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Gujarat Gramin Bank Application Form

This document is a multipurpose application form for Gujarat Gramin Bank, allowing customers to request various banking services such as issuing a new cheque book, updating personal information, or closing an account. The form requires the applicant's details, account information, and the specific service requested, along with necessary documentation. It also includes a section for bank staff to note the date of application and any relevant charges applied.

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Satish Magdum
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
626 views1 page

Gujarat Gramin Bank Application Form

This document is a multipurpose application form for Gujarat Gramin Bank, allowing customers to request various banking services such as issuing a new cheque book, updating personal information, or closing an account. The form requires the applicant's details, account information, and the specific service requested, along with necessary documentation. It also includes a section for bank staff to note the date of application and any relevant charges applied.

Uploaded by

Satish Magdum
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

GUJARA

GUJARAT GRAMIN BANK


ARAT
Head Office : Vadodara
MULTIPURPOSE APPLICATION FORM
To,
Branch Manager Date : ___________________
Gujarat Gramin Bank
Request No. : ___________________
_____________________ Branch

Name of Applicant/s : ___________________________________________________________________________________


Address : ____________________________________________________________________________________________
________________________________________________________________ Pin : _______________________________
Account No. : ____________________________________________ Mobile : ____________________________________
Type of Account : _____________________________________________________________________________________
Dear Sir / Madam, Please Tick The Approriare Box

1 Issue New Cheque Book 10 Update AADHAR Card:

2 Issue Duplicate Passbook 11 Update PAN Card:

3 Statement : From _____________ to _____________ 12 Update Mail ID :

4 Stop cheque payment : Cheque No._____________ 13 Update Date of Birth:


Document type
Date__________ in favour of _____________________
14 Update KYC :
5 Close the Account Document type
6 Debit Card Number / Pin No. : 15 Account & Signature Verification
a) Debit Card/Pin No. Lost/Misplaced. Please Block.
16 Amount Transfer of Rs. _______________ in Account
b) Debit Card Not Recieved
No.____________ while Account No. ______________
7 Complaint Debit Card : due to my Mistake. Please reverse the same amount
a) A/c Debit Twice for Rs.________________. in actual account no.________________________
b) Rs.__________________ withdraw but cash not 17 Change scheme code in account
received & a/c debit. c). I withdraw Rs.______________
18 Request for balance certificate : Please issue balance
but received Rs.___________________.
certificate as on Date______________.
8 Change the address (new address)
19 Internet banking: a. Password not received
b. User ID not enabled [Link] password
Documents type and number:
20 Others: (please mention here:)
9 Transfer Account to Branch Name________________ 21 Name / Add / Deletion :
_______________ Branch Code__________________

Note : Enclosed copy of AADHAR Card / PAN card / VoterID / Driving Licence / Light Bill / Housetax and Photos.
I/we agree that the bank may debit service charges plus Yours Faithfully
taxes to my account whenever applicable.

Signature of Applicant
For Office use Only :
Date of Application / Relevant Charged
Received Denoted Rs. : ___________________
Remarks if Any :
Date : Signature

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