Da Forms: Da-1 To Annexure-15 Page 12
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35FORM SL 3
Variation of nomination under Sections 45 ZE and 52 of the Banking Regulation
Act, 1949 and Rule 4(5) of the Banking Companies (Nomination) Rules, 1985 by
sole hirer in respect of safety locker
I, (name and address)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
cancel the nomination made by me in favour of
. . . . . . .
. . . . . . . . . . . .
(name and address)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .and hereby nominate the following person to whom in the
event of my/minor’s death, The South Indian Bank Limited Br. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . may give access to the
locker and liberty to remove the contents of the locker, particulars whereof are given
below:
Locker
Additional
Relationship
Distinguishing
Nature of
Name
Address
details, if
with hirer/s
Age
mark or No
any
if any
Place :
Date :
Name(s), signature(s) and address(es) of
* Signature(s) / Thumb impression(s) of hirer(s)
witness(es) @
*Where the locker is hired solely in the name of a minor, the nomination should be
signed by a person lawfully entitled to act on behalf of the minor.
@ Thump impression shall be attested by two witnesses.
12
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