FORM SC 3





Variation of nomination under section 45ZC read with section 56 of the Banking Regulation Act, 1949 and Rule 3(5) of the Co-operative Banks (Nomination) Rules, 1985 in respect of articles left in safe custody with banking company



I, ..........(name and address) ..............cancel the nomination made by me in favour of ............(name and address) .............and hereby nominate the following person to whom in the event of my/minor's death, the articles left in safe custody, particulars whereof are given below, may be returned by ..............(name and address of branch/office in which articles are left in safe custody)............

1. Nature of

2. Distinguishing no.

3. Additional details, if any

Nominee:-

1. Name

2. Address

3. Relationship with Depositor, if any

4. Age

5. If nominee is a minor, his date of birth

+2.As the nominee is a minor on this date, I appoint Shri/ Smt./Kum............................(name, address and age) ..............to receive the said articles on behalf of the nominee, in the event of my/minor's death during the minority of the nominee.

Place:

Date:

Name(s) signature(s) and *Signature/Thumb impression address(es) of witness(es)# of depositor

+Strike out if nominee is not a minor.

*Where articles are left in the safe custody 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.

# Thumb impression shall be attested by two witnesses.