(ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt.

of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

IF (GEN) 1845
‰¸¸÷¸¸ ¬¸¿¿./Account No.
¬¸½¨¸¸ Ÿ¸½¿/To: œÏ¤¸¿š¸ˆÅ/¨¸¢£«“ œÏ¤¸¿š¸ˆÅ
ˆ½Å›¸£¸ ¤¸ÿˆÅ/CANARA BANK,
----------------------------------------------
¢›¸¨¸¸¬¸ú ž¸¸£÷¸ú¡¸¸½¿ ˆ½Å ¢¥¸‡ ‰¸¸÷¸¸ ‰¸¸½¥¸›¸½ ˆÅ¸ œ¸€¸Ÿ¸Ä
ACCOUNT OPENING FORM FOR NON RESIDENT INDIANS
›¸¸Ÿ¸ ‡¨¸¿ œ¸÷¸¸/NAME & ADDRESS: Stamp size
Photo of
ˆ¼Åœ¸¡¸¸ ›¸ú¸½ ¢™‡ Š¸‡ ¤¡¸¸½£½ ˆ½Å ‚›¸º¬¸¸£ ‡ˆÅ ‰¸¸÷¸¸ ‰¸¸½¥¸½¿ (›¸¸Ÿ¸ ¬œ¸«’ ‡¨¸¿ ‚¸Ô¸®¸£¸½¿ ˆÅ¸½ œ¸»£¸ ¢¥¸‰¸½¿) First
Applicant
Please open an account as per details below (in capital letters & expanded initials) Latest photo
œÏ˜¸Ÿ¸ ›¸¸Ÿ¸ Ÿ¸š¡¸ ›¸¸Ÿ¸ ‚¿¢÷¸Ÿ¸ ›¸¸Ÿ¸
FIRST NAME MIDDLE NAME LAST NAME
Stamp size
1. œ¸í¥¸¸ ‚¸¨¸½™ˆÅ/First Applicant Photo of
Second
2. ™»¬¸£¸ ‚¸¨¸½™ˆÅ/Second Applicant Applicant
Latest photo
3. ÷¸ú¬¸£¸ ‚¸¨¸½™ˆÅ/Third Applicant
4. ¸¸¾˜¸¸ ‚¸¨¸½™ˆÅ/Fourth Applicant Stamp size
Photo of
Third
¢¨¸™½©¸ ˆÅ¸ œ¸÷¸¸/ Overseas address Applicant
_____________________________________________________________________ Latest photo

_____________________________________________________
ûŸ½›¸ ¬¸¿ Phone No. (‚¸ƒÄ.‡¬¸.”ú. ˆ»Å’ ˆ½Å ¬¸¸˜¸/with ISD Code)_________________________ Stamp size
ƒÄ-Ÿ¸½¥¸/E MAIL____________________ œ¸¾€Æ¬¸ ¬¸¿./FAX NO.______________________ Photo of
Fourth
Applicant
ž¸¸£÷¸ú¡¸ œ¸÷¸¸/Indian Address ________________________________________________ Latest photo
________________________________________________________________________
œ¸€¸½›¸ ¬¸¿./Phone No. ____________________________

‚›¡¸ ¤¡¸¸½£¸/Other Details

ˆ¼Åœ¸¡¸¸ „¬¸ œ¸÷¸½ œ¸£ ¢›¸©¸¸›¸ ¥¸Š¸¸‡¿ ¸í¸Â ”¸ˆÅ ¸¸›¸ú ¸¸¢í‡ (¡¸¢™ ‚¸œ¸ ‚œ¸›¸¸ ”¸ˆÅ ˆÅ¸½ £¸½ˆ½Å £‰¸›¸¸ ¸¸í÷¸½ í¸½¿, ÷¸¸½ ¤¸¸ÁƬ¸ œ¸£
¥¸Š¸¸‡¿
Please Tick  Address to which mail to be sent. If you want your mail held, please tick the
box 
¸›Ÿ¸ ¢÷¸¢˜¸ (‚¨¸¡¸¬ˆÅ ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿) / Date of Birth (in case of minor)_________________

1
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

‰¸¸½¥¸½ ¸¸›¸½ ¨¸¸¥¸½ ‰¸¸÷¸½ ˆÅ¸ œÏˆÅ¸£ /TYPE OF ACCOUNT TO BE OPENED

ˆ¼Åœ¸¡¸¸ ¤¸¸ÁƬ¸(¤¸¸ÁƬ¸¸¸½¿) œ¸£  ¥¸Š¸¸‡¿ Ÿ¸ºÍ¸ ¨¸ £¸¢©¸ / ‚¨¸¢š¸ /
Please  Tick box(es) Currency and Amt. Period
1. ¢¨¸™½©¸ú Ÿ¸ºÍ¸ (‚¢›¸¨¸¸¬¸ú) ¬¸¸¨¸¢š¸ ¸Ÿ¸¸ ‰¸¸÷¸¸ (¤¸ÿˆÅ ˆÅú ¡¸¸½¸›¸¸)
- ¬¸¸š¸¸£μ¸ ¤¡¸¸¸ (¢¨¸.Ÿ¸º.’.[¤¸ÿˆÅ] ¬¸¸.¸Ÿ¸¸) /
Foreign Currency (Non Resident) Term Deposit
Account (Bank Scheme) Simple Interest
(FCNR(B) FDR)
2. ¢¨¸™½©¸ú Ÿ¸ºÍ¸ (‚¢›¸¨¸¸¬¸ú) ¬¸¸¨¸¢š¸ ¸Ÿ¸¸ ‰¸¸÷¸¸ (¤¸ÿˆÅ ˆÅú ¡¸¸½¸›¸¸)
- ¸ÇŨ¸¼¢Ö ¤¡¸¸¸ - ŽŸ¸¸íú ‚¿÷¸£¸¥¸¸½¿ œ¸£ −¸½Š¸¸ (¢¨¸.Ÿ¸º.’.[¤¸ÿˆÅ]
ˆÅ¸Ÿ¸š¸½›¸º ¸Ÿ¸¸) /
Foreign Currency (Non Resident) Term Deposit
Account (Banks Scheme)-Compounded interest
half yearly rests (FCNR-B-KDR)
3. ‚¢›¸¨¸¸¬¸ú (¤¸¸à¸) ¬¸¸¨¸¢š¸ ¸Ÿ¸¸ - ¬¸¸š¸¸£μ¸ ¤¡¸¸¸
.. .. .. .. .. ². Ÿ¸½¿ (‚¢›¸. ¤¸¸à¸ - ¬¸¸.¸Ÿ¸¸) /
Non Resident (External) Term Deposit Simple
Interest in Rs. (NRE-FDR)
4. ‚¢›¸¨¸¸¬¸ú ¤¸¸à¸ (œ¸º›¸¢›¸Ä¨¸½©¸ ¡¸¸½¸›¸¸) ¸Ÿ¸¸ - ¸ÇŨ¸¼¢Ö ¤¡¸¸¸ -
¢÷¸Ÿ¸¸íú .. .. .. .. .. ². Ÿ¸½¿ (‚¢›¸. ¤¸¸à¸-ˆÅ¸ ¸Ÿ¸¸)
Non Resident External (Re-investment Plan)
Deposit - Compound interest- Quarterly .. .. .. ..
.. in Rs. (NRE-KDR)
5. ‚¢›¸¨¸¸¬¸ú ¤¸¸à¸ ‚¸¨¸÷¸úÄ ¸Ÿ¸¸ .. .. .. .. .. .. ². Ÿ¸½¿ (‚¢›¸.
¤¸¸à¸-ˆÅ¸ ¸Ÿ¸¸)/
Non-Resident (External) Recurring Deposit .. ..
.. .. .. ..in Rs. (NRE-RD)
6. ‚¢›¸¨¸¸¬¸ú (¬¸¸Ÿ¸¸›¡¸) ¤¸¸÷¸ ¤¸ÿˆÅ ‰¸¸÷¸¸ / ¸¸¥¸» ‰¸¸÷¸¸ / ¬¸¸¨¸¢š¸
¸Ÿ¸¸ ‰¸¸÷¸¸ (¬¸¸¨¸¢š¸ ¸Ÿ¸¸) (ˆ½Å¨¸¥¸ ¬¸¸š¸¸£μ¸ ¤¡¸¸¸ ²œ¸¡¸¸ Ÿ¸½¿
(‡›¸’¸£’¸½) - ¤¸.¤¸ÿ./¸¸.‰¸¸./¬¸¸.¸Ÿ¸¸) /
Non Resident (Ordinary) Savings Bank Account
/ Current Account / Term Deposit Account
(FDR) (Simple Interest Only) in Rs. (NRO
SB/NRO CA/NRO-FDR)
7. ‚¢›¸¨¸¸¬¸ú (¤¸¸à¸) ¤¸¸÷¸ ¤¸ÿˆÅ ‰¸¸÷¸¸ / ¸¸¥¸» ‰¸¸÷¸¸ ². Ÿ¸½¿
(‚¢›¸¨¸¸¬¸ú ¸¸¥¸» ‰¸¸÷¸¸) /Non Resident (External)
Savings Bank A/c/Current A/c. in Rs. (NRE-
CA)

