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Attestation by two witness is required only for Thumb Impression s. Signatures need not be witnessed. Acknowledgement Slip We acknowledge the receipt of Nomination Form DA1 from Mr/Mrs/Ms relating to Account No For Kotak Mahindra Bank. Form DA 1 Nomination under Section 45-ZA of the Banking Regulation Act 1949 and rule 2 1 of the Banking Companies Nomination Rules 1985 in respect of bank deposits. I/We Name s Address es nominate the following person to whom in the event of my/our/minor s death the amount of the deposit particulars whereof are given below may be returned by name and address of branch/office in which deposit is held Deposit Nature of Distinguishing No* Additional details if any Nominee Relationship with depositor if any If nominee is a minor date of birth D D M M Y Y Y Y Age As the nominee is a minor on this date I/we appoint Shri / Smt / Kum to receive the amount of the deposit on behalf of the nominee in the event of my / our / minor s death during the minority of the nominee. Date Place Signature s / Thumb Impression s Signature of First Witness Signature of Second Witness Nomination facility is available for individual as well as joint deposit accounts with or without Either or survivor mandate. Strike out if nominee is not a minor. Where deposit is made in the name of a minor the variation of nomination should be signed by a person lawfully entitled to act on behalf of the minor. Form DA 1 Nomination under Section 45-ZA of the Banking Regulation Act 1949 and rule 2 1 of the Banking Companies Nomination Rules 1985 in respect of bank deposits. I/We Name s Address es nominate the following person to whom in the event of my/our/minor s death the amount of the deposit particulars whereof are given below may be returned by name and address of branch/office in which deposit is held Deposit Nature of Distinguishing No* Additional details if any Nominee Relationship with depositor if any If nominee is a minor date of birth D D M M Y Y Y Y Age As the nominee is a minor on this date I/we appoint Shri / Smt / Kum to receive the amount of the deposit on behalf of the nominee in the event of my / our / minor s death during the minority of the nominee. I/We Name s Address es nominate the following person to whom in the event of my/our/minor s death the amount of the deposit particulars whereof are given below may be returned by name and address of branch/office in which deposit is held Deposit Nature of Distinguishing No* Additional details if any Nominee Relationship with depositor if any If nominee is a minor date of birth D D M M Y Y Y Y Age As the nominee is a minor on this date I/we appoint Shri / Smt / Kum to receive the amount of the deposit on behalf of the nominee in the event of my / our / minor s death during the minority of the nominee. Date Place Signature s / Thumb Impression s Signature of First Witness Signature of Second Witness Nomination facility is available for individual as well as joint deposit accounts with or without Either or survivor mandate.

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