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FATCA / CRS DECLARATION - INDIVIDUAL

FATCA / CRS DECLARATION - INDIVIDUALNON-MANDATORYS ignatureApplicant Name _____PART I - Please fill in the country for each of the following :1. Country of :a)Birth _____ b)Citizenship_____c)Residence for Tax Purposes Person* : Yes NoPART II - Please note :a. If in all fields above, the country mentioned by you is India and if you do not have US person status, please proceedto Part III for for any of the above field, the country mentioned by you is not India and/or if your US person status is Yes, pleaseprovide the Tax Payer Identification Number (TIN) or functional equivalent** as issued in the specific country in the table below.

FATCA / CRS DECLARATION - INDIVIDUAL NON-MANDATORY Signature Applicant Name _____ PART I - Please fill in the country for each of the following :

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