2
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

¬¸¿£¸›¸¸ /Constitution

¨¡¸¢Æ÷¸Š¸÷¸ / Individual ¬¨¸¸¢Ÿ¸÷¨¸/Proprietorship ¬¨¸¸¢Ÿ¸÷¨¸ œ¸€Ÿ¸Ä/Partnership

Firm
(‡ˆÅ¥¸/¬¸¿¡¸ºÆ÷¸/Single/Joint)
¢Ÿ¸¢ª÷¸ œ¸»Â¸ú ˆ¿Åœ¸›¸ú/Joint ‚›¡¸/Others.. .. .. .. .. .. .. .. .. .. .. .. ..(ˆ¼Åœ¸¡¸¸ ¬œ¸«’
Stock Company ˆÅ£½¿/please specify)

(¢¸›¸ Ÿ¸¸Ÿ¸¥¸¸½¿ Ÿ¸½¿ ¬¨¸¸¢Ÿ¸÷¨¸/¢í÷¸¸¢š¸ˆÅ¸£ œÏ÷¡¸®¸÷¸À ‚¢›¸¨¸¸¬¸ú ž¸¸£÷¸ú¡¸¸½¿ ˆ½Å œ¸¸¬¸ í¸½¿ „›¸Ÿ¸½¿, ˆ¼Åœ¸¡¸¸ œ¸€¸Ÿ¸Ä ‚¸½.‡.¬¸ú. Ÿ¸½¿ ÷¸˜¸¸
¢¸›¸Ÿ¸½¿ ¨¸½ ‚œÏ÷¡¸®¸÷¸À „›¸ˆ½Å œ¸¸¬¸ í¸½¿, „›¸Ÿ¸½¿ œ¸€¸Ÿ¸Ä ‚¸½.‡.¬¸ú. 1 Ÿ¸½¿ ¬¸Ÿ¸ºÍœ¸¸£ú¡¸ ¥¸½‰¸¸ œ¸£ú®¸ˆÅ ¬¸›¸™ú ¥¸½‰¸¸ˆÅ¸£ / œÏŸ¸¸¢μ¸÷¸
¥¸¸½ˆÅ ¥¸½‰¸¸ˆÅ¸£ œÏŸ¸¸μ¸-œ¸°¸ ¬¸¢í÷¸ ¢Ÿ¸¢ª÷¸ œ¸»Â¸ú ˆ¿Åœ¸¢›¸¡¸¸½¿ ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿ ¬¸¿¬˜¸¸ ±¸¸œ¸›¸ ÷¸˜¸¸ ¬¸¿¬˜¸¸ ‚¿÷¸¢›¸Ä¡¸Ÿ¸¸¨¸¥¸ú ‡¨¸¿ ¢›¸Š¸Ÿ¸›¸
œÏŸ¸¸μ¸-œ¸°¸ ‚¸¾£ ¬¸¸¸½™¸£ú œ¸€¸Ÿ¸¸½¿Ä ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿ ¬¸¸¸½™¸£ú ¢¨¸¥¸½‰¸ ¬¸¿¥¸Š›¸ ˆÅ£›¸½ −½÷¸º ›¸¸½’ ˆÅ£½¿ — /
Please note to enclose memorandum of association/Articles of Association and Certificate of
incorporation in case of Joint stock companies and Partnership deed for Partnership firms along
with overseas auditor/chartered accountant/certified Public Accountant Certificate in FORM
OAC where owernership/beneficial interest is directly held by NRI and form OAC1 where it is
held indirectly).

œ¸¸£œ¸°¸ ˆÅ¸ ¤¡¸¸½£¸ / PASSPORT DETAILS

œ¸¸¬¸œ¸¸½’Ä ¬¸¿. ¸¸£ú ˆÅ£›¸½ ˆÅú ¢÷¸¢˜¸ ¨¸ £¸«’ïú¡¸÷¸¸/ ¨¸÷¸ÄŸ¸¸›¸ ¨¡¸¨¸¬¸¸¡¸

Passport No. ¬˜¸¸›¸ Date & Place Nationality Present
of Issue Occupation
œ¸í¥¸¸ ‚¸¨¸½™ˆÅ/
First Applicant
™»¬¸£¸ ‚¸¨¸½™ˆÅ /
Second Applicant
÷¸ú¬¸£¸ ‚¸¨¸½™ˆÅ /
Third Applicant

œ¸¹£¸¸¥¸›¸ ¢¨¸¢š¸ / MODE OF OPERATION

1. ‡ˆÅ¥¸ / Single
2. ™¸½›¸¸½¿ Ÿ¸½¿ ¬¸½ „÷÷¸£¸ú¨¸ú / Either or Survivor
3. œ¸»¨¸Ä¨¸÷¸úÄ ¡¸¸ „÷÷¸£¸ú¨¸ú / Former or Survivor
4. „÷÷¸£¨¸÷¸úÄ ¡¸¸ ퟸ ™¸½›¸¸½¿ Ÿ¸½¿ ¬¸½ „÷÷¸£¸ú¨¸ú / Latter or Survivor
5. ™¸½›¸¸½¿ ¡¸¸ ퟸ¬¸½ „÷÷¸£¸ú¨¸ú / Both or Survivor of us
6. ________________________
(ˆ¼Åœ¸¡¸¸ ¬œ¸«’ ˆÅ£½¿ / Please specify)

3
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

¢¨¸œÏ½«¸μ¸ ˆÅ¸ ¤¡¸¸½£¸ / DETAILS OF REMITTANCE

1. Ÿ¸¸ÂŠ¸ ”ï¸É’ ¬¸¿. ________________ ¢™›¸¸¿ˆÅ __________ £¸¢©¸ __________________ (¬¸¿¥¸Š›¸)

Demand Draft No. ____________________ Dt. __________ for
_________________ amount (enclosed)
2. ”¸ˆÅ-‚¿÷¸£μ¸ / ÷¸¸£ ‚¿÷¸£μ¸ ¬¸¿. ____________ ¢™›¸¸¿ˆÅ _________ ________________________
ˆ½Å ¢¥¸‡
Mail Transfer/Telegraphic Transfer No. _____________ Dt. ____________ for
_____________________
3. ¢¨¸œÏ½«¸ˆÅ ¤¸ÿˆÅ ˆÅ¸ ›¸¸Ÿ¸ ÷¸˜¸¸ œ¸÷¸¸ / Name and Address of the Remitting bank
_________________________________________________
_____________________________________________________

