PART I - KNOW YOUR CLIENT FORM ( DCM …

1 part I - know your CLIENT form (For Non-Individuals)Please fill this form in ENGLISH and in BLOCK LETTERS4 a) PANb) Registration No. ( CIN)5 Status (please tick any one):Private Limited Ltd. CorporateTrustCharitiesNGO'sOthers (please specify) _____BankGovernment BodyNon Government Organization Defense Establishment SocietyLLPP artnership FIFIIHUFAOPBOIA. IDENTITY DETAILS1 Name of the Applicant2 Date of incorporation 3 Date of commencement of businessDDMMYYYYP lace of incorporationDDMMYYYY1 Correspondence AddressCity/town/villagePIN CodeStateCountry2 Specify the proof of address submitted for correspondence address3 Contact DetailsTel. (Res.)Mobile (Off.)Fax IDB. ADDRESS DETAILSP lease affix the recent passport size photograph and sign across4 Registered Address (if different from above):City/town/villageStatePIN CodeCountry5 Specify the proof of address submitted for registered addressC. OTHER DETAILS , PAN, residential address and photographs ofPromoters/Partners/Karta/Trustees and whole time directors:(Please give the detail in the format inclosed)4 DIN/UID of Promoters/Partners/Karta and whole time directors:5P l e a s e t i c k , i f a p p l i c a b l e , f o r a n y o f y o u r a u t h o r i z e d signatories/Promoters/Partners/Karta/Tru stees/whole time directors:Politically Exposed Person (PEP)Related to a Politically Exposed Person (PEP)6 Any other hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we undertake to inform you of any changes therein, immediately.

2 In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am/we are aware that I/we may be held liable for & Signature of the Authorised Signatory(ies)_____DateDDMMYYYYFOR OFFICE USE ONLY(Originals verified) True copies of documents received (Self-Attested) Self Certified Document copies receivedVerified in PersonVerified by:Seal/Stamp of the BranchDateDDMMYYYYS ignature of EmployeeBank Account Details for repayment:Name of Bank_____Branch IFSC Code_____Account attach a cancelled cheque for online fund transfer12 form for Non-IndividualsSr. with Applicant ( promoters, whole time directors etc.)PANR esidential / Registered Address12345 Name & Signature of the Authorised Signatory(ies)DateDDMMYYYY