Universal Multi State Credit Co-Operative Society Limited

Regd. No. : MSCS / CR / 745 / 2013

7, Red Cross Place, Wellesley House, 3rd Floor , Kolkata : 700 001, West Bengal , India
Phone : 91-33-2231-9135, 91-33-2262-4943, 91-33-2262-4944, Fax : 91-33-4001 4642
E-Mail : info@universalcredit.in
www.universalcredit.in

RECURRING DEPOSIT APPLICATION FORM

(To be filled in Block Letter)

First Applicant Mr./ Mrs. / Ms :.........................................................................................................................

................................................................................................. Age.

Sex. M

Fathers / Husbands Name ..............................................................................................................................

Guardian (in case of Minor) : .....................................................................Relationship...................................
TERM

Address (in Block Letter ) : ............................................................................................

P-1
..............................................................................................Pin....................................
Telephone No.( R ) : ................................................(M)...............................................

P-2
P-3
P-4

Other Information (if any) .............................................................................................

Second Applicant : Mr. / Mrs / Ms........................................................Age ..................

P-5
Please

the appropriate

Nominee / s Name : ............................................................................................................. Age.......................

Relationship : ......................................................................................................................................................
PAN ...............................................................................

BANK ACCOUNT PARTICULARS

Bank Name : ...........................................................................
Branch : .................................................Sole / First Applicant...................................................
Account No. : ....................... Code No................. Second Applicant..........................................
Self Code ........................................................... Name .............................................................

Universal Multi State Credit Co-Operative Society Limited

Regd. No. : MSCS / CR / 745 / 2013

7, Red Cross Place, Wellesley House, 3rd Floor , Kolkata : 700 001, West Bengal , India
Phone : 91-33-2231-9135, 91-33-2262-4943, 91-33-2262-4944, Fax : 91-33-4001 4642
E-Mail : info@universalcredit.in
www.universalcredit.in

FIXED DEPOSIT APPLICATION FORM

(To be filled in Block Letter)

Guardian (in case of Minor)

Age Sex

First Applicant

(To be filled in Block Letter)

Age Sex

Secnd Applicant

(To be filled in Block Letter)

Fathers /
Husbands Name

Relationship
Agriculture
Business
Professional
Home-Maker

P.O

Service

District
State

Retired

Pin

Consultant

Phone
Mob.

Others

NOMINEE DETAILS
Full Name

(To be filled in Block Letter)

Address

Mr. / Ms.

Age

P.O

Relationship

District
State

Pin.
Specimen Signature of the Application

PAN No.
Bank Account No.
Name Of Bank.
Branch Address

PAYMENT DETAILS
Mode of Operation
Deposit Amount (in figure)
Deposit Amount (in word)
Deposit Period
Cheque / DD No.

CASH

CHEQUE

DRAFT

Rs.
Years

Months

Days
Date

Drawn on.
(Name of the Bank & Branch)

SELF........................................................................NAME : ...........................................................................................................
(Yours Faithfully)
I nominate the above mentioned person to whom in the event of my death the amount of
the deposit in the account, be returned by the Society. I also declare that I, shall abide
by all others rules and regulation with regard to the development of the Society.

.....................................................
(Signature of the applicant)

Universal Multi State Credit Co-Operative Society Limited

Regd. No. : MSCS / CR / 745 / 2013

7, Red Cross Place, Wellesley House, 3rd Floor , Kolkata : 700 001, West Bengal , India
Phone : 91-33-2231-9135, 91-33-2262-4943, 91-33-2262-4944, Fax : 91-33-4001 4642
E-Mail : info@universalcredit.in
www.universalcredit.in

MONTHLY INCOME SCHEME APPLICATION FORM

(To be filled in Block Letter)

Age Sex

First Applicant

(To be filled in Block Letter)

Guardian (in case of Minor)

F

Age Sex

Secnd Applicant

(To be filled in Block Letter)

Fathers /
Husbands Name

Relationship
Agriculture
Business
Professional
Home-Maker

P.O.

Service

District
State

Retired

Pin

Consultant

Phone

Others

Mob.

NOMINEE DETAILS
Full Name

(To be filled in Block Letter)

Address

Mr. / Ms.

Age

P.O

Relationship

District
State

Pin.
Specimen Signature of the Application

PAN No.
Bank Account No.
Name Of Bank.
Branch Address

PAYMENT DETAILS
Mode of Operation
Deposit Amount (in figure)
Deposit Amount (in word)
Deposit Period
Cheque / DD No.

CASH

CHEQUE

DRAFT

Rs.
Years

Months

Days
Date

Drawn on.
(Name of the Bank & Branch)

SELF........................................................................NAME : ...........................................................................................................
(Yours Faithfully)
I nominate the above mentioned person to whom in the event of my death the amount of
the deposit in the account, be returned by the Society. I also declare that I, shall abide
by all others rules and regulation with regard to the development of the Society.

