Da Forms: Da-1 To Annexure-15 Page 5

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FORM DA 3
Variation of nomination under Section 45 ZA of the Banking Regulation Act 1949 and Rule 2(6)
of the Banking Companies (Nomination) Rules, 1985 in respect of the Bank Deposits.
I/We . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name(s) and Address(es) . . . . . . . . . .
. . . . . . . . cancel the nomination made by me / us in favour of ( Name and Address). . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . and hereby nominate the following person to whom in the event of my / our / minor’s death, the
amount of the deposit mentioned above may be returned by The South Indian Bank Ltd. ,
Branch………………………………………………………….
Details of Deposit
Nominee
If
nominee
Age
is a
Relationshi
Nature
Addl.
minor,
p with
of
Dist.No
details,
Name
Address
depositor if
date of
deposit
if any
any
birth
and
age.
** As the nominee is a minor on this date. I/We appoint Shri/Smt/Kum . . . . . . . . . . . . . . . . . . . .
....................................................................................................................(name, address and age) . . . . .
. . . . . . . . . . . . . . . ............................................................................................................ . to receive the
amount of the deposit on behalf of the nominee in the event of my / our / minor’s death during the
minority of the nominee
Place :
Date :
* Signature(s) / Thumb impression(s) of depositor(s)
Name(s), signature(s) and address(es) of
witness(es) @
*Where the deposit is in the name of a minor, the variation of the nomination should be signed by a
person lawfully entitled to act on behalf of the minor.
** Strike out if nominee is not a minor.
@ Thump impression(s) shall be attested by two witnesses.
$ Strike out the relevant portion if variation is not needed.
5

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