¤¡¸¸¸ ˆ½Å ž¸ºŠ¸÷¸¸›¸ / ›¸¨¸úˆÅ£μ¸ ‚¸¢™ ¬¸¿¤¸¿š¸ú ‚›¸º™½©¸ /INSTRUCTIONS REGARDING INTEREST
PAYMENT/RENEWAL ETC
1. ˆ¼Åœ¸¡¸¸ ¬¸¸¨¸¢š¸ ¸Ÿ¸¸ £¬¸ú™ ¬¸º£¢®¸÷¸ ‚¢ž¸£®¸¸ Ÿ¸½¿ £‰¸½ ÷¸˜¸¸ ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ œ¸£ „¬¸ú ‚¨¸¢š¸ ˆ½Å ¢¥¸‡ ›¸¨¸úˆÅ£μ¸ ˆÅ£½¿
/Please keep Term Deposit Receipt in Safe Custody and renew for similar period on
maturity
2. ˆ¼Åœ¸¡¸¸ ¤¡¸¸¸ Ÿ¸º¸½ ”ï¸É’ ¬¸½ ž¸½¸½¿ / Please remit interest by Draft to me
3. ¤¡¸¸¸ ‚¸œ¸ˆ½Å ¡¸í¸Â £−›¸½ ¨¸¸¥¸¸ Ÿ¸½£½ ¤¸¸÷¸ ¤¸ÿˆÅ / ¸¸¥¸» ‰¸¸÷¸¸ ¬¸¿. Ÿ¸½¿ ¸Ÿ¸¸ ˆÅ£½¿ /Credit Interest to my
SB/CA No. with you _______________________________
4. _____________________________________________________
(ˆ¼Åœ¸¡¸¸ ‚›¡¸ ‚›¸º™½©¸ ¬œ¸«’ ˆÅ£½¿/Please specify other instruction)

@‡.’ú.‡Ÿ¸./”½¢¤¸’ ˆÅ¸”Ä ATM/DEBIT CARD:

Please issue me/us Debit Card (Name to be embossed on Card)

œ¸í¥¸¸ ‚¸¨¸½™ˆÅ /First Applicant

™»¬¸£¸ ‚¸¨¸½™ˆÅ /Second Applicant

÷¸ú¬¸£¸ ‚¸¨¸½™ˆÅ /Third Applicant

¸¸¾˜¸¸ ‚¸¨¸½™ˆÅ /Fourth Applicant

4
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

@Æ¡¸¸ ƒ¿’£›¸½’ ¤¸ÿ¢ˆ¿ÅŠ¸ ¬¸º¢¨¸š¸¸ ¸¸¢í‡ À í¸Â ›¸íì

INTERNET BANKING FACILITY REQUIRED: Yes No

ˆÅ. œ¸»Ž÷¸¸Ž ¬¸º¹¨¸š¸¸‡¿ ¸¾¬¸½ ‰¸¸÷¸¸ ¡¸¸¾£¸, ¬¸¿¨¡¸¨¸−¸£ ¡¸¸¾£¸ ™½‰¸›¸¸ ‚¸¹™, œ¸¡¸¸Äœ÷¸ −ÿ
a Enquiry facilities like Enquiry of Account Details, viewing transaction details etc. is
sufficient í¸Â /YES ›¸íì/NO

‰¸. ¹¨¸î¸ú¡¸ ¬¸¿¨¡¸¨¸−¸£ ¬¸º¹¨¸š¸¸‡Â ¸¾¬¸½ ¹›¸¹š¸‚¿÷¸£μ¸, ƒÄ ž¸ºŠ¸÷¸¸›¸

b Financial Transaction facilities like Funds Transfer, E payment, Deposit Opening, Stop
Payment etc.
¸¸¢í‡/REQUIRED ›¸íì ¸¸¢í‡/NOT REQUIRED

Ÿ¸¸½¤¸¸ƒ¥¸ ¤¸ÿ¢ˆ¿ÅŠ¸ ¬¸º¢¨¸š¸¸ ¸¸¢í‡/MOBILE BANKING FACILITIES REQUIRED

í¸Â/YES ›¸íì/NO
‚¸œ¸ˆÅ¸ Ÿ¸¸½¤¸¸ƒ¥¸ ¬¸¿/YOUR MOBILE NO.________________________

‡¬¸.‡Ÿ¸.‡¬¸ ‚›¸º£¸½š¸ ¬¸º¢¨¸š¸¸ / SMS REQUEST FACILITY

¸¸¢í‡/REQUIRED ›¸íì ¸¸¢í‡/NOT REQUIRED

‚¥¸’Ä ¬¸º¢¨¸š¸¸/ALERT

¸¸¢í‡/REQUIRED ›¸íì ¸¸¢í‡/NOT REQUIRED

¸¸÷¸ ¸ÿˆÅ/¸¸¥¸» ‰¸¸÷¸¸, ‡›¸ ‚¸£ ƒÄ/‡›¸ ‚¸£ ‚¸½ ‰¸¸÷¸¸‚¸½¿ ˆ½Å ‰¸º¥¸›¸½ œ¸£ „œ¸¥¸š¸ −ÿ @AVAILABLE ONLY
WITH OPENING OF SB/CA NRE/NRO ACCOUNTS

¡¸¹™ ‚¥¸’Ä ¬¸º¢¨¸š¸¸ ¸¸¢í‡ ÷¸¸½ ¢›¸Ÿ›¸ ¤¡¸¸¾£¸ ™½¿ / IF ALERT FACILITY IS REQUIRED, PROVIDE THE
FOLLOWING DETAILS
‚¥¸’Ä ˆ½Å œÏˆÅ¸£ ¹ˆÅ÷¸›¸ú £¸©¸ú ˆ½Å ¹¥¸‡ ¹ˆÅ¬¸ ‰¸¸÷¸¸ ¬¸¿. Ÿ¸½¿ ‚¥¸’Ä ¡¸¹™ ¡¸− ¬¸º¹¨¸š¸¸ ¸¸¹−‡ ÷¸¸½ ¬¸¿™½©¸
TYPE OF ALERT ‚¥¸’Ä ž¸½¸¸ ¸¸‡ ž¸½¸¸ ¸¸‡ (¡¸−¸Â ‡ˆÅ ¹ˆÅ¬¸ Ÿ¸¸š¡¸Ÿ¸ ¬¸½ ž¸½¸¸ ¸¸›¸¸ −¾ „¬¸½
(›¡¸»›¸÷¸Ÿ¸ £¸©¸ú ¬¸½ ¡¸¸™¸ ‰¸¸÷¸¸‚¸½¿ ˆÅ¸ ¹’ˆÅ ˆÅ£½¿ — IF THIS
².10,000/- −¸½›¸ú „¥¥¸½‰¸ ¹ˆÅ¡¸¸ ¸¸‡ — FACILITY IS REQUIRED,
¸¸¹−‡) AMOUNT A/C NO. FOR TICK ONE OF THE
ABOVE WHICH WHICH ALERT FOLLOWING ITEMS
ALERT TO BE TO BE SENT THROUGH WHICH ALERT
SENT (MIN. (MORE THAN MESSAGE TO BE SENT
AMOUNT ONE ACCOUNT
SHOULD CAN BE
RS.10,000-) MENTIONED
HERE
›¸¸Ÿ¸½ ¥¸½›¸™½›¸ DEBIT ‡¬¸ ‡Ÿ¸ ƒÄ-Ÿ¸½¥¸ E ™¸½›¸¸½¿
TRANSACTION ‡¬¸ MAIL BOTH
SMS
¸Ÿ¸¸ ¥¸½›¸™½›¸ CREDIT ‡¬¸ ‡Ÿ¸ ƒÄ-Ÿ¸½¥¸ E ™¸½›¸¸½¿
TRANSACTION ‡¬¸ MAIL BOTH
SMS

5
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

Ÿ¸¸−¨¸¸£ ©¸½«¸‚¥¸’Ä ¥¸¸Š¸» ›¸−ú¿ NOT ‡¬¸ ‡Ÿ¸ ƒÄ-Ÿ¸½¥¸ E ™¸½›¸¸½¿

BALANCE ALERT APPLICABLE ‡¬¸ MAIL BOTH
ON MONTHLY SMS
BASIS
‰¸¸÷¸¸‚¸½¿ Ÿ¸½¿ ’ú‚¸½”ú ž¸½¸›¸½ ¥¸¸Š¸» ›¸−ì NOT ‡¬¸ ‡Ÿ¸ ƒÄ-Ÿ¸½¥¸ E ™¸½›¸¸½¿
ˆ½Å ¹¥¸‡ / TOD IN THE APPLICABLE ‡¬¸ MAIL BOTH
A/Cs. SMS
‚¥¸’Ä ž¸½¸›¸½ ˆ½Å ¹¥¸‡ ƒÄ-Ÿ¸½¥¸
‚¸ƒÄ.”ú.
E MAIL ID TO
WHICH ALERT TO
BE SENT

‹¸¸½«¸μ¸¸‡Â /DECLARATIONS:

1Å. Ÿ¸ÿ / ퟸ ‡÷¸™Ã׸£¸ ‹¸¸½«¸μ¸¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ ¢ˆÅ Ÿ¸ÿ / ퟸ ž¸¸£÷¸ú¡¸ Ÿ¸»¥¸ ˆÅ¸ / ˆ½Å ‚¢›¸¨¸¸¬¸ú ž¸¸£÷¸ú¡¸ Ÿ¸»¥¸ ˆÅ¸ / ˆ½Å
‚¢›¸¨¸¸¬¸ú ž¸¸£÷¸ú¡¸ í» / íÿ ¢ˆÅ ¡¸í¸Â ¢™¡¸¸ Š¸¡¸¸ ˆÅ¸½ƒÄ ¢¨¸¨¸£μ¸ / ‹¸¸½«¸μ¸¸ ÷¸¸¢÷¨¸ˆÅ ³œ¸ ¬¸½ “úˆÅ ›¸íì œ¸¸¡¸¸ ¸¸÷¸¸ / ¸¸÷¸ú í¾ ÷¸¸½
‚¸œ¸ Ÿ¸½£½ / ퟸ¸£½ ׸£¸ ¸Ÿ¸¸ ˆÅú Š¸ƒÄ £¸¢©¸ œ¸£ ˆÅ¸½ƒÄ ¤¡¸¸¸ ‚™¸ ˆÅ£›¸½ ˆ½Å ¢¥¸‡ ¤¸¸š¡¸ ›¸íì í¸½¿Š¸½ —

1. I/We hereby declare that I am/we are Non Resident Indian/s of Indian origin. I/We
understand that the above account/s will be opened on the basis of the statements/declarations
made by me/us and I/we also agree that if any of the statements/declarations made herein is
found to be not correct in material particulars you are not bound to pay any interest on the
deposit made by me/us.

2. Ÿ¸ÿ / ퟸ „¬¸ˆ½Å ¢¥¸‡ ¬¸íŸ¸÷¸ í» / íÿ ¢ˆÅ ¸Ÿ¸¸£¸¢©¸ / £¸¢©¸¡¸¸½¿ ˆÅú ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ ˆÅú ¢÷¸¢˜¸ / ¢÷¸¢˜¸¡¸¸½¿ ˆ½Å ¤¸¸™ Ÿ¸ÿ /
ퟸ „›¸ œ¸£ ¢ˆÅ¬¸ú ¤¡¸¸¸ ˆÅ¸ ™¸¨¸¸ ›¸íì ˆÅ³¿Š¸¸ / ˆÅ£½¿Š¸½ — Ÿ¸ÿ / ퟸ ¢¨¸™½©¸ú Ÿ¸ºÍ¸ (‚¢›¸¨¸¸¬¸ú) ‰¸¸÷¸¸ (¤¸ÿˆÅ) ¡¸¸½¸›¸¸ /
‚¢›¸¨¸¸¬¸ú (¤¸¸à¸) ¥¸½‰¸¸ / ‚¢›¸¨¸¸¬¸ú (¬¸¸š¸¸£μ¸) ¥¸½‰¸¸ ¡¸¸½¸›¸‚¸½¿ ˆ½Å „œ¸¤¸¿š¸¸½¿ ˆÅ¸ ‚›¸ºœ¸¸¥¸›¸ ˆÅ£›¸½ ˆ½Å ¢¥¸‡ ¬¸íŸ¸÷¸ í» / íÿ — Ÿ¸ÿ
/ ퟸ ž¸¸£÷¸ Ÿ¸½¿ ¬˜¸¸¡¸ú ¢›¸¨¸¸¬¸ ˆ½Å ¢¥¸‡ ¨¸¸œ¸¬¸ ‚¸›¸½ œ¸£ ÷¸º£¿÷¸ ‚¸œ¸ˆÅ¸½ ‚œ¸›¸½ ¥¸¸¾’›¸½ ˆÅú ¬¸»¸›¸¸ ™½›¸½ ˆÅ¸ ¨¸¸›¸ ™½÷¸¸ í» / ™½÷¸½ íÿ —

I/We agree that no claim will be made by me/us for any interest on the deposit/s for any period
after the date/s of maturity of the deposit/s. I/we agree to abide by the provisions of Foreign
Currency (Non Resident) Account (Banks) Scheme/Non Resident (External) Account/Non
Resident (Ordinary) Account Schemes. I/We hereby undertake to intimate you about my/our
return to India for permanent residence immediately on arrival.

3. Ÿ¸ÿ / ퟸ ƒ¬¸ˆ½Å ¢¥¸‡ ¬¸íŸ¸÷¸ íÂÁ» / íÿ ¢ˆÅ Ÿ¸½£½ / ퟸ¸£½ ‚›¸º£¸½š¸ œ¸£ ¬¸Ÿ¸¡¸ œ¸»¨¸Ä £¸¢©¸ ¢›¸ˆÅ¸¥¸›¸½ ˆÅú ‚›¸ºŸ¸¢÷¸ ™ú ¸¸÷¸ú í¾
÷¸¸½ ¸Ÿ¸¸£¸¢©¸ œ¸£ ¤¡¸¸¸ ƒ¬¸ ¬¸¿¤¸¿š¸ Ÿ¸½¿ ¤¸ÿˆÅ ׸£¸ ¢›¸š¸¸Ä¢£÷¸ œÏ¸¢¥¸÷¸ ©¸÷¸¸½¿Ä ˆ½Å ‚¸š¸¸£ œ¸£ ‚›¸ºŸ¸÷¸ ¢ˆÅ¡¸¸ ¸¸‡Š¸¸ —

I/We agree that if the premature withdrawal is permitted of my/our request, the payment of
interest on the deposit may be allowed in accordance with the prevailing stipulations laid down
by the Bank in this regard.

6
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

4. Ÿ¸ÿ / ퟸ ‚¸œ¸¬¸½ ‚›¸º£¸½š¸ ÷¸˜¸¸ ‚¸œ¸ˆÅ¸½ œÏ¸¢š¸ˆ¼Å÷¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ ¢ˆÅ Ÿ¸½£½ / ퟸ¸£½ ׸£¸ „Æ÷¸ ‰¸¸÷¸½ Ÿ¸½¿ ˆÅ¸’½ Š¸‡
¬¸ž¸ú ¸½ˆÅ ¡¸¸ ‚›¡¸ ‚¸™½©¸ ¬¨¸úˆÅ¸£½¿ ÷¸˜¸¸ Ÿ¸ÿ / ퟸ ‚¸œ¸¬¸½ ‡½¬¸½ ¬¸ž¸ú ¸½ˆÅ „Æ÷¸ ‰¸¸÷¸½ Ÿ¸½¿ ›¸¸Ÿ¸½ ”¸¥¸›¸½ ˆÅ¸ ‚›¸º£¸½š¸ ˆÅ£÷¸¸ í» /
ˆÅ£÷¸½ íÿ ž¸¥¸½ íú ‡½¬¸½ ‰¸¸÷¸½ Ÿ¸½¿ „¬¸ ¬¸Ÿ¸¡¸ £ˆÅŸ¸ ¸Ÿ¸¸ í¸½¿ / ¸Ÿ¸¸ £ˆÅŸ¸ ¬¸½ ‚¢š¸ˆÅ £ˆÅŸ¸ ˆ½Å ¸½ˆÅ ¢™‡ Š¸‡ í¸½¿ —