.....................................................
(Signature of the applicant)

Terms & Conditions

1.A person desirous to be member of Universal Multi State Credit Co-Operative Society Limited.
has to submit his application in the prescribed form addressed to the Chief Executive
of the Society accompanied by membership fee. A person cannot be enrolled as a member if he/she
has not attained the age of 18 years.
2.Application must be completed in full in Block letters in English and should be made by Indian nationals
only. However signature(s) can be done in English, Hindi or Bengali.
3.Any quantum of deposit under various schemes will be accepted.
4.All payments must be made by cheque /DD favoring Universal Multi State Credit Co-Operative Society Limited
payable at Kolkata / Agra.
5.For Recurring Deposit scheme:
a.All the deposit are to be paid on or before due date and in case of any delay, interest @ 2% p.m.
will be charged on the delayed installment amount.
b.It is also to be ensured that all entries in the book are filled and signed by the authorized person
of the society only.
c.Entries in the recurring deposit book are to be endorsed from the office only at least once in a month
and in case of may discrepancy it is suggested to intimate the office immediately for necessary
rectification. It is also advised to preserve your original money receipt. In case of loss of the recurring
deposit scheme book, the same new book will be issued on payment of Rs.10/-(Rupees Ten Only) after
completion of necessary formalities.
6.Members are requested to open Saving Bank Account in their respective places for smooth operation
in case they are not holding the same.
7.A member should clearly mention the details of his/her Nominee.
8.Member are requested to keep the society's Certificates and other valid documents in safe custody.
9.Always communicate to the respective Marketing Executive in connection with any clarification
regarding various schemes of deposits.
10.Deposit are accepted on the understanding that the member Account Holder assumes full
responsibility for genuineness, validity and correctness of all signatures.
11.After completion of the term, maturity shall be paid to the members along with the interest as per
the scheme.
12.The decision of the Board will be final and the Board reserves the right to accept or reject any
application.
13.The Board may amend / alter any of the schemes from time to time.
14.The Society reserves the sole right to terminate any contract at any point of time without society.
15. Incase of any dispute, it shall be referred to arbitrator in Kolkata jurisdiction mutually agreed as per
the provision of the Act and Rule.

Universal Multi State Credit Co-Operative Society Limited

Regd. No. : MSCS / CR / 745 / 2013
7, Red Cross Place, Wellesley House, 3rd Floor , Kolkata : 700 001, West Bengal , India
Phone : 91-33-2231-9135, 91-33-2262-4943, 91-33-2262-4944, Fax : 91-33-4001 4642
E-Mail : info@universalcredit.in
www.universalcredit.in

MEMBERSHIP FORM OF NOMINAL MEMBER (AGENT)

No.

To,
The Chief Executive Officer,
Universal Multi State Co - Operative Society Ltd.
Respected Sir,
I wish to enroll myself as a member of your society, for which the details are mentioned hereunder
for your approval.
Members Full Name. : .........................................................................................................................
Fathers / Husbands Name. : ...............................................................................................................
Date of Birth : .......................................................Educational Qualification : ......................................
Address :.................................................................................................................................................
..................................................................................................... ..........................................................
Tel No. ..............................................................Mob. ............................................................................
Nominee :..........................................................Relationship : ...............................................................
Introduced by : .......................................................................................................................................
Membership No. : .......................................................Signature : .........................................................
KINDLY GIVE BELOW THE FULL NAME AND ADDRESS OF THE PERSON FOR THE
PURPOSE OF REFERENCE

Name & Address : .....................................................................................................................................

...................................................................................................................................................................
I hereby agree to obey and abide by the rule and regulations mentioned herein and all administrative
instructions and circulars issued or to be issued by UNIVERSAL MULTI STATE CO-OPERATIVE SOCIETY
LIMITED.

Date :

Full Signature of the Member

Universal Multi State Credit Co-Operative Society Limited

Regd. No. : MSCS / CR / 745 / 2013
7, Red Cross Place, Wellesley House, 3rd Floor , Kolkata : 700 001, West Bengal , India
Phone : 91-33-2231-9135, 91-33-2262-4943, 91-33-2262-4944, Fax : 91-33-4001 4642
E-Mail : info@universalcredit.in
www.universalcredit.in

MEMBERSHIP FORM OF ORDINARY MEMBER (CUSTOMER)

No.

To
The Chief Executive Officer,
Universal Multi State Co-Operative Society Limited
Respected Sir,
I wish to enroll myself as a member of your society, for which the details are mentioned hereunder
for your approval.

Members Full Name :

Fathers / Husbands Name :
Date of Birth : ................................................................. Educational Qualification :.....................................................
Address :.........................................................................................................................................................................
......................................................................................... ..............................................................................................
Tele. No. ................................................................... Mob. ...........................................................................................
Nominee : ....................................................................... Relationship : .......................................................................
Introduced By : ..............................................................................................................................................................
Membership No. : ............................................................ Signature : ...........................................................................
KINDLY GIVE BELOW THE FULL NAME & ADDRESS OF THE PERSON FOR THE
PURPOSE OF REFERENCE
Name & Address : ..........................................................................................................................................................
........................................................................................................................................................................................
I hereby agree to obey & abide by the rules and regulations mentioned herein and all administrative and circulars
issued or to be issued by UNIVERSAL MULTI STATE CO-OPERATIVE SOCIETY LIMITED.

Date : ................................

...................................................................
Full Signature of the Member