ACCOUNT OPENING FORM
 
PERSONAL DETAILS
SALUTATION* FULL NAME*
 FATHER/HUSBAND NAME* DATE OF BIRTH *
 GENDER* ADDRESS LINE 1 *
ADDRESS LINE 2 CITY *
 STATE * PIN CODE *
MOBILE NUMBER * (+91) EMAIL ID*
ACCOUNT DETAILS
STATE * CITY *
BRANCH * BRANCH CODE
PIN CODE TYPE OF ACCOUNT*
VERIFICATION
,do hereby declare that what is stated above is true to the best of my knowledge and belief. Verified today.
Date :16-Jun-2019   Place* :
*
I/We understand that a booklet on the Banking Codes & Standards Board of India Code(BCSBI) posted on your website shall be provided to me on demand. I/We confirm having received,read and understood (a) the accounts rules and hereby agree to be bound by the terms & conditions outlined in these rules which governs the account(s) which I/We am/are opening/will open and (b) amendment to the rules made from time to time and those relating to various services availed by me/us when displayed by the Bank on its notice board or on its website and those relating to various services offered by Bank including but not limited to debit card,credit card,internet banking,mobile banking and other facilities listed in the form. The usage of these facilities is govenrned by the terms and conditions stipulated by the Bank from time to time.
INTRODUCTION BY EXISTING ANDHRA BANK CUSTOMER(OPTIONAL)
I/WE CONFIRM THAT I AM/WE ARE AN ACCOUNT HOLDER WITH ANDHRA BANK FOR OVER 6 MONTHS.I/WE CERTIFY THAT I/WE HAVE KNOWN
MR/MRS    SINCE . HE/SHE IS RESIDING AT THE ADDRESS GIVEN ABOVE.
SALUTATION NAME
ACCOUNT NUMBER
PAN/GIR DETAILS
PAN/GIR NUMBER
NOMINATION
NOMINATION FACILITY
NOMINATION (FILL FORM DA-1) NOMINATION UNDER SEC. 45ZA OF THE BANKING REGULATION ACT, 1949 AND RULE 2(1) OF THE BANKING COMPANIES (NOMINATION) RULES 1985 IN RESPECT OF BANK DEPOSIT.
I/we nominate the following person to whom in the event of my/our/minor's death the amount deposit in the above account may be returned by the Andhra Bank Branch.
NAME ADDRESS 1
ADDRESS2 CITY
STATE PIN CODE
RELATION DATE OF BIRTH
 MINOR    
As the nominee is minor on this date, I/we appoint Mr/Ms 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.
ADDRESS1 ADDRESS2
CITY STATE
PIN CODE
CUSTOMER PROFILE
ID TYPE* PID NUMBER *
ISSUE DATE* EXPIRY DATE*
ISSUE PLACE* ISSUED BY *
OCCUPATION INCOME
COMMUNITY CATEGORY
EDUCATIONAL QUALIFICATION
ADDITIONAL INFORMATION
REQUEST FOR ADD-ON
ADDITIONAL INFORMATION FOR CROSS SELLING
DOCUMENT TO BE SUBMITTED
Please attach  identity proof ,address proof and recent photograph and originals thereof will have to be produced for verification.
PASSPORT SIZE PHOTOGRAPH *   
(Only JPG,BMP and PNG file types are allowed with maximum size of 100KB)
PROOF OF IDENTITY *
(Only PDF,PNG and JPG file types are allowed with maximum size of 500KB)
PROOF OF ADDRESS *
(Only PDF,PNG and JPG file types are allowed with maximum size of 500KB)
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ENTER SECURITY CODE*