KERALA TRANSPORT DEVELOPMENT FINANCE CORPORATION LTD APPLICATION FORMS APPLICATION FORM FOR DEPOSIT & RENEWAL TR. No: KERALA TRANSPORT DEVELOPMENT FINANCE CORPORATION LIMITED (fully Owned by Government of Kerala) Regd: Office: O-3, SAPHALLYAM COMMERCIAL COMPLEX, TRIDA, PALAYAM, THIRUVANANTHAPURAM 695 033. APPLICATION FORM FOR DEPOSIT & RENEWAL Please " " Tick in the appropriate box TYPE OF DEPOSIT PERIOD OF DEPOSIT PERIODIC INTEREST PAYMENT SCHEME 12 MONTHS 48 MONTHS MONEY MULTIPLIER SCHEME 24 MONTHS 60 MONTHS 36 MONTHS Amount Rs......................................... in words (Rupees............................................ .......................................................................................................................................... NAME & ADDRESS OF THE FIRST APPLICANT (IN BLOCK LETTERS) Mr./Mrs./Miss. PIN AGE SECOND APPLICANT'S NAME: Mr./Mrs./Miss. AGE THIRD APPLICANT'S NAME: Mr./Mrs./Miss. AGE GUARDIAN'S NAME (IN CASE OF MINOR ONLY) Mr./Mrs./Miss. AGE DATE OF BIRTH OF MINOR NOMINEE: Mr./Mrs./Miss RELATIONSHIP WITH NOMINEE INDICATE YOUR CHOICE ON WHICH BANK YOU REQUIRE INTEREST WARRANTS BY MAKING ATICK MARK STATE BANK OF TRAVANCORE THE FEDERAL BANK LTD. (if no indication is given, we will draw interest warrants as per our choice) NAME OF BANK AND ADDRESS (in Block letters) (For payment of interest through Bank only) PIN S.B./CA/CNo. OF Mr./Mrs./Miss. INTEREST PAYABLE MONTHLY QUARTERLY ACCOUNT CODE (TICK) MINOR MAJOR JOINT MODE OF REMITTANCE (TICK) CASH CITY CHEQUE O/S CHEQUE DD RENEWAL COMBINATION INTER SCHEME TRANSFER STATUS RESIDENT NRI CATEGORY (TICK) INDIVIDUAL FIRM COMPANY INSTITUTIONS GOVERNMENT H.U.F. TAX CODE & FURNISH 1. PERMANENT A/C No. 2. PARTICULARS OF I.T.O 3. TAX TO BE DEDUCTED YES NO 4. FORM 15H ENCLOSED YES NO 1. NAME OF THE BANK & CITY ON WHICH CHEQUE/DD IS DRAWN WITH NO. & DATE 2. EXISTING FIXED DEPOSIT NO. IN THE CASE OF RENEWAL 3. DETAILS OF DEPOSITS ALREADY HELD WITH US (if any) DECLARATIONS 1. I/We hereby deposit with you in Fixed Deposit as per particulars given above. 2. 1/We hereby declare that the amount is not being deposited out of the funds acquired by me/us by borrowings or accepting deposits from any other person. 3. I/We read the terms and conditions of the Deposit or had them read out and translated to me/us and understood them and agree to abide by them. 4. The Fixed Deposit Receipts should be made payable in first named Depositer/ Either or Survivor/Joint Depositers in order/Nominee SIGNATURE OF APPLICANTS 1. 2. 3. DATE: PLACE: FOR OFFICE USE DATE OF RECEIPT AMOUNT RS. CASH/D.D/CHEQUE/OLD FDR No. DATE OF REALISATION DATE OF MATURITY CASHIER / MANAGER (D) FDR No.
