g§emo{YV ànÌ "H$' (21 Aà¡b, 2014 H$mo A{Ygy{MV) AmdoXZ g§»`m emIm H$m Zm_:_____________ 8% ~MV (H$a`mo½`) ~m§S>, 2003 Ho$ {bE AmdoXZ J¡a g§M`r (Ohm§Ano{jV hmo √ H$m {MhZ bJmE§Ÿ& joÌ '*' A{Zdm`©h¢) Ho$db H$m`m©b` à`moJ Ho$ {bE Xbmb H$m Zm_ Ed§H$moS> Cn-Xbmb H$m Zm_ Ed§H$moS> ~¢H$ emIm _wha emIm H$m Zm_ Ed§H$moS> ~rEbE g§»`m qbH$ gob H$mo A§VaU H$s VmarI ({XZm§H$/_mh/df©) {deof Mmby ImVm _| O_m H$s VmarI ({XZm§H$/_mh/df©) gaH$mar ImVm _| O_m H$s VmarI ({XZm§H$/_mh/df©) AmdoXZ àmá H$s VmarI ({XZm§H$/_mh/df©) emIm H$m nyam nVm Ûmam gË`m{nV AmdoXH$ (H$m|) H$m/Ho$ Zm_ [ gm\$ Ajam| _| ] àW_§AmdoXZ: lr/lr_Vr/gwlr A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ {ÛVr` AmdoXH$: lr/lr_Vr/gwlr V¥Vr` AmdoXH$: lr/lr_Vr/gwlr A{^^mdH$: lr/lr_Vr/gwlr A{^^mdH$ H$m Ad`ñH$ Ho$ gmW g§~§Y [ ] {nVm [ ] _mVm [ ] d¡Y A{^^mdH$ *OÝ_ {V{W : àW_ AmdoXH$ ({XZm§H$/_mh/df©) ................/................/...................qbJ: nwê$f/_{hbm *OÝ_ {V{W : X²{dVr` AmdoXH$ ({XZm§H$/_mh/df©)................/................/.................qbJ: nwê$f/_{hbm *OÝ_ {V{W : V¥Vr` AmdoXH$ ({XZm§H$/_mh/df©)................/................/...................qbJ: nwê$f/_{hbm _mVm H$m Zm_ A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ AmdoXH$ H$m nÌmMma H$m nVm : Q>obr\$moZ (H$m`m©b`/Amdmg) B©-_ob H$m nVm PAGE01 pñW{V : [ ] {Zdmgr ì`{º$ [ ] EM `y E\$ [ ] Ad`ñH$ H$s Amoa go [ ] Y_m©W©g§ñWmZ [ ] _w»VmaZm_m YmaH$ [ ] {díd{dÚmb` {Zdoe H$m ã`m¡am : [ ] Z`m ~m§S> ~hr ImVm Imob| [ ] _oao ~m§S> ~hr ImVm g§»`m ............................................................... _| O_m H$a| Ym[aVm H$m VarH$m : [ ] EH$b [ ] g§`wº$ A§eXmZ H$m VarH$m : [ ] ZH$X [ ] M¡H$/{S>_m§S> S´>mâQ> [ ] H$moB©EH$ AWdm CÎma O¡{dV M¡H$ / {S>_m§S> S´>mâQ> g§.................................. {XZm§H$ : ....... /....... /............ 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ImVm g§»`m ~¢H$ Am¡a emIm H$s Zm¡A§H$s` H$moS> g§»`m, Omo ~¢H$ Ûmam Omar E_AmB©grAma MoH$ na A§{H$V hmo AmB©E\$Eggr H$moS> hñVmja Ed§n¡Z g§»`m hñVmja/A§JyR>o H$s N>mn@ n¡Z g§»`m Am`H$a gH©$b/ dmS>©/{Obm ~¢H$ ImVm g§»`m Ed§emIm E_AmB©grAma H$moS> Ed§ AmB©E\$Eggr H$moS> àW_ AmdoXH$* {ÛVr` AmdoXH$ V¥Vr` AmdoXH$ @A§JyR>o H$s N>mn Xmo Jdmhm| Ûmam AZwà_m{UV hmo *g^r joÌ A{Zdm`©h¡Ÿ& Jdmh : àW_ Jdmh H$m Zm_.................................................................................. {ÛVr` Jdmh H$m Zm_............................................................................... nVm.......................................................................................................... nVm......................................................................................................... ................................................................................................................ ............................................................................................................... hñVmja................................................................................................... hñVmja.................................................................................................. PAGE02P02 EZB©grEg/EZB©E\$Q>r AmXoe nÌ (~¢H$ ImVo H$s _moMZ am{e/ã`mO O_m H$aZo hoVw Omo ~m§S> ~hr ImVm YmaH$ ~¢H$ Ûmam Zht O_m H$s OmVr) 1) àW_ AmdoXH$ H$m Zm_ àW_ AmdoXH$ : lr/lr_Vr/gwlr A§{V_ Zm_ àW_ Zm_ _Ü` Zm_ 2. ~¢H$ Ho$ ImVo H$m {ddaU : ~¢H$ H$m Zm_................................................................. ................................... emIm …................................................................................. ~¢H$ Ûmam Omar E_AmB©grAma M¡H$ na ~¢H$ d emIm H$s Zm¡A§H$ H$s H$moS> g§»`m AmB©E\$Eggr H$moS> (H¥$n`m H$moS> g§. Ho$ gË`mnZ Ho$ {bE ~¢H$ Ûmam AmnH$mo Omar {H$E JE M¡H$ H$s EH$ N>m`mà{V AWdm H¢${gb M¡H$ g§b¾ H$a|)Ÿ& 3. ImVo H$m àH$ma [ ] ~MV ImVm [ ] Mmby ImVm ImVm g§»`m boOa g§»`m boOa n¥ð> g§»`m _¢ EVÛmam ............................................................................................................ 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XO©h¡VWm Omo Bg Zm_m§H$Z Ho$ XO©Zm_m§H$Z Ho$ XO©{H$E OmZo Ho$ níMmV aÔ hmo OmEJm & ñWmZ ................................... {XZm§H$ : ....... /....... /............ àW_ AmdoXH$ Ho$ hñVmja/A§JyR>m {ZemZ @ A§JyR>o Ho$ {ZemZ H$mo Xmo Jdmhm| Ûmam AZwà_m{UV {H$`m OmE Jdmh : àW_ Jdmh H$m Zm_...................................................................... {ÛVr` Jdmh H$m Zm_..................................................................... nVm......................................................................................... nVm......................................................................................... .............................................................................................. .............................................................................................. hñVmja................................................................................... hñVmja................................................................................... PAGE04 8% ~MV (H$a`mo½`) ~m§S> 2003 _| {ZdoXH$m| Ho$ {bE OmZH$mar ^maV gaH$ma Zo {XZm§H$ 21 _mM©, 2013 H$s AnZr A{YgyMZm g§»`m E\$ 4 (10) S>ãë`y EÊS> E_ / 2013 Ho$ Ûmam 8% (H$a`mo½`) ~m§S>, 2003 H$mo ewê$ {H$`m h¡Ÿ& Bg `moOZm Ho$ _w»` nhby {ZåZmZwgmar h¢:- _X 8% ~MV (H$a`mo½`) ~m§S>, 2003 {Q>ßnUr 1) {ZdoeH$ H$s loUr EH$b ì`{º$, {hÝXy A{d^m{OV n[adma, {díd{dÚmb`, Y_m©W©g§ñWm BZ ~m§S>m| _| {Zdoe Ho$ {bE A{Zdmgr ^maVr` nmÌ Zhr h¢Ÿ& 2) {Zdoe H$s gr_m A{YH$V_ 1000/- ê$nE VWm 1000/- ê$nE Ho$ JwUm§H$ {Z{Y àmá H$aZo Ho$ VmarI/M¡H$/S´>mâQ> Ho$ ImVo _| AmZo H$s VmarI H$moB©A{YH$V_ gr_m Zht 3) ~m§S> Omar H$aZo H$s VmarI 4) ~m§S> Ho$ ànÌ ~m§S> dhr ImVm 5) {dH$ën J¡a g§M`r/g§M`r {dH$ën _| n[adV©Z H$s AZw_{V Zht h¡Ÿ& 6) ã`mO J¡a g§M`r {dH$ën Ho$ _m_bo _| ã`mO N>_mhr AmYma na Xo` hmoJm Ÿ& g§M`r {dH$ën Ho$ _m_bo _| ã`mO n[an¹$Vm Ho$ g_` Xo` hmoJmŸ& N>_mhr ã`mO 1 \$adar/1 AJñV H$mo Xo` h¡Ÿ& 7) n[an¹$Vm Ho$ ~mX ã`mO n[an¹$Vm Ho$ ~mX ã`mO Xo` Zht h¡Ÿ& 8) ~¢H$ boIm {ZdoeH$ Ho$ {bE `h A{Zdm`©h¡{H$ dh ~¢H$ ImVo H$m ã`m¡am Xo Vm{H$ ã`mO/n[an¹$Vm am{e H$m ^wJVmZ H$aZm AmgmZ hmo gHo$Ÿ& 9) H$a bm^ ~m§S> go hmoZo dmbr Am` H$a `mo½` h¡Ÿ& gån{Îm H$a H$s Ny>Q> h¡Ÿ& ã`mO ^wJVmZ na H$a H$mo òmoV go H$mQ> {b`m OmEJmŸ& 10) Zm_m§H$Z gw{dYm nyU©YmaH$ AWdm g^r g§`wº$ YmaH$, EH$ AWdm A{YH$ ì`{º$`m| H$mo Zm_m§{H$V H$a gH$Vo h¢Ÿ& A{Zdmgr ^maVr` ^r Zm{_V {H$E Om gH$Vo h¢Ÿ& VWm{n, ã`mO/n[an¹$Vm am{e H$m g§àofU Cg g_` àofU Ho {bE àM{bV {dXoer {d{Z_` {Z`_m| Ho VhV hmoJmŸ& 11) n[an¹$Vm Ad{Y 6 df©Ho$ níMmVŸ& 12) g_`nyd©_moMZ 29 OwbmB©2013 H$s gaH$mar A{YgyMZm Am¡a 16 AJñV, 2013 H$s A{YgyMZm Ho$ n[adVu g§emoYZ Ho$ AZwgma `h gw{dYm nmÌ {ZXoeH$m| H$mo CnbãY h¡Ÿ& 13) A§VaUr`Vm ~m§S> H$m {ÛVr`H$ ~mOma _| ì`mnma Zht hmoJmŸ& VWm{n, ~m§S>m| na F$U {b`m Om gHo$JmŸ& 14) BZ ~MV ~m§S>m| H$s à{V^y{V na ~¢H$m| go F$U BZ ~m§S>m| Ho$ YmaH$, ~m§S> à{V^y{V Ho$ ~Xbo F$U hoVw AZwgy{MV ~¢H$m|, Ho$ nj _| enW, {Jadr AWdm {b`Z aI gH|$JoŸ& 15) AmdoXZ nÌ ^maVr` ñQ>oQ> ~¢H$ VWm gå~Õ ~¢H$m| H$s emImE§, 18 amï´>r` H¥$V ~¢H$, {ZOr joÌ Ho$ 3 ~¢H$ Am¡a ñQ>m°H$ hmopëS>J̈ H$manmoaoeZ Am°\$ B§{S>`m {b. PAGE05 {ZdoeH$/AmdoXH$ Ho$ H$V©ì` H$) H¥$n`m AmdoXZ nyU©ê$n go ^a|Ÿ& I) AYyao ^ao JE AmdoXZ go ~m§S>m| Ho$ Omar hmoZo _| {dbå~ hmoJm ({ZdoXH$ H$mo ZwH$gmZ hmoJm)Ÿ& J) `{X YmaH$ Ûmam AmdoXZ _w»VmaZm_m Ho$ O[aE àñVwV {H$`m OmVm h¡_yb _w»VmaZm_m H$s AZwà_m{UV à{V Ho$ gmW gË`mnZ Ho$ {bE àñVwV H$a|Ÿ& K) `{X AmdoXZ Ad`ñH$$H$s Amoa go h¡Vmo ñH$yb AWdm ZJa {Z`_ àm{YH$mar H$m OåZ H$m _yb à_mU-nÌ AZwà_m{UVà{V Ho$ gmW gË`mnZ Ho$ {bE àñVwV H$a|Ÿ& S>) H¥$n`m `h ZmoQ> H$a| {H$ Zm_m§H$Z H$s gw{dYm ghm`Vm/~MV ~m§S> Ho$ EH$_mÌ YmaH$ AWdm g^r g§`wº$ YmaH$m| ({ZXoeH$m|§) H$mo h¡Ÿ& M) `{X Zm_{ZX}{eV ì`{º$ Ad`ñH$ h¢Vmo H¥$n`m CgH$s OÝ_{V{W {bI| VWm BgHo$ {bE A{^^mdH$ ^r {Z`wº$ {H$`m Om gH$Vm h¡Ÿ& N>) `{X {Zdoe Adí`H$ H$s Am¡a go h¡Vmo Zm_m§{H$V gw{dYm CnbãY Zht hmoJrŸ& O) H¥$n`m g§M`r/J¡a g§M`r ~m§S>m| Ho$ {ZJ©_ Ho$ {bE n¥WH$ AmdoXZ nÌ ({^Þ-{^Þ a§Jm|) _| ^a|Ÿ& {dH$ën _| n[adV©Z H$s AZw_{V Zht h¡Ÿ& P) H¥$n`m nVo _| n[adV©Z go `WmerK«AdJV H$amE§Ÿ& A) n[an¹$Vm {V{W Ho$ níMmV, n[an¹$Vm ~mX H$m ã`mO Xo` Zht hmoJm Ÿ& AV: Xo` VmarI na ^r YZam{e dmnmg b|Ÿ& Q>) H¥$n`m AnZr OÝ_{V{W/C_«Xem©E§Ÿ& R>) BboŠ Q´>m{ZH$ VarHo$ go AnZm ^wJVmZ àmá H$aZo Ho$ {bE AnZm ~¢H$ ImVm CnbãY H$amdmE§Ÿ& S>) H$a bmJy hmoZo g§~§Yr H$moB©^r OmZH$mar ~¢H$/emIm H$mo Xr OmEŸ& {ZdoeH$ Ho$ A{YH$ma H$) ~m§S> à_mUnÌ {Z{Y àmá hmoZo/M¡H$/S´>mâQ> Ho$ ImVo _| O_m hmoZo H$s VmarI H$mo Omar {H$`m OmEJmŸ& I) {Z{dXm Ho$ AmdoXZ H$s VmarI go 5 {XZ Ho$ ^rVa Ym[aVm à_mUnÌ Omar {H$E OmE§JoŸ& J) ~m§S> H$a ã`mO ZH$X _| A§eXmZ H$s VmarI AWdm M¡H$ Ho$ ZH$XrH$aU H$s VmarI go àmoÕÿV hmoVm h¡Ÿ& ã`mO AmdoXZ \$m_©_| CgHo$ Ûmam _wh¡`m H$amE JE YmaH$ Ho$ ImVo _| grYo O_m {H$`m OmEJmŸ& K) 1 \$adar/1 AJñV H$mo ã`mO ~¢H$ ImVo _| O_m {H$`m OmEJmŸ& S>.) {ZdoeH$ H$mo ã`mO Ho$ ^wJVmZ H$s agrX Xo` {V{W go EH$ _mh A{J«_ _| Omar H$s OmEJrŸ& M) ~m§S> H$s Xo` VmarI Ho$ EH$ _mh nyd©n[an¹$Vm gyMZm {^Odm Xr OmEJrŸ& N>) ã`mO Am¡a _ybYZ Ho$ {Z:ewëH$ {S>_m§S> S´>mâQ> AWdm g_Vwë` M¡H$ na ^wJVmZ H$s gw{dYm CnbãY h¡Ÿ& O) A§Va ~¢H$ emIm AWdm A§Va ~¢H$ emIm _| ~m§S> Ho$ A§VaU H$s gw{dYm C~bãY h¡Ÿ& P) ~MV ~m§S>m|§Ho$ g§~§Y _| {Zdoe, _moMZ, EZB©grEg/EZB©E\$Q>r A{YXoe Am{X Ho$ {bE AmdoXZ nÌ do~gmB©Q www.hdfcbank.com (~¢H$ Am¡a EgEMgrAmB©Eb do~gmBQ>) na CnbãY h¡Ÿ& Ì) EH$_mÌ YmaH$ AWdm g^r g§`wº$ YmaH$, ~m§S> Ho$ A{YH$ma Ho$ g§~§Y _| EH$ AWdm A{YH$ ì`{º$`m| H$mo Zm_{ZX}{eV H$a gH$Vm h¡Ÿ& A{Zdmgr ^maVr`m| H$mo ^r Zm_{ZX}{eV {H$`m Om gH$Vm h¡Ÿ& Q>) Zm_m§H$Z Omar {H$E OmZo dmbo H$m`m©b` _| XO©{H$`m OmEJm VWm YmaH$ H$mo n§OrH$aU H$m à_mU-nÌ Omar {H$`m OmEJmŸ& R>) Z`m Zm_m§H$Z XO©H$adm H$a Zm_m§H$Z _| n[adV©Z {H$`m Om gH$Vm h¡Ÿ& S>) Omar H aZo dmbo H$m`m©b` H mo AZwamoY H aHo _m¡OyXm Zm_m§H Z H mo aÔ H adm`m Om gH Vm h¡Ÿ& T>) {Zdoe H$s VmarI go 6 df©nyao hmoZo na _moMZ hmo gHo$Jm & U) {XZm§H$ 29 OwbmB©, 2013 H$s A{YgyMZm Am¡a 16 AJñV, 2013 H$s n[adVu A{YgyMZm Ho$ O[aE gaH$ma Ûmam Omar eVm] Ho$ AZwgma, n[an¹$Vm g_` nyd©_moMZ H$s gw{dYm ewê$ H$s JB©h¡Ÿ& PAGE06 V) YZam{e dmng boZo Ho$ AZwamoY H$s VmarI go nm§M H$m`©{Xdg Ho$ ^rVa {ZdoeH$ ^wJVmZ àmá H$aZo Ho$ {bE nmÌ hmo OmEJmŸ& W) ã`mO/YZam{e dmng boZo _| {db§~ go ~MZo Ho$ {bE AmdoXH$, AY©dm{f©H$ ã`mO/n[an¹$Vm na YZam{e Ho$ B©grEg/EZB©E\$Q>r/AmaQ>rOrEg AWdm ~¢H$ ImVo _| grYo H«o${S>Q> H$aZo H$m {dH$ën Xo gHo$Jm Ÿ& X) {ZdoeH$, {db§~ ^wJVmZ Ho$ {bE ^maVr` [aOd©~¢H$ Ûmam n[anÌm| Ho$ _mÜ`_ go g_`-g_` na Omar Xam| na à{Vny{V©H$m hH$Xma h¡Ÿ& `{X ~¢H$ Cn`wº$ AZwnmbZ Zht H$aVm h¡Vmo Amn Cgr ~¢H$ Ho$ H$mC§Q>a na CnbãY ànÌ _| ^maVr` [aOd©~¢H$ Ho$ ZOXrH$s H$m`m©b` H$mo {ZåZmZwgma {b{IV _| {eH$m`V H$a gH$Vo h¡: joÌr` {ZXoeH$, ^maVr` [aOd©~¢H$, J«mhH$ godm {d^mJ/~¢qH$J bmoH$nmb (ñWmZ) -------------------------------------------------------------------------- Amn AnZr {eH$m`V {ZåZ{b{IV H$mo g§~§{YV H$a gH$Vo h¡: _w»` _hmà~§YH$ à^mar, gaH$mar Am¡a ~¢H$ boIm {d^mJ, Ho$ÝÐr` H$m`m©b`, ~mB©-----, _w§~B©, g|Q´>b aobdo ñQ>oeZ Ho$ gm_Zo _w§~B©- 400008, _hmamï´> {S>ñŠ bo_a : _¢Zo {ZdoeH$ H$s OmZH$mar H$m ã`m¡am VWm A{YH$ma Am¡a H$V©ì` n‹T> Am¡a g_P {bE h¢Ÿ& EO¢Q>/~¢H$ Zo Bg `moOZm Ho$ nhbwAm| go _wPo AdJV H$am {X`m h¡Ÿ& AmdoXH$ Ho$ hñVmja -------------------------------------------------------------------- `hm§go \$mS>| -------------------------------------------------------------------------------- PAGE07 -------------------------------------------------------------------- `hm§go \$mS>| -------------------------------------------------------------------------------- AmdoXZ ànÌ H$s nmdVr AmdoXZ g§»`m ~¢H$ emIm ……………………………………………................ {XZm§H$: ....... /....... /............ lr/lr_Vr/gwlr ....................................................................................................................................................... go 8% ~MV (H$a`mo½`) ~m§S>, 2003 H$s IarX Ho$ {bE 6 df©H$s Ad{Y Ho$ {bE .................................................................................................. ............ê$nE ZH$X/S´>mâQ>/no Am°S>©a/ M¡H$ g§»`m......................................... {XZm§H$ :....... /....... /............ (~¢H$ Am¡a emIm) go àmá hþEŸ& BZ na ................................................................ ê$nE .............................................................................. (ê$nE .....................................................................................Ho$db) H$s Zm__mÌ H$s_V na g§M`r/J¡a g§M`r AmYma na ã`mO Xo` h¡Ÿ& {XZm§H$, ~¢H$ H$s _wha d ~¢H$ Ho$ à{lH¥$V A{YH$mar Ho$ hñVmja PAGE08 Revised Form A (Notified on April 21, 2014.) Name of the Application Number branch:_________________ APPLICATION FORM FOR 8% SAVINGS (TAXABLE) BONDS, 2003 Non Cumulative (Put √ wherever required. Fields with '*' are mandatory) For Office use only Broker's name & Code Sub Broker's name & Code Bank branch stamp Branch name & Code BLA Number Date of transfer to Link Cell (DD/MM/YYYY) Date of Credit to Special Current A/C (DD/MM/YYYY) Date of Credit To Govt. A/C (DD/MM/YYYY) Date of receipt of Application (DD/MM/YYYY) Full Address of the Branch Verified By Applicant(s) name(s) [in block letters] 1stApplicant: Mr/Mrs/Ms Last Name First Name Middle Name Last Name First Name Middle Name Last Name First Name Middle Name Last Name First Name Middle Name 2ndApplicant: Mr/Mrs/Ms 3rdApplicant: Mr/Mrs/Ms Guardian : Mr/Mrs/Ms Guardian's relationship with minor [ ] Father [ ] Mother [ ] Legal Guardian st *Date of Birth: 1 Applicant (DD/MM/YYYY) ............./............./............. Gender: M/F *Date of Birth: 2ndApplicant (DD/MM/YYYY) ............./............./............. Gender: M/F *Date of Birth: 3rdApplicant (DD/MM/YYYY) ............./............./............. Gender: M/F Mother's maiden name Last Name First Name Middle Name Communication address of the applicant: Telephones (office/residence) Email Address PAGE09 Status: [ ] Resident Individual [ ] On behalf of minor [ ] Power of Attorney holder Investment details: [ ] HUF [ ] Charitable Institution [ ] University [ ] Open a new Bond Ledger Account [ ] Credit to my Bond Ledger Account No…………………................. Mode of Holding: [ ] Single [ ] Joint Mode of investment: [ ] Cash [ ] Cheque/DD [ ] Anyone or Survivor Cheque/DD No……………………… dated: ....... /....... /............ drawn on (Bank/branch) ……………………............................ (DD/MM/YYYY) ………………………………………………………………………..…………………………………….……………………………...... for (Amount) `…………………………………(Rupees………….………………….………………………………………….…only) *Bank details of First Applicant: (Please provide the following details for Interest / Redemption payment) Interest Payment Options: Directly credit interest amount to my bank account No. Particulars of the Bank account: Bank name…………………………...... Branch…………………………………………………. Account Number Nine digit Code number of the Bank & Branch appearing on the MICR Cheque issued by the bank IFSC Code Signature and PAN Number Signature/Thumb Impression@ PAN Number I.T. Circle/Ward/ District Bank A/c No. and Branch MICR CODE & IFSC CODE 1st Applicant* 2nd Applicant 3rdApplicant @Thumb impression to be attested by two witnesses on the back side *All fields Mandatory. Witnesses: Name of 1st Witness………………………………........... Name of 2nd Witness……………………………… .......... Address……………………………….............................. Address……………………………….............................. ...................................................................................... ...................................................................................... Signature…………………………………….................... Signature…………………………………….................... PAGE10P02 NECS/NEFT Mandate Form (For credit of Redemption amount/interest to bank account not held with bank having the Bond Ledger Account) 1. Name of the First Applicant 1stApplicant: Mr/Mrs/Ms Last Name First Name Middle Name 2. Particulars of the Bank account: Bank name…………………………............... Branch …………………………...................... Nine digit Code number of the Bank & Branch appearing on the MICR Cheque issued by the bank IFSC Code (Please attach a photocopy of the Cheque leaf or a cancelled cheque issued to you by the bank for verification of the Code number) 3. Account Type [ ] S. B. Account [ ] Current Account Account Number Ledger Number Ledger Folio No. I hereby authorize ………………………………………………………….……………................(name of the bank) to credit my interest/redemption amounts through NECS/NEFT. I hereby declare that the particulars given above are correct and complete. If the transaction is delayed at all for reasons of incomplete or incorrect information, I would not hold the user institution responsible. I hereby agree to discharge the responsibility expected of me as a participant under the scheme. Place………………………...................Date:....... /....... /............ (Signature of the Applicant)………………….............................. Bank Certification (Not required if photocopy of the cheque is submitted) …………………………………………………………………………………………………………………………..