FORM SL 3





Variation of nomination under sections 45ZE and 52 read with section 56 of the Banking Regulation Act, 1949 and Rule 4(6) of Co-operative Banks (Nomination) Rules, 1985 by sole hirer in respect of safety locker



I, ...............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 death/minor's death ..............(name and address of branch/office in which .................may give access to the locker and liberty to remove the contents of the locker, particulars whereof are given below:

Locker:-

1. Nature of

2. Distinguishing mark or No.

3. Additional details if any

Nominee:-

1. Name

2. Address

3. Relationship with hirer, if any

4. Age

Place:

Date:

Name(s) and signature(s) and *Signature/Thumb impression

address(es) of witness(es)+ of hirer

* Where the locker is hired solely in the name of a minor, the nomination should be signed by a person lawfully entitled to act on behalf of the minor.

+ Thumb impression shall be attested by two witnesses.