Nomination Form

FORM FOR NOMINATION, CANCELLATION OF NOMINATION AND VARIATION OF NOMINATION IN RESPECT OF THE BANK DEPOSITS, ARTICLES IN SAFE CUSTODY AND SAFETY LOCKERS

(See Sections 45-ZA, 45-ZC and 45-ZE read with Section 56 of the Banking Regulation Act, 1949 and rules 2 to 4 of the Banking Companies (Nomination) Rules, 2025)

Nominee Selected : Yes

Bank Name : The South Indian Bank Ltd

1. Bank Customer details

Name of the student

Nature of deposit/nature of articles/nature of locker

: Mubashir

: Savings Account

2.Nomination Details

I/We, the undersigned, hereby nominate the following individual(s) to receive the amount of the deposits(s) or the articles in safe custody or the contents of the locker in respect of the particulars above mentioned in the event of my/our death:

No	Name	Address	Email/Mobile number, if any.	Relationship	Age	Order of priority in case of successive nomination	Percentage of the amount deposited in a bank.
1	Joseph	Mangalassery, Calicut, Kerala, India, 680002		Father	50	First	50%
2	Mariya	Mangalassery, Calicut, Kerala, India, 680002		Mother	40	Second	50%

*In case of nomination in respect of the article in safe custody or locker, this column is to be deleted. & The bank may allow to modify these details in e-nomination from time to time, if required.

1.Simultaneous nomination refers to nomination of one more nominee but not exceeding four, with defined percentage and total amounting to 100%.

2.Successive nomination refers to nomination in favour of one individual in order of priority and is also limited to four nominees; and the nominee lower in the order shall become effective only after the death of the nominee in the higher order.

3.Column (H) above is not applicable in case of nomination in respect of the articles in safe custody/lockers.

4.In respect of the deposits, out of column (G) and (H), only one column is to be filled.

5.Total percentage across all nominees in column (H) must equal 100%.

6.If more than one individual is nominated, the order of priority shall be deemed to be in order in which names appear in column (B)

I/We, the undersigned, hereby declare that the above nomination is made in supersession of all the previous nominations, if any, made by me/us in respect of the deposit/article in safe custody/locker described above. I/We declare that the above nomination has the effect of cancelling previous nominations in respect of the bank deposit/ article in custody of bank/locker.

No	Name	Address	Name of Guardian.	Relationship	Email/Mobile number of guardian, if any

5.Declaration & Signature

I/We declare that the information provided above is true to the best of my/our knowledge and belief. I/We understand that this nomination will supersede any previous nominations for the above-mentioned accounts(s).

Name of the student

: Mubashir

Signature/E-authentication date

6. Application/Declaration for submitting physical Aadhaar card/E-Aadhaar card/Masked Aadhaar /Offline Electronic Aadhaar xml for the purpose of opening bank accounts for myself and minors where I Act as natural guardian

In the name of Mr./Ms And Mr./Ms submitting physical Aadhaar card /E-Aadhaar card/Masked Aadhaar Ofline Electronic Aadhaar xml for the purpose of opening bank accounts.

7. Income tax declaration for generating form 60 for tax filing

purpose For the Minor where I am acting as guardian:

Agricultural income (₹)
Other than agriculture income (₹)

If Guardian Pan is not given in the module:

Declaration for myself as I am not in possession of a valid PAN Card:

Agricultural income (₹)
Other than agriculture income (₹)

I/We hereby confirm that I have submitted my physical Aadhaar card /E-Aadhaar card /Masked Aadhaar/ Offline Electronic Aadhaar xml voluntarily as an officially valid document for opening a bank account by my ward/minor. I/We hereby authorise and give informed consent to the Bank (and it’s all service providers), for the following informed purposes: for establishing my identity, carrying out my identification, demographic or other authentication/verification/identifications as may be permitted as per applicable law. I/We hereby declare that all the above information voluntarily furnished by me it true, correct and complete. I/We do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I/We do not have a Permanent Account Number and my/our estimated total income (including Income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction is held will be less than maximum amount not chargeable to tax.

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Nomination Form

3. Cancellation of Nomination/ Variation of Nomination

4. Guardian Details (if any nominee is a minor)