I/We request and authorise you to honour all cheques or other orders drawn by me/us on the
said account and I/we request you to debit such cheques to the said account whether such
account be for the time being in credit/overdrawn.
5. Ÿ¸½£½ / ퟸ¸£½ ׸£¸ ¬¸Ÿ¸¡¸-¬¸Ÿ¸¡¸ œ¸£ ¨¸¬¸»¥¸ú ¡¸¸ œ¸£ÇŸŸ¸μ¸ ˆ½Å ¢¥¸‡ ¸Ÿ¸¸ ¢ˆÅ‡ ¸½ˆÅ¸½¿ ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿, ¡¸¢™ ¸½ˆÅ ‡½¬¸½ ¬˜¸¸›¸¸½¿
œ¸£ ™½¡¸ í¸½, ¸í¸Â ‚¸œ¸ˆÅú ©¸¸‰¸¸ ›¸íì íÿ, Ÿ¸ÿ / ퟸ „›í½¿ œ¸»μ¸Ä÷¸À Ÿ¸½£ú / ퟸ¸£ú ¢¸ŸŸ¸½™¸£ú ÷¸˜¸¸ ¸¸½¢‰¸Ÿ¸ œ¸£ ‚¸œ¸ ¬¸½ „›í½¿ ¢ˆÅ¬¸ú
‚›¡¸ ¤¸ÿˆÅ ˆ½Å Ÿ¸¸š¡¸Ÿ¸ ¬¸½ ¨¸¬¸»¥¸ ˆÅ£›¸½ ˆÅ¸ ‚›¸º£¸½š¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ — ¡¸¢™ ‡½¬¸½ ¸½ˆÅ / ”ï¸É’ ‚¸œ¸ ׸£¸ œ¸£ÇŸ¢Ÿ¸÷¸ ¢ˆÅ‡
¸¸÷¸½ íÿ ÷¸˜¸¸ ¨¸½ Ÿ¸¸Š¸Ä Ÿ¸½¿ ¡¸¸ ‚›¡¸˜¸¸ ‰¸¸½ ¸¸÷¸½ íÿ ÷¸¸½ Ÿ¸ÿ / ퟸ Ÿ¸¸¿Š¸½ ¸¸›¸½ œ¸£ ‡½¬¸½ ”ï¸É’¸½¿, ¸½ˆÅ¸½¿ ˆÅú œ¸»μ¸Ä £¸¢©¸ ˆÅú ‚¸œ¸ˆÅ¸½
œÏ¢÷¸œ¸»¢÷¸Ä ˆ½Å ¢¥¸‡ ¬¸íŸ¸÷¸ í» / íÿ —

In the matter of cheques lodged by me/us with you from time to time for collection or
negotiation where the cheques payable at places where you have not established your branches,
I /We request you to collect them through any bank entirely at my / our risk and responsibility.
Where such drafts/cheques are negotiated by you and the same are lost in transit or otherwise,
I/We hereby agree to reimburse to you the full amount of such drafts, cheques on demand
6. Ÿ¸ÿ / ퟸ ‡½¬¸½ ‰¸¸÷¸½ ˆ½Å œÏ¸¸¥¸›¸ ˆ½Å ¢¥¸‡ ¢œ¸€¥¸í¸¥¸ ¥¸¸Š¸» ¤¸ÿˆÅ ˆ½Å ¢›¸¡¸Ÿ¸¸½¿ ˆÅ¸ ‚›¸ºœ¸¸¥¸›¸ ˆÅ£›¸½ ÷¸˜¸¸ „¬¸¬¸½ ‚¸¤¸Ö í¸½›¸½
ˆ½Å ¢¥¸‡ ¬¸íŸ¸÷¸ í¿» / íÿ —

I/We agree to comply with and to be bound by the Banks rules for the time being in force for
the conduct of such accounts. I/We declare that the rules in force have been read by me/us.
7. Ÿ¸ÿ / ퟸ ¤¸ÿˆÅ ˆÅ¸½ ƒ¬¸ˆ½Å ¢¥¸‡ œÏ¸¢š¸ˆ¼Å÷¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ ¢ˆÅ ¡¸¢™ ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ ¬¸½ œ¸í¥¸½ ¤¸ÿˆÅ ˆÅ¸½ Ÿ¸½£½ / ퟸ¸£½
ˆÅ¸½ƒÄ œÏ¢÷¸ˆ»Å¥¸ ‚›¸º™½©¸ œÏ¸œ÷¸ ›¸ í¸½¿ ÷¸¸½ ¸Ÿ¸¸£¸¢©¸ ˆÅ¸½ ¤¸ÿˆÅ „÷¸›¸ú íú ‚¨¸¢š¸ ˆ½Å ¢¥¸‡ ¬¨¸÷¸À ›¸¨¸úˆ¼Å÷¸ ˆÅ£ ™½¿ — Ÿ¸ÿ / ퟸ ¡¸í
¬¸Ÿ¸¸÷¸¸ í» /¬¸Ÿ¸¸÷¸½ íÿ ¢ˆÅ ›¸¨¸úˆÅ£μ¸ „¬¸ ¬¸Ÿ¸¡¸ ¥¸¸Š¸» ž¸¸£÷¸ú¡¸ ¢£{¸¨¸Ä ¤¸ÿˆÅ ˆ½Å ¢™©¸¸-¢›¸™½Ä©¸¸½¿ ˆ½Å „œ¸¤¸¿š¸¸½¿ ˆ½Å ‚›¸º¬¸¸£ í¸½Š¸¸ —

I/We authorise the bank to automatically renew the deposit on the due date for an identical
period unless the instructions to the contrary from me/us is received by the bank before
maturity, I /we understand that the renewal will be in accordance with the provisions of the
Reserve bank of India guidelines/directives in force at the time of renewal.
8. Ÿ¸ÿ / ퟸ ¡¸í ž¸ú ¬¸Ÿ¸¸÷¸¸ í» / ¬¸Ÿ¸¸÷¸½ íÿ ¢ˆÅ ›¸¨¸úˆ¼Å÷¸ ¸Ÿ¸¸£¸¢©¸ œ¸£ ™½¡¸ ¤¡¸¸¸ ˆÅú ™£ ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ ˆ½Å ¬¸Ÿ¸¡¸ ¡¸¸
›¸¨¸úˆÅ£μ¸ ˆÅú ¢÷¸¢˜¸ ˆÅ¸½ œÏ¸¢¥¸÷¸ ˆÅ£, ¸¸½ ž¸ú ˆÅŸ¸ í¸½, ›¸¨¸úˆÅ£μ¸ ˆÅú ‚¨¸¢š¸ ˆ½Å ¢¥¸‡ ¥¸¸Š¸» ¬¸¿¬¸»¢¸÷¸ ™£ í¸½Š¸ú ÷¸˜¸¸ ›¸¨¸úˆÅ£μ¸
¸Ÿ¸¸ £¬¸ú™ œ¸£ „¬¸½ Ÿ¸½£½ / ퟸ¸£½ ׸£¸ ›¸¨¸úˆÅ£μ¸ / ž¸ºŠ¸÷¸¸›¸ ˆ½Å ¢¥¸‡ ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ ˆÅú ¢÷¸¢˜¸ ˆÅ¸½ ¡¸¸ ¤¸¸™ Ÿ¸½¿ œÏ¬÷¸º÷¸ ¢ˆÅ‡ ¸¸›¸½
œ¸£ ›¸¸½’ ¢ˆÅ¡¸¸ ¸¸‡Š¸¸ — Ÿ¸ÿ / ퟸ ‚¸Š¸½ ¡¸í ž¸ú ¬¸Ÿ¸¸÷¸¸ í» / ¬¸Ÿ¸¸÷¸½ íÿ ¢ˆÅ ‚¢÷¸™½¡¸ ¸Ÿ¸¸£¸¢©¸ ¡¸¸ „¬¸ˆ½Å ¢ˆÅ¬¸ú ¢í¬¬¸½ ˆÅ¸
›¸¨¸úˆÅ£μ¸ ‚¨¸¢š¸ œ¸»£ú í¸½›¸½ ˆÅú ¢÷¸¢˜¸ ¬¸½ ¢ˆÅ¡¸¸ ¸¸ ¬¸ˆÅ÷¸¸ í¾ ¤¸©¸÷¸½ô ¢ˆÅ ‚¢÷¸™½¡¸ ‚¨¸¢š¸ 14 ¢™›¸ ¬¸½ ‚¢š¸ˆÅ ›¸ í¸½ —
I/We further understand that the rate of interest applicable on the deposit renewed shall be at the
appropriate rate of interest for the period of renewal as prevailing on the date of maturity or on
the date of renewal whichever is lower and that the renewal will be noted on the deposit receipt
on my/our presenting the same on the maturity date or later for renewal/payment. I/we also
understand that the overdue deposit or a portion thereof can be renewed from date of maturity
provided the overdue period does not exceed 14 days

