APPLICATION FOR MEMBERSHIP
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1 {kfrhkwfrz jkf k #200@ek= P.F. Index No dì;k /kukns k #i;s 2010@dk laykxu Salary A/c No. (SB/CA djsaa ijfokj dy;k.k tek jkf k #i;s&800 va k jkf k #i;s& Mobile No. izos k kqyd #i;s&10-00 #i;s&2010 GRAM: HELP Phone: , State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal (A Multi State Cooperative Society Regd.No.MSCS/CR/132/2001) C/o State Bank of India, Local Head Office, Mezz Floor, Hoshangabad Road, Bhopal APPLICATION FOR MEMBERSHIP To, The President State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit Bhopal Sir, I apply that I may admitted as a member of your Society and be allotted...shares of Rs.25/- each. I send herewith Rs...payment thereof inclusive of the admission fee of Rs.10/- and agree to abide by the byelaws of the society which are now or hereafter may come in force. 1. Name (Block Letters) : 2. Father s / Husband s Name : 3. Cast : 4. Date of Birth : 5. Designation : 6. Department/Section : 7. Branch : 8. Basic Pay : 9. Dearness Allowance : 10. Other Allowances : 11. Date of appointment in SBI : 12. Residential address : 13. Whether he was a member : Previously and if so, how the : membership terminated and when: 14. Whether the applicant is a member of any other Co-operative Credit Society : I hereby solemnly declare that all the information given above is true. PLACE... DATE... Signature of Applicant We, the members of the society propose that Ku./ Smt./Shri... who to your knowledge, possess all the qualifications to become a member of the society, may be admitted as a member. Proposed by...membership No... Full Name... Seconded by...membership No...
2 Full Name... To, The President State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal I...agree to the installment of share capital, loan or and other sums that may, at any time, and from time to time become due and payable by me to the Society being recovered by the Society from my monthly Salary through the officers for the time being disbursing such Salary. I herewith furnish an agreement authorising such officer to effect as and when necessary recoveries from my salary. PLACE... DATE... Signature of Member CERTIFICATE The Applicant Shri...is a permanent employee of State Bank of India...Branch/Department 1. Designation : 2. Branch : 3. Date of Birth : 4. Date of Appointment : 5. Basic Pay : 6. Dearness Allowance : 7. Other Allowances : PLACE: DATE: For State Bank of India CHIEF/BRANCH/OFFICE MANAGER (Office Seal) NOMINATION PLACE: DATE: I hereby nominate... (mention relationship) aged...to Succeed in the event of my share or interest in the society and receive any amount that may be due to me from the society. Signature of Nominee Signature of Applicant Witness 1. Signature - 2. Name (in Block Letters) - 3. Designation - 4. Address - OFFICE NOTE Kum./Smt./Shri... admitted as member of the Society from... Membership No... Bhopal, Dated... PRESIDENT
3 C/o State Bank of India...Dept. Branch... The Branch / Chief /Manager/Office Manager State Bank of India State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal (Regd.No.MSCS/CR/132/2001 Dear Sir, FAMILY GRATUITY DEPOSIT SCHEME Membership No... Kindly deduct from my salary a sum of Rs.800/- (Rupees Eight Hundred only) each month and credit/remit the same on my behalf to the S.B.I. (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Savings Account at the Udayachal (Bhopal) Branch as my contribution towards the above scheme. I hereby declare that this authority shall not be revoked by me without written consent of the Society. Thanking you, Yours faithfully, Signature... Name of Member... Designation... Branch/Department...
4 Kum./Smt./Shri... Place: State Bank of India... Date: Chief/Branch/Office Manager State Bank of India... Through President, State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal I... have applied for admission as a member of/a loan from State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal and I hereby authorise you to recover from and out of my monthly salary and pay such sum or sums to the said Society in payment of all or any instalments of share capital loan or loans, deposits and all other sums that may from time to time and at any time become due and payable by me to the said Society towards the instalments of instalments of shares capital, deposits loan or loans of other sums that may be due and payable by me to the society, I agree to accept as sufficient evidence as may liability a demand from on officer of the society certified by him to be correct. I agree that you make recoveries from my salary in the manner above mentioned so long as I continue to be a member of the society I shall not at any time ask for the suspension of the recoveries except with the express consent of the Managing Committee of the Society. 2. If I am transferred to any other Branch, I request and authorise yourself and the Society to communicate to my new pay disbursing officer a copy of this agreement and request and authorise him to make the recoveries. There upon the disbursing officer shall effect recoveries according to the demand list sent to him by the society or yourself. FORWARDED to the Chief /Branch/Office Manager Signature of Member... Admitted on... and Membership No... For S.B.I. (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal PRESIDENT
5 State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Maryadit, Bhopal (Regd.No.MSCS/CR/132/2001) The President State Bank of India (Bhopal Circle) Adhikari Sahakari Sakh Samiti Mayadit, Bhopal FOR OFFICE USE Membership No. Branch/Deptt Initials Gram: Help FAMILY GRATUITY DEPOSIT SCHEME APPLICATION FOR MEMBERSHIP 1. The undersigned member of the Society apply for membership of the Family Gratuity Deposit Scheme. 2. I agree and undertake to deposit Rs.800/- (Rupees Eight Hundred only) per month towards the aforesaid scheme and hereby authorise the society to recover the same from my monthly salary and that my employer, the State Bank of India shall be competent to deduct from monthly salary payable to me by them, an amount as advised by the Society from time to time and to pay the amount so deducted to the Society towards the aforesaid scheme. 3. I agree to abide by the Society s Bye-laws and the Rules framed thereunder and also Rules of the aforesaid Scheme, which are now in force or as may be modified or altered from time to time. 4. Particulars of the Members. Full Name Kum./Smt./Shri Short Name as on Bank s record: Designation Deptt/Branch Date of Birth Married/Unmarried Residential Address (Local) Permanent native place address 5. I nominate the following person to receive the amount payable under the aforesaid scheme in the event of my death (Nominate should NOT by any other than Wife/Husband of Son/Daughter or Father/Mother of the Member.
6 PARTICULARS OF THE NOMINEE Full Name Minor/Major Kum./Smt./Shri Relation with the member If minor, indicate name of the guardian Guardian s relation with the nominee Permanent Residential Address Signed before me Signature of witness Applicant s Signature Full Name... Membership No... Branch/Deptt...Membership No. Date: FOR OFFICE USE ONLY This form is in order, put up for approval Please. Cant Scrutiniser Manager Admitted as a member of the Family Gratuity Deposit Scheme on... recovery to be commence from the month of...20 President Admission ratified by the Managing Committee In its meeting held on...20 Manager Posted in Loan Ledger L.F.No. Initial Initial F.G.D.A. Sent on Register
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SECOND SCHEDULE [FORM A] To Under Regulation 6 of the Insolvency and Bankruptcy Board of India (Insolvency Professionals) Regulations, 2016] The General Manager (IP Division) Insolvency and Bankruptcy
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