03 PROOF OF IDENTITY / ADDRESS (Please tick the appropriate Box (any one ID type) and give details)*
A - PASSPORT B - VOTER'S IDENTITY CARD C - DRIVING LICENCE D - UID (AADHAR) Any Other
E - NREGA JOB CARD F - LETTER ISSUED BY NATIONAL POPULATION REGISTER CONTAINING DETAILS OF NAME & ADDRESS
S- Simplified Measures Account Document (Type code)
Document code Description
O1 Identity card with applicants photograph issued by Central/State Government Departments, Statutory/Regular authorities/Public sector
undertakings, scheduled commercial banks and public financial institutions
O2 Letter issued by a gazetted officer, with a duly attested photograph of the person
Document No/Identification Number*
Issue Date:* D D M M Y Y Y Y Expiry Date (If applicable):* D D M M Y Y Y Y
04 LOCAL ADDRESS DETAILS (Please tick the appropriate Box (any one ID type) and give details)*
Address type* Residential/Business Residential Business Registered Office Unspecified
Address*
City/Village*: District*:
State:* ISO 3166 Country Code* Pin:*
05 Permanent Address Details (Please tick the appropriate Box (any one ID type) and give details)*
Address type* Residential/Business Residential Business Registered Of ce Unspeci ed
Address*
City/Village*: District*:
State:* ISO 3166 Country Code* Pin:*
06 If the Proof of Address (OVD) provided does not contain current address-please provide any of the documents below.
Utility Bill PPO/FPPO Property or Municipal tax receipt
Letter of allotment of accommodation issued by employer/ issued by State or Central Government departments, statutory or regulatory bodies, Public sector undertaking,
scheduled commercial banks, nancial institutions and listed companies. Similarly, leave and license agreements with such employers allotting of cial accommodation.
Self declaration (If Aadhar is voluntary provided for identi cation purpose and current address is different from address available in Central Identities Data Repository
Authentication of Aadhar number using e-KYC authentication facility provided by UIDAI is mandatary)
Document No. : Date: D D M M Y Y Y Y
07 DECLARATION CUM UNDERTAKING CUM SELF–CERTIFICATION
1) I have read the copy of Terms and Conditions of the Account Opening given to me. The Terms and Conditions have been explained to me/us and having understood,
I accept the same.
2) I hereby declare that I have submitted the Aadhaar Card issued by UIDAI voluntarily for identification and /or address proof towards the compliance of KYC
norms under the PMLA, 2002
3) For the purpose of cross sell/upsell/ offers/ various offers on Bank products, I am aware that the bank will need to assess my creditworthiness
Therefore, I hereby give my consent to Bank of Maharashtra to access my CIC report and credit score
4) I hereby consent that the Bank may verify the same with the UIDAI and authorise the UIDAI expressly to release the identity and address through biometric / OTP based
authentication to the Bank YES NO (E-KYC authentication and Aadhar seeding is mandatory for availing DBT bene t)
PHOTO*
Please Paste
Signature/Thumb impression
Recent passport Size
of the Applicant
(Do not Staple)
Please sign in black ink only
Place: Date: D D M M Y Y Y Y
08 FOR OFFICE USE / ATTESTATION Documents received Self certi ed True copies Notary
Whether self-certi cation & documents received as part of account opening process have been veri ed and found correct YES/NO (Branch to proceed with opening only when certi cation is
(YES) Certi ed that the implications and conditions for the operation of the account have been explained to the depositor (only in case of illiterate applicant)
Depositor is Illiterate Blind Staff Risk Category:* High Medium Low
Details of one or two identi cation marks, if any, such as a mole or scar (mandatory for illiterate applicant) In
person veri cation carried out and Signature/LTI of the applicant veri ed by:
Of cial Name: PF No: S T A F F Designation
Date: D D M M Y Y Y Y Signature Code of Of cial Signature
02