7
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

9. Ÿ¸ÿ / ퟸ ‡÷¸™Ã׸£¸ ‹¸¸½¢«¸÷¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ ¢ˆÅ ퟸ¸£½ ׸£¸ ¬¸Ÿ¸¡¸-¬¸Ÿ¸¡¸ œ¸£ ¤¸ÿˆÅ ˆÅ¸½ ¬¸¸ÿœ¸½ ¸¸›¸½ ¨¸¸¥¸½ ¬¸ž¸ú
¢¨¸™½©¸ú ¢¨¸¢›¸Ÿ¸¡¸ ¥¸½›¸™½›¸, „›¸ ¥¸½›¸™½›¸¸½¿ ˆÅú œ¸»¢÷¸Ä ˆ½Å ¬¸Ÿ¸¡¸ ¢¨¸.¢¨¸.œÏ.’. (œ¸½€Ÿ¸¸) 1999 ˆ½Å œÏ¸¢¥¸÷¸ œÏ¸¨¸š¸¸›¸¸½¿ ˆ½Å ¬¸‰÷¸ ‚›¸ºœ¸¸¥¸›¸
Ÿ¸½¿ í¸½¿Š¸½ —
I/We hereby declare that all forex transactions, as may be entrusted by us to the Bank from time
to time will be in strict conformity with the prevailing provisions of FEMA 1999 at the time the
transactions are put through.
10. Ÿ¸ÿ/−Ÿ¸ ¬¸Ÿ¸¸÷¸¸ −»Â/−ÿ ¹ˆÅ ˆ½Å›¸£¸ ¸ÿˆÅ ”½¹¸’ ˆÅ¸”Ä ˆÅ¸ „œ¸¡¸¸½Š¸ ¹¨¸¹›¸Ÿ¸¡¸ ¹›¸¡¸¿°¸μ¸ ¹¨¸¹›¸¡¸Ÿ¸›¸ ˆ½Å ‚›¸º¬¸¸£ ¬¸‰÷¸ú
ˆÅ¡¸¸ ¸¸‡Š¸¸ ‚¸¾£ ¬¸Ÿ¸¸¸ −¾ ¹ˆÅ ƒ¬¸ˆ½Å ‚›¸ºœ¸¸¥¸›¸ Ÿ¸½¿ ¡¸¹™ ¸»ˆÅ −¸½÷¸¸ −¾ ÷¸¸½, Ÿ¸ÿ û½ÅŸ¸¸ ¹™©¸¸¹›¸™½Ä©¸¸½¿ ¸¸½ ¬¸Ÿ¸¡¸ ¬¸Ÿ¸¡¸ œ¸£ ¸¸£ú
¹ˆÅ¡¸½ ¸¸÷¸½ −ÿ „¬¸ˆ½Å ¹¥¸‡ ¹¸ŸŸ¸½™¸£ −¸½Š¸¸ ‚¸¾£ ¬¸Ÿ¸¸¸ −¾ ¹ˆÅ ž¸¸£÷¸ú¡¸ ¹£¸Â¨¸Ä ¸ÿˆÅ ¡¸¸ ˆ½Å›¸£¸ ¸ÿˆÅ ˆ½Å ˆÅ−›¸½ œ¸£ ‚¿÷¸£¸Ä«’ïú¡¸
ˆÅ¸”Ä ¬¸º¹¨¸š¸¸ ¬¸½ ¨¸¿¹¸÷¸ £−»ÂŠ¸¸/£−½¿Š¸½ —
I/We undertake to utilize the Canara Bank Debit Card strictly in accordance with the exchange
control regulations and understand that in the event of my failure to do so, I would be liable for
action under FEMA guidelines issued from time to time and will also be debarred from
International Card facility at the instance of Reserve Bank of India or Canara Bank

11. Ÿ¸ÿ ‹¸¸½«¸μ¸¸ ˆÅ£÷¸¸ −»Â ¹ˆÅ Ÿ¸¾ / −Ÿ¸›¸½ ™¬÷¸¸¨¸½¸ ¹¸¬¸Ÿ¸½¿ Ÿ¸¸›¸™¿” ‚¸¾£ ©¸÷øô −ÿ ‚¸¾£ ˆ½Å›¸£¸ ¸ÿˆÅ ˆ½Å ¨¸½¸ ¬¸¸ƒ’
WWW.CANARABANK.CO.IN Ÿ¸½¿ ˆ½Å›¸£¸ ¸ÿˆÅ ˆÅ¸ ƒ¿’£›¸½’ ‚¸¾£ Ÿ¸¸½¸¸ƒ¥¸ ¸ÿ¹ˆ¿ÅŠ¸ ¬¸½¨¸¸‚¸½¿ ˆ½Å ¹›¸¡¸¿°¸μ¸ ‚™¸¨¸ˆÅ ˆÅ¸½
œ¸¸ ‚¸¾£ ¬¸Ÿ¸¸¸ −¾ — ‚¸Š¸½, Ÿ¸ÿ ƒ¬¸ˆ½Å ¹¥¸‡ ž¸ú ¬¸−Ÿ¸÷¸ −»Â ¹ˆÅ ƒ¿’£›¸½’, Ÿ¸¸½¸¸ƒ¥¸ ¸¾¹ˆ¿ÅŠ¸ ˆ½Å Ÿ¸¸š¡¸Ÿ¸ ¬¸½ ¡¸»¸£ ‚¸ƒÄ ”ú ‚¸¾£
œ¸¸¬¸¨¸”Ä ¬¸½ „œ¸¡¸ÄºÆ÷¸ ‰¸¸÷¸½ Ÿ¸½¿ ¸¸½ ‚›¸º£¸½š¸ ¨¡¸Æ÷¸ ¹ˆÅ¡¸½ Š¸¡¸½ −ÿ ¨¸½ ˆÅ¸›¸»›¸›¸ Ÿ¸½£½ œ¸£ ¸¸š¡¸ −ÿ ‚¸¾£ Ÿ¸ÿ Š¸¸½œ¸›¸ú¡¸÷¸¸ ‚¸¾£ ƒ¿’£›¸½’
Ÿ¸¸½¸¸ƒÄ¥¸/ƒÄ Ÿ¸½¥¸ ׸£¸ Ÿ¸º¸½ ™ú Š¸ƒÄ ¬¸»¸›¸¸ ˆÅú Š¸¸¾œ¸›¸ú¡¸÷¸¸ ˆÅ¸½ ¸›¸¸‡ £‰¸›¸¸ Ÿ¸½£ú ¹¸ŸŸ¸½™¸£ú −ÿ — ‚›¡¸ ¬¸¿¡¸ºÆ÷¸ š¸¸£ˆÅ¸½¿ ¬¸½
„œ¸¡¸ÄºÆ÷¸ ¬¸¿¡¸ºÆ÷¸ ‰¸¸÷¸¸‚¸½¿ ˆÅ¸½ ™½‰¸›¸½/œ¸»Ž÷¸¸Ž ˆÅ£›¸½/œ¸¹£¸¸¹¥¸÷¸ ˆÅ£›¸½ −½÷¸º ‚¸±¸¸ œ¸°¸ Ÿ¸½£½ œ¸¸¬¸ −¾ —
I declare that I/we have read and understood the document containing the Terms and Conditions
and Disclaimer governing Canara Bank's Internet and Mobile Banking Services as provided in
the Bank's Internet Banking Website - www.canarabank.in and I/we accept the same. Further,
I also agree that the transactions and requests executed in the above mentioned accounts through
Internet, Mobile Banking under my user id and password will be legally binding on me and I
am responsible for maintenance of secrecy and confidentiality of the information passed on to
me by the Bank through Internet/Mobile/E mail. I have the mandate from the other Joint
Holders to view/enquire/operate the Joint accounts mentioned above

