Be pheda ATAL PENSION YOJANA (APY) - SUBSCRIBER REGISTRATION FORM yn Fund Regulatory and Development Authority) fe oranch Manager, fan Branch pear scmadem, Jest that sn APY account be opened in tardatr elds. lease fil the formin English and BLOCK et feank eras: Bank a/cnumber (ee [sani Name I Bank Bronch* PERSONAL BETAS: ome of Appian in a furome paeor sie 214 TT eT eee TT TT obi TT mal 1 [aad ered Ye nef Tard, spous name ls mandatory fame ofspocie fda omnes nome aaa ominee’s Relationship wih he abicibar I sonal Details case nominee i» Minor patecfanmy Ts Ta T/T [mT eee eusrion's name eter beefy of other Hatton soda sear chee ve No eer [ncoe Tes Payer ves No PENSION DETAILS sion Amount (laze TKU™ [00 [T0000 20] ss TT ‘Contrtbution Amount | hereby authorize the bank to debit my above mertioned bark account til the age of 60 fr making payer (Monthly ) funder ASY as applicable based on my age and the Perséon Amount selected by me. i the transaction i inns} [sper ct tecedral rut arc wed até tnt ego ao eo robe egy the Bank) fo scone sata monte ety eon Pscton a autonaionby ata ete pret ghar sores APY ad hari tnd te endo St, hry soe a re ce at fecrracr true et we odors th bet fy noted uc eet he he a ay ange st eran fr rnd peentin voit ies esa a bean rwatsont f ernloate or oar have Es hve undersod th 0" pene utr pe ob bound yt tame rd and pono ees un the hae poy RDN ate STE Te Ty Te sienatare start impressions of Proce subscriber * in ascot animes "ACKNOWLEDGEMIENT - SUBSCRIBER REGISTRATION FOR ATAL PENSION YOIANA (APY) {To be filles by the Bank) Tome ofthe Subreribor PRAN Number Lr rrr ‘Garanteed Pension Amount Periodicity of Contribution ently ‘Monthly Contribution Amount under APY okey nome ofthe Bank lan Branch tecelving Officer's Nam Date of Receipt of application: Stamp and Signature ofthe