Pursuant to issuance of Long-Term (Subordinated) Deposits – Series II (LTD-II), I/we am/are aware of the "Call Option" given by Abhyudaya Co-op. Bank Ltd. as per approval given by RBI.

Accordingly, I/we declare that I/we am/are holding LTD-II Certificate bearing No. dated .

I/We further declare that I/we wish to participate/avail facility of call option given by bank and accordingly, I/we am/are handing over LTD-II certificate as mentioned above to base branch i.e. branch along with latest KYC documents for further procedure.

Please credit the proceeds of this LTD-II Certificate to my/our SB/CD/CC Account No. at Branch.

I/We am/are not willing to participate in "Call Option" given by Abhyudaya co-op. Bank Ltd. and wish to continue holding LTD-II certificate No. till maturity.