Customer Id No.
(Office Use Only)
The Jammu & Kashmir Bank Account No.
Corporate Headquarters
M A Road, Srinagar 190 001 (Office Use Only)
Branch Date
Nomination Form DA 1
Nomination under Section 45 ZA of the Banking Regulation Act 1949 and Rule 2(1) of the Banking
Companies (Nomination ) Rule 1985 in respect of Bank Deposit.
I / We
Name(s) and Address(es)
nominate the following person to whom in the event of my / our / minor’s death the amount of deposit in the account, particulars
where of are given below, may be returned by the Jammu & Kashmir Bank Ltd.,
(Name of branch where account is held)
1. Deposit
Nature of Deposit
Account No.
Additional details, if any
2. Personal Details of Your Nominee
Full Name (IN BLOCK LETTERS)
Address with Telephone / Fax Mobile / E-mail Etc.
Pin code City
Relationship with Depositor, if any Date of Birth
* As the nominee is a minor on this date, I / We appoint
Name(s), Address(es) & Age
to receive amount of the deposit in the Account on behalf of the nominee in the event of my / our / minor’s death during
the minority of the nominee.
3. Personal Details of Your Witnesses
Witness 1 Witness 2
Name
Address
Signature
Place
Date
** Signature(s) / *** Thumb impression(s) of Depositor(s)
* Leave out if nominee is not a minor.
** Where deposit is made in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of the minor.
*** Thumb impression shall be attested by 2 witnesses.
For Office Use Only
Nomination Serial No