‚›¸º¤¸¿š¸ ˆ½Å ‚›¸º¬¸¸£ ›¸¸Ÿ¸¸¿ˆÅ›¸ ‚œ¸½¢®¸÷¸ / NOMINATION AS PER ANNEXURE

›¸¸Ÿ¸¸¿ˆÅ›¸ ‚¸¨¸©¡¸ˆÅ÷¸¸ ›¸íì / NOMINATION NOT REQUIRED
œ¸í¥¸½ ‚¸¨¸½™ˆÅ ˆ½Å í¬÷¸¸®¸£ / Signature of 1st Applicant
™»¬¸£½ ‚¸¨¸½™ˆÅ ˆ½Å í¬÷¸¸®¸£ / Signature of 2nd Applicant
÷¸ú¬¸£½ ‚¸¨¸½™ˆÅ ˆ½Å í¬÷¸¸®¸£ / Signature of 3rd Applicant
¸¸¾˜¸½ ‚¸¨¸½™ˆÅ ˆ½Å í¬÷¸¸®¸£ / Signature of 4th Applicant
¬˜¸¸›¸ / Place:
¢™›¸¸¿ˆÅ / Date:

8
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

œ¸¢£¸¡¸ / INTRODUCTION:
Ÿ¸ÿ ‚¸¨¸½™ˆÅ ˆÅ¸½ (¨¡¸þÆ÷¸Š¸÷¸ ³œ¸ ¬¸½) --------- ¨¸«¸øÄ¿ ˆÅú ‚¨¸¹š¸ ÷¸ˆÅ ˆ½Å ¹¥¸‡ ¸¸›¸÷¸¸ −»Â ‚¸¾£ ‚¸¨¸½™›¸ Ÿ¸½¿ „¥¥¸½¹‰¸÷¸ „›¸ˆÅ¸
œ¸÷¸¸ / ¨¡¸¨¸¬¸¸¡¸ ˆÅú œ¸º¹«’ ˆÅ£÷¸¸ −»Â — Ÿ¸¾¿ ¹¬¸ûŸ¹£©¸ ˆÅ£÷¸¸ −»Â ¹ˆÅ ¸ÿˆÅ ƒ¬¸ ‰¸¸÷¸½ ˆÅ¸½ ‰¸¸½¥¸›¸½ œ¸£ ¹¨¸¸¸£ ˆÅ£ ¬¸ˆÅ÷¸¸ −¾ — I

KNOW THE APPLICANT (PERSONALLY FOR A PERIOD OF _______YEARS & CONFIRM

HIS/HER/THEIR ADDRESS/OCCUPATION STATED IN THE APPLICATION. I RECOMMEND
THAT THE BANK MAY CONSIDER TO OPEN THE ACCOUNT

›¸¸Ÿ¸ / NAME MR/MRS/MS___________________________________

‰¸¸÷¸¸ ¬¸¿ / ACCOUNT NO. __________________

œ¸÷¸¸ / ADDRESS___________________________________________
________________________________________________________

¢œ¸›¸ ˆ»Å’ / PINCODE______________________

œ¸¢£¸¡¸ˆÅ÷¸¸Ä ˆ½Å í¬÷¸¸®¸£ / SIGNATURE OF INTRODUCER

í¬÷¸¸®¸£¸½¿/œ¸¢£¸¡¸¸½¿ ˆÅ¸ ¬¸÷¡¸¸œ¸›¸/VERIFICATION OF SIGNATURES/ INTRODUCTIONS

í¬÷¸¸®¸£ ¢ˆÅ¬¸ú ¤¸ÿˆÅ / ž¸¸£÷¸ú¡¸ ™»÷¸¸¨¸¸¬¸ / „¸¸¡¸¸½Š¸ / ˆÅ¸¿¬¸º¥¸½’ / œ¸¢£¸¸¡¸ˆÅ (ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿ ‰¸¸÷¸¸ ¬¸¿.
(________________________)
Authentication of Signature to be made by a Bank / Indian Embassy / High Commission /
Consulate / Introducers A/c No_______________
©¸¸‰¸¸ ˆÅ¸ ›¸¸Ÿ¸ /Name of the Branch
„œ¸£¸½Æ÷¸ í¬÷¸¸®¸£ ¬¸÷¡¸¸¢œ¸÷¸ / Above signature verified

¬¸÷¡¸¸œ¸›¸ ˆÅ£›¸½¨¸¸¥¸½ ¨¡¸¢Æ÷¸ ˆÅ¸ ›¸¸Ÿ¸ / í¬÷¸¸®¸£ ‚¸¾£ £¤¸”õ ˆÅú Ÿ¸ºí£ ÷¸˜¸¸ / Ÿ¸ºÍ¸ ‡¨¸¿ œ¸÷¸¸ Name/Signature of person
verifying with rubber stamp and/or Seal & address

¬¨¸úˆ¼Å÷¸ ™£ /Accepted at _________________%

œÏ¢÷¸í¬÷¸¸®¸£ / Countersigned

ˆ¼Å÷¸½ ˆ½Å›¸£¸ ¤¸ÿˆÅ / For Canara Bank

œ¸¡¸Ä¨¸½®¸ˆÅ SUPERVISOR/ œÏ¤¸¿š¸ˆÅ/MANAGER

9
 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

‚›¸º¤¸¿š¸ / ANNEXURE

1. ›¸¸Ÿ¸¸¿ˆÅ›¸ œ¸€¸ÁŸ¸Ä ”ú.‡. 1 /NOMINATION FORM DA 1

(ˆ½Å¨¸¥¸ ÷¸ž¸ú ž¸£¸ ¸¸‡ ¸¤¸ ¡¸í ¬¸º¢¨¸š¸¸ ¸Ÿ¸¸ˆÅ÷¸¸Ä ׸£¸ ‚œ¸½¢®¸÷¸ í¸½ / NOMINATION TO BE FILLED IN
ONLY IF THE FACILITY IS REQUIRED BY THE DEPOSITOR)

¤¸ÿˆÅ ¸Ÿ¸¸£¸¢©¸¡¸¸½¿ ˆ½Å Ÿ¸¸Ÿ¸¥¸½ Ÿ¸½¿ ¤¸ÿ¢ˆ¿ÅŠ¸ ¢¨¸¢›¸¡¸Ÿ¸›¸ ‚¢š¸¢›¸¡¸Ÿ¸, 1949 ˆÅú š¸¸£¸ 45 {¸½Œ‡. ÷¸˜¸¸ ¤¸ÿ¢ˆ¿ÅŠ¸ ˆ¿Åœ¸›¸ú (›¸¸Ÿ¸¸¿ˆÅ›¸)
¢›¸¡¸Ÿ¸ 1985 ˆ½Å ¢›¸¡¸Ÿ¸ 2(1) ˆ½Å ‚¿÷¸Š¸Ä÷¸ ›¸¸Ÿ¸¸¿ˆÅ›¸
Nomination under Sec. 45 ZA of the Banking Regulation Act 1949 and rule 2(1) of the
Banking Companies (Nomination) rule 1985 in respect of Bank Deposits.

