I ffi ' PGS-ITffi Application Form t{qfufrt'fieb ft{ =y\il LIMITD XCLLNC IN BANKING \ryww. d ho ko bq n kltd. co m
LIMITD XCLLNC ]N BANKiNG LAKHOPOTI DPOSIT SCHM Application Form Applicant's Photograph To The Manager Dhaka Bank Limited LDS Account Number Date Branch Customer lc Dear Sir, Customer ld Please open a Lakhopoti Deposit Scheme Account as per the following details: Monthly Deposit AmountTk. LDS lnstallment, charges (if any) to be debited from Link A/C No. (in words only itttuit ] +years 5 years f] oyears [ 8 years! toyears Customer lnformation Form (ClF) I tzyears Name of the Customer/Applicant :...... aather's Name/Spouse! Name : Mother's Name: Nat,onality:.. DateofBirth, ffi - Marital Status: I Gender: I Married lrlate! single I l-emale,] others National ID No.:. Passport/Driving License No. (if available) : - t'l f avai'able) : - :,:.?J <>) :: -:- =^: \ddress : Corltact Details :.Telephone : Residence : Office: Mobile =-_. :=,:=-:r'status: IResident I r-:':::.r: Service l l Business tr. : - = -' :he O'ganization : -mail :...... Non-Resident Others (please specify) -:: 9 dt uil, Number of years at present mployment/business if lhe Account Holder is a Minor, name of the Guardian Address: lrwe do solemnly declare that all information provided here is true I shall provide any kind of relevant information/documents in addition to the information provided herein as per requirement. Page 1 of 3 Signature of A/C Holder or Guardian (if Holder is Minor)
tl,lot(a=h\n I( LIMI XCLLNC IN T BANKIN D G Nominee! Photograph Nominee(s) : ln case of mylour death, l/we nominate the following person(s) to receive the balance of the Account. lave can change or cancel mylour Nomination anytime. Name & Address Date of Birth Relation Share o/o Signature or Thumb lmpression 1 2 3. Name of the Guardian : Address of the Guardian : Relationship with Nominee Signature of the Guardian Guardian! Photograph Monthly lnstalment Size [Lakhopoti Deposit Scheme] Tenure 4 years 5 years 6 years 8 years 10 years '12 years Lakhopoti 10 lac 18,640.80 14,503.20 11,751.20 8,326.00 6,286.84 4,940.00 Lakhopoti 25 lac 46,602.00 36,258.00 29,378.A0 20,815.00 15,717.00 12,350.00 Lakhopoti 50 lac 93,204.00 72,516.00 58,756.00 4 r,630.00 31,434.00 24,700.00.:.. r i.-'1, Sector Code : Maker; Name:...... mployee ld: Signature :... (under SBS-2 of Bangladesh Bank) Checker: Name:... mployee ld: Signature: Manager/Authorized Officer : Name: mployee ld: Signature: Page 2 of 3
Customer Copy LDS Account Number lal(ai,.-.- LII,AITD XCf tinci I! ANK]NG LAKHPOTI DPOSIT SCHM Branch Customer ld I Tenure: l=l 4years Account Holder Name Mailing Address: L l 5 years I oyears [ 8yeutt ['toyears I t2yuars Date: Monthly DepositTk. Matured Value Tk. (lncluding Tax as applicable) Opening Date: (in words Maturity Date: Authorized Signature Name & PA No. Branch Seal Authorized Signature Name & PA No.
TRMS & CONDITIONS 1. The name of this plan ls,lakhopott DPOSIT SCHM',and the Acccunt Holder indicates'lakhopoti DPOSIT SCHN4', Account Holder' 2.ThetenureofLDSwill be415/6/9/10ll2yearsatrhediscretionoftheappiicant.howevettenurechosenatthetimeofopeningschemecannotbechanqedlateron' 3. Month ly insta llment will be autornatically realized from the linked savings/cu rrent Account. lf a person does not have any such Accou nt, open ing of ner'v SB "cd Accou nt will be required. bethesoleresponsibility'oftheaccountholdertosettlelhearr-'arinstallment 4. lntheevenroffailuretopaymonthlyinstallmentwithinnextl0daysofduedates,itwill amount through written instruction (Late payment charge wili be applicable to installments ciefaulted)' 5. Any institution, club or non-prcfit organization havi ng legal entity also ca n open LDS Account su bject to proper mai ntenance of Know Your cusiomer (KYC) and Transaction Proflle (TP) as well as document checklist for opening savings/current Account. 6. ln the event of encashment of the scheme, Account Holder will require to present the Acknowledgement Slip (customer copy of LDS)' 7. ncashment on or before maturity of LDS can be done only through issuing Branch' g. LDS Account Holder are to preserve the Acknowiedgernent slip (customer copy) with due care. in case the Acknowiedgement slip(s) is/are lost' stolen' burned' destroyed or altered into d;fferent form,the Account Holder will notify such incident to Bank on immediate basis in writii-}g whereupon the Bank will issue Duplicate Slip after observing necessary formaiities'