…………………… Certified that the particulars furnished above are correct as per our records. (Date, Bank Stamp & Signature of Authorised Official) PAGE11 H.U.F. declaration form (Mandatory if applicant is Karta of HUF) I,……………………………………………………………, residing at the address given against First Applicant, do solemnly affirm that I am the Karta of the Hindu Undivided Family and as such have full powers to sell, endorse, transfer or otherwise deal in the 8% Savings (Taxable) Bonds, 2003 standing in the name of the HUF. Specimen signature for and on behalf of the HUF (name of the HUF)……..…………………………………………………............... (Signature of the Karta with seal of HUF) Place :……………………………………………..................................... Date : ....... /....... /............ Nomination facility (optional) I, …………………………………………………………………… residing at……………………………………............................... ………………………………………………………, and holder of Bond Ledger Account No……………………..………................ ………………………………................................... nominate the following person/s who shall on my death have the right to the bond / receive payment of the amount for the time being due on the bond(s) specified below : Particulars of Nominee/s Sr. No. Date of issue Amount (`) Date of repayment Full name with expanded initials and address of nominee Date of birth Relationship to holder Particulars of bank account If nominee is minor, please fill in the line below: As………………………………………………………....... the sole nominee above is a minor on this date, I appoint Mr/Mrs/ Ms………………………………………………………….. to receive the amount for the time being due on the above bond(s) in the event of my death during the minority of the said nominee…………………………………………………(name of the nominee who is a minor). Change of nomination: This nomination is in substitution of the nomination dated: ....... /....... /............ made by me and registered on your books at…………………………………………………………………………. which shall stand cancelled on registration of this nomination. Place…………………..... Date : ....... /....... /............ Signature / Thumb impression of the 1st Applicant @Thumb impression to be attested by two witnesses. Witnesses: Name of 1st Witness………………………………........... Name of 2nd Witness……………………………… .......... Address……………………………….............................. Address……………………………….............................. ...................................................................................... ...................................................................................... Signature…………………………………….................... Signature…………………………………….................... PAGE12 INFORMATION FOR INVESTORS IN 8% SAVINGS (TAXABLE) BONDS, 2003 Government of India had introduced 8% Savings (Taxable) Bonds, 2003 vide their notification No. F.4 (10)-W&M/2003 dated March 21, 2003. The main features of the Scheme are as under:- Item 8% Savings (Taxable) Bonds, 2003 Remarks 1) Category of Investor Individual Non resident Indians are not eligible to invest in these bonds HUF University Charitable Institution No maximum limit 2) Limit of investment Minimum ` 1000/- and in multiples of ` 1000/- 3) Date of Issue of bonds Date of receipt of subscription in cash or date of realization of cheque / draft 4) Forms of Bonds Bond Ledger Account 5) Option Non-cumulative / Cumulative Change of option is not permitted. 