from Former of us, in its absolute discretion and subject to such terms and conditions as the Bank may stipulate, (a) grant loan / advance against the security of the term deposit receipt to be issued in our joint names or (b) make premature payment of the proceeds of the term deposit or (c) close the account without reference to the other depositors. The Bank will be fully discharged while closing the account in this manner.
Date of birth (In case of minor)
Whether under Natural or Legal Guardian
Full Signature
1
2
3
Specimen Singnature
1
2
3
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 on the event of fall in
the minimum balance the Bank may realise the service charge
I certify that I have known for past months/years and confirm his/her/their occupation and address. I also confirm that I know all the depositors Signature
Name
Account No.
Address
If the account is to be opened on self introduction, description of the papers furnished.
Paste one passport size photograph and sign across it in presence of the branch official
Paste one passport size photograph and sign across it in presence of the branch official
Paste one passport size photograph and sign across it in presence of the branch official
How do the depositors know the introducer?
Relation Neighbour
Colleague Friend
Others (Please specify)
For Office use :
Verified Introducer’s Signature. Official’s Name : Official’s Signature :
Account opened on : DD/MM/YYYY
Letter of thanks sent to customer on : DD/MM/YYYY.
Acknowledgement received from customer on : DD/MM/YYYY
Letter of patronage sent to the introducer on : DD/MM/YYYY
Reply received from the introducer on : DD/MM/YYYY
Name of the Second Official Signature of the Second Official
Form No. DA-1 for nomination is executed below Do not require nomination
Please do not indicate the nomination on the passbook / deposit receipt
cut here cut here
UNITED BANK OF INDIA
.....................................Branch
Shri/Smt...................................................................
Dear Sir/Madam
We acknowledge nomination made by you in favour of Shri/Smt.......................................................................
aged...........years in respect of your account.......................................numbering.........................................on
the basis of
DA 1 Form dated...................
Yours faithfully
Branch Manager
Date.........................
" "
FORM –DA1
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 Age If noiminee is minor,
Depositor, if any his/her date of birth
Names, Signature and addresses of witnesses..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
Strike out if the nominee is not a minor @ Thumb impression shall be witnessed by two witnesses
Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act
on behalf of the minor
2 As the nominee is a minor on this date, I / We appoint Shri/Smt/Kum
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)
(Name, Address and Age)
Depositor First Second Third
Annual Income Less than Rs. 50,000/-
Rs. 50,000/- to Rs. 1 Lac
Rs. 1 Lac to Rs. 2 Lac
Rs. 2 Lac to Rs. 5 Lac
Rs. 5 Lac to Rs. 10 Lac
Above Rs. 10 Lac
Principal Economic Activity Agriculture
Salaried
Professional
Business
Retired
Others
Nil
Residence Own
Family
Employer
Rented
Others
Source of Wealth Self Acquired
Inherited
Gifted
Others
Additional Information : (Please put a )
Depositor First Second Third
Educational Qualification High School Leaving
Graduate
Post Graduate Professional
Others Assets Two Wheeler Four Wheeler Insurance Policy Investment
Do you have Credit Card? If so, which Card?
How many times have you been abroad in last three years
Dealing with other Banks, if yes, give particulars
Signature
CONFIDENTIAL
UNITED BANK OF INDIA
............................................Branch
CUSTOMER PROFILE
Name Name of
(1) ................................................................................. ...............................................................................
†F/M/H
(2) ................................................................................. ...............................................................................
†F/M/H
(3) ................................................................................. ...............................................................................
†F/M/H
Address of Communication : ......................................................................................................
Telephone Number : (R) (O)
(Mob.)
Type of Account & Account Number
Date of Opening the Account : ......................................................................................................
Residential Status : Resident /Non Resident
Sex : Male / Female
Age : ..........Years
Educational Qualification : (a) School Final (b) Graduate
(c) Post Graduate (d) Professional (e) Others
:
Principal Economic Activity
Annual Income : ......................................................................................................
Annual Turnover expected :
Purpose of opening the account :
Classification of the Account as : Low Risk / High Risk
Observation of the official opening the account : ...................................................................................................... :
(Briefly indicate reason for risk classification also)
Date :..............................
Signature of the Bank Official
F-Father, M-Mother, H-Husband
Should be based on Annual Income
To be obtained through discussion
High Risk : Customer transactions crossing threshold limit
Low Risk : Pensioner’s Account, Priority Sector/Micro Credit Account, Accounts opened for disbursing funds under Government
Sponsored Schemes.
BUSINESS PROFILE
Geographical Location of the Business : ...............................................................................................................
Nature/Activity of Business/Occupation : ...............................................................................................................
Estimated income from the business : ...............................................................................................................
Any other source of income : ...............................................................................................................
Total annual income : ...............................................................................................................
Approximate value of movable and : ...............................................................................................................
Immovable assets
Details of existing bank accounts : ...............................................................................................................
Detail of Credit Facilities, if any, availed : ...............................................................................................................
Details of foreign countries, if any, visited : ...............................................................................................................
during last three years
Signature of the Customer Signature of the Bank Official