FORM E
[See sub paragraph (1) of paragraph 12]

Nomination under the Public Provident Fund Scheme, 1968

To
The Branch Manager
Allahabad Bank
______________________ Branch
I,..............................................................................hereby nominate the person(s) mentioned below
to whom to the exclusion of all other persons, in the event of my death the amount standing to my credit in
the Public Provident Fund Account No ..............................at the time of my death would be payable.
Serial No Name(s) of the
nominee(s) Full addressees)
Date of birth of
nominee( s) in
case of minor
Proportionate
amount for each
nominee
* As the nominee(s) at Serial No.(s)………………………………..specified above is/are minor(s),
appoint Sri/Smt/Kumari ..................................................Address ...............................................................
to receive the sum due under the said account in the event of my death during the minority of the
nominee(s).
Signature of witness Signature/Thumb impression
of Subscriber
Name & Address
--------------------------------------------------------------------------------------------------------------------------------
TO BE USED BY THE ACCOUNTS OFFICE
The above nomination has been registered on …………………. and an entry made in the passbook.
Date…………………….. Signature of Accounts Officer
Delete if not applicable