6) Interest In case of non -cumulative option, interest is payable on half yearly basis. In case of Cumulative option, interest is payable at the time of maturity Half-yearly interest is payable on 1st February /1st August 7) Post Maturity Interest Post Maturity Interest is not payable 8) Bank account It is mandatory for the investors to provide bank account details to facilitate payment of interest /maturity value 9) Tax benefits Income from the bonds is taxable. Wealth tax is exempted. Tax will be deducted at source while interest is paid 10) Nomination Facility The sole Holder or all the joint holders may nominate one or more persons as nominee. Non-Resident Indians can also be nominated. However, remittance of the interest/maturity proceeds will be subject to the foreign Exchange regulations prevailing at the time of remittance 11) Maturity period After 6 years 12) Premature redemption Facility is available to the eligible investors as per the Govt. Notification dated July 29, 2013 and subsequent amendment vide Notification dated August 16, 2013. 13) Transferability The bonds are not tradable in the secondary market. However, the Bonds shall be eligible as collateral for loans. 14) Loans from banks against the security of these Savings bonds The holders of the said bonds shall be entitled to create pledge, hypothecation or lien in favour of scheduled bank for loans against the security of the bonds. 15) Application forms Available at designated branches of SBI and Associate banks,18 Nationalised banks, 3 Private Sector banks and Stock Holding Corporation of India Ltd. PAGE13 DUTIES OF INVESTOR/ APPLICANTS A) Please fill up the application in all respects B) Incomplete applications are liable to result in delay of issue of the bonds (at the cost of the applicant) C) In case the application is submitted by a Power of Attorney (POA) holder, please submit original POA for verification, along with an attested copy D) In case the application is on behalf of a minor, please submit the original birth certificate from the School or Municipal Authorities for verification, together with an attested copy E) Please note that nomination facility is available to a Sole Holder or all the joint holders (investors) of a Relief/Savings bond. F) In case nominee is a minor, please indicate the date of birth of the minor and a guardian can be appointed G) Nomination facility is not available in case the investment is on behalf of minor H) Please fill separate application form (different colours) for issue of CUMULATIVE / NON-CUMULATIVE bonds. Change of option is not permitted. I) Please notify the change of address immediately J) POST MATURITY INTEREST IS NOT PAYABLE AFTER DATE OF MATURITY. HENCE PLEASE OBTAIN REDEMPTION PROCEEDS ON THE DUE DATE K) Indicate your date of birth / age. L) Provide your bank account details for receiving payment through Electronic mode M) Any information regarding tax applicability may be provided to the bank/branch RIGHTS OF THE INVESTOR a) The Bond will be issued on the same day if subscription is received in cash and on realization of the cheque if subscription is received through cheque. b) The Certificate of Holding will be issued within 5 days from the date of tender of application. c) The interest on the bond accrues from the date of subscription in cash or date of realization of cheque. The interest will be credited to the bank account of the holder directly provided by him/her in the application form. d) The interest on the date of 1st February / 1st August will be credited to the bank account. e) An advice of payment of interest will be issued to the investor one month in advance from the due date. f) Maturity intimation advice will be issued one month before the due date of the bond. g) Facility