TR. No:

KERALA TRANSPORT DEVELOPMENT FINANCE CORPORATION LIMITED
(Fully Owned by Government of Kerala)
Regd: Office: O-3 & 4, SAPHALLYAM COMMERCIAL COMPLEX, TRIDA, PALAYAM, THIRUVANANTHAPURAM - 695 033.
APPLICATION FORM FOR DEPOSIT & RENEWAL

Please "ü " 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 A TICK MARK
HDFC BANK LTD.   IDBI 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.