FORM-1

APPLICATION FOR OPENING AN ACCOUNT UNDER Please affix latest

''SUKANYA SAMRIDDHI ACCOUNT'' coloured passport size
photograph of
Parent/Guardian
Please fill all the details in CAPITAL LETTERS only. Fields with (ASTERIX) are MANDATORY
35 mm X 35 mm
Young Star New SSY: Please sign across
photograph
Transfer in SSY:
Young Star
*(Branch seal to be affixed)'

PARENT/GUARDIAN'S DETAILS
*Name of Parent / Guardian
Mr. Ms.

Husband/Father /mother’s name :

Date of Birth: In words __________________________________________________________________.

Aadhaar Number of Guardian:

*Permanent Account Number (PAN) of Guardian :

Relationship with Minor : Father Mother Court Appointed

*I here by declare that the date of birth of the minor is and I am her natural and lawful guardian appointed by
court order, dated ______________________________ (copy enclosed). I shall represent the said minor in all future transactions of any
description in the above account until the said minor attains majority.

PERSONAL DETAILS OF MINOR

*Name of Account holder (girl child) Miss:

Type of Account : Minor

*Date of Birth: In words __________________________________________________________________.

*Details of Birth Certificate (copy to be enclosed):

*Certificate No.:

*Date of issue:______________________________ Issuing authority:___________________________________________________________________

*COMMUNICATION ADDRESS

Land mark: Locality:

State: City: PIN:

Country:
(please specify if
other than India)

Mobile No.: Tel No.:

E-mail ID:

I confirm having checked my mobile number and understand that all SMS alerts (transaction, one time passwords) will be received on above
mentioned mobile number.

PERMANENT ADDRESS

*Same as communication address: Yes No (if no, below fields are mandatory)

Land mark: Locality:

State: City: PIN:

Country :
(please specify if
other than India)
 KYC DOCUMENTS

Details of KYC documents attached - Parent / Guardian’s

Type of ID proof:____________________________________________
(* PAN is not considered as ID proof)

Type of Address proof:______________________________________

(The following documents are accepted as valid documents for the purpose of identification and address proof:
1. Passport 2. Driving license 3. Voter’s ID card 4. Job card issued by NREGA signed by the State Government officer 5. Letter issued by the
National Population Register containing details of name and address)
_________________________________________________________________________________________________________________________________

The operation of the account will be:-

(a) By the Guardian till the depositor attains majority.

(b) By the depositor herself on attaining majority.

NOMINATION

I............................................................................... here by nominate the persons mentioned below to whom to the exclusion of all other

persons inthe event of my death the amount standing to my credit in ................................................................................. (Name of Scheme) at

the time of my death would be payable.

Sr Name(s) of the Full Address (s) Addhar number of Date(s) of birth of share of Nature of
No. nominee(s) nominee (optional) Nominee in case of minor entitlement entitlement
and relationship Trustee or
owner

1.

2.

3.

4.

As the nominee(s) at serial No(s) ....................................................................................................... specified above is/ are minors(s). I appoint

Shri/Smt/Kumari ................................................................................ S/o/D/o.W/o....................................................................................................

Address .......................................................................................................................................................................................................................

to receive the sum due under the said accont in the event of my death during the minority of the nominee(s).

1. signature of witness ......................................................................................................................

Name & Address ................................................................................................................................

2. signature of witness ......................................................................................................................

Name & Address ................................................................................................................................

Place: signature of thumb impression of guardian

date:
 INITIAL DEPOSIT & STANDING INSTRUCTION
I hereby tender ` ____________________________________________________(in words) towards initial subscription in

SSY Account by : Cheque No. drawn on ____________________________________

Dated Bank ___________________________ Branch favouring ICICI Bank - SSY account no.

Debit Mandate: Debit my existing account. ICICI Bank account

Standing Instructions: Debit Account No.

*Frequency: Monthly Quarterly Half Yearly Yearly

Date of Debit: Start date & End date

Amount in Words Rupees___________________________________________________________
• Deposit amount should not exceed Rs. 1,50,000 per financial year

