FORM SL 3A





Variation of nomination under sections 45ZE and 52 read with the section 56 of Banking Regulation Act, 1949 and Rule 4(7) of the Co-operative Banks (Nomination) Rules, 1985 by joint hirers in respect of safety locker



We, ............(names and addresses) ..............cancel the nominations(s) made by us in favour of [names and address(es)] .............and hereby nominate the following person (s) to whom in the event of the death of one or more of us, ..........(name and address of branch/office in which the locker is situated) ..............may give access to the locker and liberty to remove the contents of the locker, particulars whereof are given below, jointly with the survivor or survivors of us.

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

5. Place:

6. Date:

Name(s) signature(s) and address(es) * Signature/Thumb impression of witness(es)+ of hirers

* 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.