I/We______________________________________________________
(›¸¸Ÿ¸ ÷¸˜¸¸ œ¸÷¸¸ /œ¸÷¸½/Name/s and addresses/es)

Ÿ¸½£½ / ퟸ¸£½ / ›¸¸¤¸¸¢¥¸Š¸ ˆÅú Ÿ¸¼÷¡¸º œ¸£ ¢›¸Ÿ›¸¢¥¸¢‰¸÷¸ ˆÅ¸½ ‰¸¸÷¸½ Ÿ¸½¿ ¸Ÿ¸¸£¸¢©¸ œÏ¸œ÷¸ ˆÅ£›¸½ í½÷¸º ›¸¸¢Ÿ¸÷¸ ˆÅ£÷¸¸ í» / ˆÅ£÷¸½ íÿ,
¢¸¬¸ˆÅ¸ ¤¡¸¸½£¸ ›¸ú¸½ ¢™¡¸¸ Š¸¡¸¸ íÿ, ˆÅ¸½ ¨¸í £¸¢©¸ ˆ½Å›¸£¸ ¤¸ÿˆÅ /_____________________ ©¸¸‰¸¸ ׸£¸ ¨¸¸œ¸¬¸ ˆÅú ¸¸‡ —
Nominate the following person to whom in the event of my/our/minors death the amount of
deposit in the account, particulars whereof are given below, may be returned by CANARA
BANK ________________
¸Ÿ¸¸£¸¢©¸ / DEPOSIT
¸Ÿ¸¸£¸¢©¸ ˆÅ¸ ¬¨¸³œ¸ Nature Of ¢¨¸Ž¸½™ˆÅ ¬¸¿‰¡¸¸ ‚¢÷¸¢£Æ÷¸ ¤¡¸¸¾£¸, ¡¸¢™ ˆÅ¸½ƒ −¸½ ÷¸¸½
Deposit Distinguishing Number Additional Details,Any

›¸¸¢Ÿ¸÷¸ú / NOMINEE
›¸¸Ÿ¸ ‡¨¸¿ œ¸÷¸¸ ¸Ÿ¸¸ˆÅ÷¸¸Ä ¬¸½ ¹£©÷¸¸, ¡¸¢™ ˆÅ¸½ƒÄ í¸½ ÷¸¸½ ‚¸¡¸º ¡¸¢™ ›¸¸¢Ÿ¸¹÷¸ ›¸¸¤¸¸¢¥¸Š¸ −¸½ ÷¸¸½
Name & Address Relationship With Depositor, If Age „¬¸ˆÅú ¸›Ÿ¸ ¢÷¸¢˜¸ If
Any Nominee is Minor, his
date of birth

*¸»Â¢ˆÅ ›¸¸¢Ÿ¸÷¸ú ‚ž¸ú ›¸¸¤¸¸¢¥¸Š¸ í¾, Ÿ¸ÿ / ퟸ As the nominee is minor on this date, I/We
appoint_______________________________________________
__________________________________________________________
(›¸¸Ÿ¸, œ¸÷¸¸ ‡¨¸¿ ‚¸¡¸º / Name, address and age)

ˆÅ¸½ ›¸¸¢Ÿ¸÷¸ú ˆ½Å ›¸¸¤¸¸¢¥¸Š¸ í¸½›¸½ ˆÅú ‚¨¸¢š¸ ˆ½Å ™¸¾£¸›¸ Ÿ¸½£ú / ퟸ¸£ú ›¸¸¤¸¸¢¥¸Š¸ ˆÅú Ÿ¸¼÷¡¸º í¸½›¸½ œ¸£ ‰¸¸÷¸½ ˆÅú £ˆÅŸ¸ ˆÅ¸½ ›¸¸¤¸¸¢¥¸Š¸ ˆÅú
‚¸½£ ¬¸½ œÏ¸œ÷¸ ˆÅ£›¸½ í½÷¸º ›¸¸¢Ÿ¸÷¸ ˆÅ£÷¸½ íÿ — Ÿ¸ÿ ¡¸í ž¸ú ›¸¸½’ ˆÅ£÷¸¸ í» ¢ˆÅ ¢›¸¢š¸¡¸¸½¿ ˆÅ¸ ƒ›¸ ‰¸¸÷¸¸½¿ ¬¸½ ‚¢›¸¨¸¸¬¸ú ›¸¸¢Ÿ¸÷¸ú ˆÅ¸½
œÏ÷¡¸¸¨¸÷¸Ä›¸ ž¸¸£÷¸ú¡¸ ¢£{¸¨¸Ä ¤¸ÿˆÅ ˆÅú ‚›¸ºŸ¸¢÷¸ / ¢¨¸™½©¸ú Ÿ¸ºÍ¸ ¢¨¸¢›¸¡¸Ÿ¸¸½¿ ˆ½Å ‚š¸ú›¸ í¸½Š¸¸ /

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 (ž¸¸£÷¸ ¬¸£ˆÅ¸£ ˆÅ¸ „œ¸ÇÅŸ¸/A Govt. of India undertaking)
(œÏ.ˆÅ¸. ¤¸½¿Š¸¥¸»£/H.O.BANGALORE)

to receive the amount of the deposit in the account, on behalf of the nominee, in the event of
my/our/minors death, during the minority of the nominee. I have also noted that repatriation of
funds in these accounts to Non Resident Nominees is subject to RBI approval/Foreign
Exchange Regulations
¸Ÿ¸¸ˆÅ÷¸¸Ä/‚¸½¿ ˆ½Å í¬÷¸¸®¸£
Signature(s) of Depositor(s)

¬¸¸®¸ú ˆÅ¸ ›¸¸Ÿ¸, í¬÷¸¸®¸£ ÷¸˜¸¸ œ¸÷¸¸ **

Name, Signature & Address of Witness**

¬˜¸¸›¸ / Place _____________________

¢™›¸¸¿ˆÅ / Date ______________

¸í¸Â £¸¢©¸ ›¸¸¤¸¸¢¥¸Š¸ ˆ½Å ›¸¸Ÿ¸ œ¸£ ¸Ÿ¸¸ ˆÅú Š¸ƒÄ í¸½, ¨¸í¸Â ›¸¸¤¸¸¢¥¸Š¸ ˆ½Å œ¸®¸ Ÿ¸½¿ ˆÅ¸›¸»›¸ú ÷¸¸¾£ œ¸£ ‚›¸ºŸ¸÷¸ ¨¡¸¢Æ÷¸ íú ›¸¸Ÿ¸¸¿ˆÅ›¸ œ¸£
í¬÷¸¸®¸£ ˆÅ£ ¬¸ˆÅ÷¸¸ í¾
Where deposit is made in the name of minor, the nomination should be signed by a person
lawfully entitled to act on behalf of the minor

›¸¸Ÿ¸¸¿ˆÅ›¸ ¬¨¸úˆ¼Å÷¸ ‡¨¸¿ œ¸¿¸úˆ¼Å÷¸ ¢ˆÅ¡¸¸ Š¸¡¸¸ / Nomination accepted and Registered

œ¸¿¸úˆÅ£μ¸ ¬¸¿ / Vide Regn. No ___________________dated ___________

ˆ¼Å÷¸½ ˆ½Å›¸£¸ ¤¸ÿˆÅ / For CANARA BANK

œ¸¡¸Ä¨¸½®¸ˆÅ / Supervisor œÏ¤¸¿š¸ˆÅ / Manager

* ¡¸¢™ ›¸¸¢Ÿ¸÷¸ú ›¸¸¤¸¸¢¥¸Š¸ ›¸ í¸½, ÷¸¸½ ˆÅ¸’ ™½¿ /Strike out if nominee is not a minor
** ¤¸¸¡¸½¿ í¸˜¸ ˆ½Å ‚¿Š¸»“½ ˆÅ¸ ¢›¸©¸¸›¸ ™¸½ ¬¸¸¢®¸¡¸¸½¿ ׸£¸ ¬¸¸®¡¸¸¿¢ˆÅ÷¸ ¢ˆÅ¡¸¸ ¸¸¡¸½ / LTI to be attested by 2 witnesses

//FORM-NRE opening form//

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