IMPORTANT TERMS & CONDITIONS FOR SUKANYA SAMRIDDHI ACCOUNT

• ICICI Bank Limited (“ICICI Bank”), has been authorized/permitted by Ministry of Finance to accept subscription under the Sukanya Samriddhi Account Rules,
2014 (“Rules”). These Terms and Conditions for Sukanya Samriddhi Account (the “Terms”) apply to and regulate the provision of services pertaining to
Sukanya Samriddhi Account through ICICI Bank.
• These Terms are in addition to and not in derogation with (i) terms and conditions / rules / regulations / notifications / directives etc. governing Sukanya
Samriddhi Account and issued by appropriate / competent authorities under Rules / other applicable laws; (ii) Terms and Conditions for Sukanya Samriddhi
Account as available at the website of ICICI Bank and (iii) in case any other services of ICICI Bank like internet banking is availed, terms and conditions applica-
ble to such services shall be applicable (collectively referred to as “Primary Terms”).
• All capitalized terms used herein but not defined shall have the same meaning as specified under the Primary Terms.
• Guardian acknowledges that she/he has read the Terms and Conditions for Sukanya Samriddhi Account as available at the website of ICICI Bank and hereby
agrees to the same.
• The Account shall be opened with a minimum deposit of Rs. 250/- (Rupees Two Hundreds and Fifty only) or such other amount as maybe specified from
time to time by Ministry of Finance By way of cash or cheque.
• Subsequent deposit may be made by the Guardian in multiples of Rs. 50/- (Rupees Fifty only) such other amount as maybe specified from time to time by
Ministry of Finance by way of cash or cheque /electronic medium.
• Maximum amount deposited in an Account cannot exceed Rs.1,50,000/- (Rupees one lakh fifty thousand only) in a financial year or such other amount as
may be specified from time to time.
• Deposits in an account may be made till completion of 15 (fifteen) years, from the date of opening of the Account.
• An irregular account (where minimum amount of Rs.250/- or any other amount as may be specified from time to time, has not been deposited in any financial
year) may attract penalty of Rs. 50/- (Rupees fifty only) per year or such other amount as maybe specified from time to time.
• Partial withdrawal is permissible after the Beneficiary account holder has attained the age of eighteen years or has passed tenth standard, whichever is
earlier.
• Premature closure is permissible under below scenario without penalty:
a. Death of Beneficiary Account holder.
b. The Account holder becoming a Non-citizen or Non resident of India.
c. On ground of medical support in life threatening diseases of the Account holder or death of the guardian after completion of 5 year from account
opening.
• Interest: Interest as notified by Ministry of Finance from time to time shall be accrued to the account as per the Rules.
• Operation of account: The Account shall be opened and operated by the Guardian of a Beneficiary till the Beneficiary attains the age of 10 (ten) years. On
attaining age of 10 (ten) years, the Beneficiary may operate the Account, however, deposit in the account may be made by the Guardian or any other person
or authority.
• No failure or delay by ICICI Bank in exercising any right, power or privilege hereunder shall operate as a waiver thereof nor shall any single or partial exercise
of any other right, power or privilege hereunder shall operate as a waiver there of nor shall any single or partial exercise of any other right, power or privilege.
The rights and remedies of ICICI Bank as stated herein shall be cumulative and not exclusive of any right or remedies provided by law.
• The Guardian hereby agrees that the Guardian shall, at his/her own expenses, indemnify, defend and hold harmless ICICI Bank from and against any and all
liability any other loss/claims that may occur, arising from or relating to the operation or use of the Account or the services of ICICI Bank or breach, non-per-
formance or in adequate performance by the Guardian of these Terms or acts, non-errors, representations, misrepresentations, misconduct or negligence
of the Guardian in performance of its obligations.
• The Guardian hereby undertakes to comply with all the specified conditions under the Primary Terms and these Terms.
• ICICI Bank may, at its sole discretion, utilize the services of external service provider’s or agent’s and on such terms as required or necessary, in relation to
its products /services.
• The laws of India shall govern these Terms, ICICI Bank and the Guardian hereby agree that any legal action or proceedings arising out of the Terms shall be
brought in the courts or tribunals at Mumbai, India irrevocably submit them selves to the jurisdiction of such courts and tribunals.
a. Interest at the rate, to be notified by the Govt, compounded yearly shall be credited to the account till the account completes 21 years or maturity
whichever is earlier
b. The girl child must be a citizen of India as well as Resident Indian.
c. if the Bank finds out later that the residential status was non-resident or the citizenship was not Indian at the time of account opening then such
accounts will be treated as invalid and will be closed. No interest shall be payable on such accounts from the date of opening of the account.
I hereby declare that I have not opened a Sukanya Samriddhi Account in the name of the depositor in any of the Post office/Bank in the country.
I further declare that I and the depositor both are Resident citizen of India and undertake to inform the account office of any change in our residency/citizenship
status in future.
I hereby undertake to abide by the scheme provisions and Government Savings Promotion Rules, 2018 applicable on the Scheme and amendments issued
there to from time to time.

Date : Signature or thumb impression of Parent/guardian

DE-DUPE
For ICICI Bank Limited
I have checked customer’s residental status and I here by confirm that customer is not holding any NRI account under any CUST ID with ICICI Bank.
I have checked customer has not opened SSY account for the girl child with ICICI Bank

Bank
Name of Bank Official:___________________________________
Seal

Employee ID:___________________________________________ Sign:____________________________________________