# THE TAMIL NADU STATE APEX COOP.
BANK LTD
Head Office
CASA ACCOUNT OPENING FORM FOR INDIVIDUALS
/ Branch
(Singleloint/Proprietorship Concerns)
Date
Customer ID : Account No :
I/We request the Bank to open an account as per details below:
SAVINGS ACCOUNT With Chegue Facility Without Cheque Facility
Individual HUF Non-Trading Association
CURRENT ACCOUNT
Partnership
Firm Limited Companies Government Dept,
APPLICANTS DETAILS (All in BLOGK Letters)
Particulars Details of Applicant (A) Details of Applicant (B) Details of Applicant (C)
Name
Father/Husband's Name
Date of Birth
Gender
PAN/GIR No.
Aadhaar No.
Residential Address
Permanent Address
PiN Code
Mobile No.
Email ID
Affix Photogrdph of Affix Photograph of Affix Photograph of
Person opening the Person opening the Person opening tie
account accourt account
APPLICANT (A) APPUCANT (B) APPUCANT (C)
Mode of operation Self Jointly EorS AorS
1 1 1
Signature of the Applicant
2 2 2
Whether SN4S Alerts required Yes No
If yes,
Mobile Number
Whether RuPay Debit Card is required Yes No
Whether Net Banking is required Yes Dno
CUSTOMER PROFILE:
0ccupation Salaried / Self-employed / Business / Retired / Student / Others .....
Source of Income Monthly Income Rs.
Marital Status Married / Unmarried Qualification HSC / Graduate / Post Gratuate
Account facilitv availed
any other Bank, please
mention if any
I{OMINATIOI{ : (Form DA -1) Nomination under Sec.45ZA of the Banking Regulation Act, 1949 and Rule 2(1) of
the Banking Companies (Nomination) Rules, 1985 in respect of Bank Deposit.
. I/We nominate the following. person to whom in the event of my/our death the amount of deposit inthe
above account may b3 returned by the Bank
Name of the Nominee Proof of Identity
Add ress
Mobile No. Email ID
Relationshio with Date of Birth
Depositor, if any of Nominee
As the nominee is minor on this date, I/We appoint Mr/Mrs/Ms
(Name and Address) to receive the amount ofthe deposit on behalfofthe nominee in the
event of my/out minor's death during the minority ofthe nominee)
Applicant's Signature (A) ( B) (c)
Particulars of Identification (Attach copies of documents)
a) Aadhar Card D c) Voter ID tf e) Driving Licence
b) PAN Card D d) Passport E f) NREGA Card D
FOR BANK'S USE
Applicant(s) interviewed and the purpose of opening account as ascertained is
Account opened on Passbook delivered to the customer on
Verified the opening of the account and letter of thanks sent to the customer on
The specimen slgnature(s) of the applicants was scanned and added to the account on
Nomination details entered in the system on Registration No
Potential activity expected in the account (Monthly /Annual Turnover) Rs
Source of Funds R5 Threshold Limit Rs.
Risk Classification Low l-l Medium [---l Hieh l---l
Reason for Risk Classification made
NAME:
DATE:
CODE NO
SIGNATURE OF THE CHIEF ]IIANAGER / MANAGER :