3 i I LI XC M LLNC TD ]N BANKING t. ThenameofthisSchemeis'LAKHOPOTI DPOSITSCHM'andtheAccountHolderindicates'LAKHOPOTI DPOSITSCHM'AccountHolder. 2. A person of 18 years ofage or above can open any number of Lakhopoti Deposit Scheme (LDS) singly orjointly. 3. ThetenureofLDSwill be4/5/6lglloll2yearsatthediscretionoftheapplicant.however,tenurechosenatthetimeofopeningschemecannotbechanged later on. 4. A passport size photograph is required to open the Account. 5. A passport size photograph ofthe Nominee(s) attested by LDS Account Holder must be attached to Application Fornl. 6. MonthlyinstallmentwillbeautomaticallyrealizedfromthelinkedSavings/CurrentAccount. lfapersondoesnothaveanysuchaccount,openingofnewsb/cd Account will be required. 7. Deduction of monthly installments will start from the day of opening the above Accounts and all subseqtrent installments will be deducted of the following months. Sufficient avallabie/cleared fund must be kept in the iinked Account on or within the next 1 0 days of due dates for deduction of the installment amount 8. lntheeventoffailuretopaymonthlyinstallmentwithinnextl0daysofduedates,itwillberhesoleresponsibilityoftheaccountholdertosettlethearrear installment amount through written instruction (Late payment charge n,il1 be applicable to installments defaulted). 9. Ifanyinstallmentremainsunpaidfor3(three) consecutlvemonthstheaccountwill beclosedautomaticallyandsettledasperbank'srule. 'I 0. Any institutlon, club or non-profit organization having legal entity also can open LDS Account subject to proper maintenance of Know Your Customer (KYC ) and Transaction Profile (TP) as well as document checklist for opening Savings/Current Account. 1 1. Dhaka Bank Limited reserves the right to make changes/alteration/amendments/adciitions/modifications etc. of LDS and to its related charges, fees etc. without assiqrrirq any reason whatsoever at any time. 1 2. ln the event of encashment of the Scheme, Accountholder will require to present the Acknowledgement SIip (customer copy of LDS). 13. LDS Account Holder are to preserve the Acknowledgement Slip (customer copy) with due care. ln case the Acknowledgement Slip(, islare lost, stolen, burned, destroyed or altered into different form, the Account Holder will notify such incident to Bank on immediate basis in writing whereupon the Bank will issue Duplicate Slip after observing necessary formalities. I 4. Overdraft facility of maximum 800/0, or Tk.50,000.00 whichever is higher would be offered to LDS Account Holders. 1 5. Any benefit from LDS may come under purview of lncome Tax or any other levy as decided by Government of Bangladesh. I 6. ln case of death of the LDS Account Holder the relevant Account will be closed. Nomineeis) r'vill receive the proceeds of the Scheme(s). lf the Nominee(s) is/are Minor, the proceeds of the Scheme(s) will go to the Legal Guardian of the Nominee(s). 1 7. LDS Account Holder will fix the share of payment to each Nominee by fixing the share of amount receivable by such Nominee(s) in case the number of tr s & ffi 4 #j e a s "& g & a 3! 3 I 1 i z : J t :Jj Nominees is more ihan one. l8 Deposited amount will be payable to Nominee(s) as per prior written authority recorded with the Bank.ln that case, Succession Certificate wiii not be 'ec-::ed and the matter can be finalized at the Branch level. -9 -:aeeveniofldsaccountholder'sdeath,he/hernominee(s)willnotbeallowedtocontinuetheldsaccount. 20. in case of corporate bodies, Nomination should be clearly articulated.the Nomination of a Scheme should be in conformity with relevant Company Act and the concerned Company's Memorandum and Articles of Association. 21. ncashment on or before maturity of LDS can be done only through issuing Branch. 22. Premature ncashment: Account Relationship Less than i2 months Scheme Accounts are encashed or ciosed before maturity, 12 months or more but iess than 60 months rules will be applicable to settle the account: 60 months or more but less than '144 months ] Prevailing Savings Account Rate+1% 23. IftheschemeHolderexpiresafteravailingacreditfacility,Nominees/heirsoftheLDSAccountHolderwill bepaidtheremainingbalanceoftheschemeafter adjustment of outstanding Ioan amount by encashing the instrument. Declaration 7w1]h1'r[ir?".lare that the above information and all information provided in the Customer Information Form (ClF) is true and l/we am/are not barred under any Law or Act that is enforceable within Bangladesh. l/we am/are aware of the rules cf opening and operation of the LDS as stated in the Terms and Conditions section above and l/we agree to abide by the Rules and Regulations of Dhaka Bank Limited for maintaining such Scheme. l/we further declare that l/we shall solely be responsible for any misinformation and hold the Bank absolutely indemnified against any consequences arising there from. Rate oflnterest No lnterest Prevailing Savings Account Rate Signature of Account holder Name:- Page 3 of 3 Signature of Bank Official Name: