Self Help Group - Savings Bank Account Opening Form

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ANNEXURE I

Form No.
Bank of Maharashtra

& Logo
Self Help Group - Savings Bank Account Opening Form
To: For Official Use Only
SB A/c No
The Branch Manager Customer ID
_____________________ Bank SHG Scheme
_____________________ Branch Code
(NRLM/Others)
Sub:-Application for SHG-SB A/C opening SHG Gender Code
(Male/Female)
Dear Madam/Sir,

1. We request you to open a Savings Bank Account in name of our Self Help Group. We agree to abide
by the rules and regulation of the bank related to Savings Account.

Name of SHG
Date of Number of Name of Facilitating
Formation Members Agency (if any)
Address Street ……………………….Village/ City…………………….Gram Panchayat……………….
Block ………………………..District…………………………..Pin………………………..
2. The Savings Account will be operated at Branch by Joint Signature and at BC Point Aadhaar based
Biometric authentication of Any Two among the following representatives of our Self Help Group. A copy
of resolution taken by our Self Help Group in this regard is attached.
3. Request for Cheque Book : Yes / No

Affix passport
Affix Affix passport Affix passport
passport
Size Size Size
Size Photo
photograph photograph photograph

Name : Name: Name:


Date of Birth: Age: Date of Birth: Age: Date of Birth: Age:
Designation: Designation: Designation:
Address: Address: Address:

Mobile: Mobile: Mobile:

KYC Documents Provided KYC Documents Provided KYC Documents Provided


Bank

Enclosed Copy of address & ID proof Enclosed Copy of address & ID proof Enclosed Copy of address & ID proof
Voter ID Driving license Voter ID Driving license Voter ID Driving license
Aadhar Card Job Card Aadhar Card Job Card Aadhar Card Job Card
PAN Card Passport PAN Card Passport PAN Card Passport

Any other document accepted by Any other document accepted by Any other document accepted by
Bank (specify) ………………………. Bank (specify) …………………….. Bank (specify) ……………………..

1
I give Consent for Aadhaar based I give Consent for Aadhaar based I give Consent for Aadhaar based
eKYC Account Opening for this SHG eKYC Account Opening for this SHG eKYC Account Opening for this SHG
and its Operation based on Aadhaar and its Operation on Aadhaar and its Operation based on Aadhaar
Biometric Authentication at BC point. Biometric Authentication at BC Point Biometric Authentication at BC Point

Yes No Yes No Yes No


C C C C C C

Specimen Signature/Thumb
Impression Specimen Signature/Thumb Specimen Signature/Thumb
Impression Impression

4.We hereby declare that the above information is true and correct. We have agreed to the terms
and conditions and also agree to abide by any amendments to the terms and conditions as may
be stipulated by the Bank from time to time.

5. Further, we confirm that in case of request of change of signatory details, we will submit our
request to Branch. After this submission, we will not do transaction at BC Point till the signatory
details are updated in Branch. However, if any transactions are done at BC Point by earlier
signatories, we shall be solely responsible for the same & Bank will not have any responsibility
towards it.

Yours faithfully,

1.______________ 2. __________________ 3. ________________

(Signature/Thumb Impression of SHG Representatives with Seal of SHG)

Date: Place:

Enclosure:
i. Copy of Resolution by Self Help Group to open Savings Account
ii. Photographs of authorized representatives
iii. Copy of ID and address proof of authorized representatives.

For Bank Use Only

1. The applicant has affixed his signature or thumb print, as the case may be, in my presence
2. I have explained the rules / regulations to the applicant __________________
3. Account has been opened on _______________________________
4. Cheque Book has been issued.

Date:__________________ Officer____________________

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