FORM A
Application for opening a new account
Acknowledgement
[See paragraph 4(1)]
State Bank of India, Branch . State Bank of India, Branch
Site Restoration Fund Scheme, 1999 Site Restoration Fund Scheme, 1999
[Paragraph 4(4)]

Branch .
Deposit A/c. No. . Deposit A/c. No. .
(for office use)
Voucher No. .
Voucher Date .
Amount deposited (in figures) . Received from : .
(in words) . Name .
By cheque/DD No./Bank transfer . Address
Name and address of the depositor :
Rupees received as
deposit under the Site Restoration Fund
Scheme. The amount will be credited subject to
realisation.
The statement of account will be sent in due course.
Permanent Account No. of depositor
.
Bank details for withdrawal : Date : .
Name .
Branch . Place : .
A/c No. .
Signature of the depositor
Date :
Place :
(For office use only)
Opened account in favour of .
on . Signature of Officer -in-Charge
The A/c. No. allotted is .
Signature of Officer-in-Charge