Sidbi Fixed Deposit Application Form (Page 7 of 8) in pdf

Sidbi Fixed Deposit Application Form Page 7

DECLARATION

SIGNATURE OF THE APPLICANT

I hereby declare that the particulars given herein are true, correct and complete to the best of my knowledge and belief.

The documents submitted along with the application are genuine and I am not making this application for the purpose of

contravention of any Act, Rules, Regulations or any Statute or Legislation or any Notification/ Directions issued by any

governmental or statutory authority from time to time. I authorise SIDBI, its authorised agents and representatives to

disclose, share, remit in any form, mode or manner all /any of the information provided by me. I hereby agree to provide

Date :

any additional information/documents that may be required in connection with this application.

Place :

FOR OFFICE USE

Branch of SIDBI

Date of Receipt

Maker

Checker

Whether all information has been filled up by the applicant

YES / NO

Copy of the documents submitted as identity proof and address proof have been verified with the originals as

YES / NO

produced by the applicant. Other KYC documents as required under the guidelines have been obtained and

verified

The names of the parties connected with the transaction have been checked in the latest updated list(s) of terrorist

YES / NO

individual / organizations circulated by KYC Cell and the name(s) of the depositor do not match with any name(s)

mentioned in the said list(s).

Sidbi Fixed Deposit Application Form Page 7