Online Forms

Application For Term Deposits

• Branch : Select Nilambur Main Branch Wandoor Main Branch Kalikavu Branch Chungathara Branch Karuvarakundu Pookkottumpadam Edakkara Pandikkad Akampadam Edavanna Nilambur Evening Karulai Edakkara Evening Wandoor Evening Pothukal Thuvar Vazhikadavu Thrikkalangode Thiruvali Karuvarakundu Evening Cherukode Chokkad Mampad Erumamamunda Vaniyambalam Karappuram Nilambur Co-Operative Urban Bank Head Office
• Date :
• E.KYC Reg.No :
• Customer Number :
• Contract Number :
• Account Number :

• A-IDENTITY DETAILs

• 1. Name Of Applicant/s :
• Father's/ Husband's Name :
• Date Of Birth :
• Gender : Male Female
• Staff : YES No
• Retired Staff : Yes No
• Minor : Yes No
Name of the guardian and his/ her relation ship to the minor
Name :
Relationship :
• Pan card Number :
• Unique identification number(UID/Aadhar if any):
• Specify the proof of id submitted any other(Please Specify):

• ADDRESS DETAILS

• Address(If diffrent from avove Mandatory for non resident applicant to specify overseas address) :
• Pin :

• CONTACT DETAILS

• Phone - Residence :
• Mobile :
• Email :

• ACCOUNT DETAILS

• Type of Account : FD:Individual FD:Senior Dhannia: IND Dhannia: Senior Others Cash Certificate
• Mod Of Operation: Single E or S Joint F or S A or S Others
• Nomination Opted: Yes No
• Total deposit Amount
• No.of Contract Required
• Period Of Deposit
• Days
• Month
• Year
• Rate Of interest :
• Interest Payment Periodicity
• Monthly Quarterly Yearly Maturity
• Our A/c linked with Dep .
• Other bank account No.
• IFSC code
• Name
• TDS to be deducted Yes No
• 15 H 15 G Exemption certificate
• TDS to be deducted from A/c
• Automatic Renewal Yes No
• Option for A/R with Interest With Out Interest
• Number of Auto Renewal
• Deposit due notice required Yes No
• Depositor Signature

• Introduction

• I conform that ,I personally know the applicant(s) detailed above for the last months/years and confirm his/her/their identity ,occupation and address
• Name
• Account Number /Address
• Mobile
• Email

• Form DA1

• Nomination under Section 45 ZA read with Section 56 of the Banking Regulation Act 1949.and Rule 2 (1) of the Co-op Banks (Nomination) Rules, 1985 in respect of the Bank Deposits

• I/We nominates the following person to whom in the event of my/our/minors death,the amount to the deposit,particulars where of are given below, may be returned by The Nilambur Co-Operative Urban Bank ,

Deposit Particulars

Nature Of :

Distinguishing No :

Additional details if any :

Nominee

Name and Address :

Relationship with depositor if any :

Age :

If nominee is a minor his date of birth :

• As the nominee is a minor on this date ,I/We appoint Sri. /Smt. / Kum.(Name, address and Age) to receive the amount of the deposit on behalf of the nominee in the event of my/our minor's death during the minority of the nominee

• Place
• Date
• Witness Name and address