for payment of interest and principal by 'demand draft free of cost or at par cheques' for up country customers is available. h) The facility of intra-bank branch and inter bank branch transfer of the bonds is available. I) Application forms for investments, redemption, NECS/NEFT Mandate, etc, in respect of Savings Bonds are available on the website at www.hdfcbank.com (Banks and SHCIL website). j) A sole holder or all the joint holders may nominate one or more nominees to the rights of the bonds. Non-resident Indians can also be nominated k) The nomination will be registered at the office of Issue and a Certificate of Registration will be issued to the holder. l) The nomination can be varied by registering a fresh nomination. m) The existing nomination can be cancelled by a request to the Office of Issue. n) The redemption is due on expiry of six years from the date of investment. o) Premature redemption facility has been introduced as per the conditions issued by the Govt. vide its Notification dated July 29, 2013 and subsequent amendment vide Notification dated August 16, 2013. PAGE14 p) The investor is entitled to receive repayment amount within five clear working days from the date of tender of acquaintance. q) To avoid delay in receipt of interest / redemption proceeds applicants may indicate his choice, for availing of half yearly interest / redemption proceeds through ECS/NEFT/RTGS or direct credit to the bank account. r) Investors are entitled for compensation for delayed payments at the rate decided by RBI vide their circulars issued from time to time. In case the bank does not comply with the above, you may lodge a complaint in writing in the form provided at the counter and address the same to the nearest office of Reserve Bank of India as under : THE REGIONAL DIRECTOR, RESERVE BANK OF INDIA, CUSTOMER SERVICE DEPARTMENT/ BANKING OMBUDSMAN (LOCATION) -------------------------------------------------------------------------YOU MAY ALSO ADDRESS YOUR COMPLAINT TO: THE CHIEF GENERAL MANAGER IN-CHARGE DEPARTMENT OF GOVERNMENT AND BANK ACCOUNTS CENTRAL OFFICE BYCULLA, OPP. BOMBAY CENTRAL RAILWAY STATION MUMBAI- 400 008, MAHARASHTRA Disclaimer: -I have read and understood the details of information for the investors as well as rights and duties of investors. The agent/bank has explained the features of the scheme to me. Signature of the applicant -------------------------------------------------------------------- TEAR AWAY HERE ------------------------------------------------------------------ PAGE15 -------------------------------------------------------------------- TEAR AWAY HERE ------------------------------------------------------------------ Acknowledgement of Application Form Application Number Bank branch……………………………………………........ Date : ....... /....... /............ Received from Mr/Mrs/Ms………………………………………………………………………………..……...Cash/Draft/PayOrder/ Cheque No.………………… dated : ....... /....... /............ drawn on (Bank and branch)………………....................................... for `……………….................(Rupees……………………………………………………………........ only) for the purchase of 8% Savings (Taxable) Bonds, 2003 for a period of 6 years, interest payable on cumulative [ ] /payable on Non-cumulative [ ] basis of the nominal value of `…………………......... (Rupees………………………………………………………...............only). Date, Bank Stamp & Signature of the authorized official of the Bank. PAGE16