Example: barber

(Please refer instruction A at the end)

know your customer (KYC) application form | IndividualImportant marked with * are mandatory wherever fill the form in English and BLOCK fill the date in DD-MM-YY particular section update, please tick () in the box section number and strike off the sections not required to be read section wise detailed of code as per Indian Motor Vehicle Act, 1988 is available at the of two character ISO 3166 country codes is available at the number of applicant is mandatory for update OTP based E-KYC check box is to be checked for accounts opened using OTP based E-KYC in non-face to face modeFor office use Details (Please refer instruction A at the end)(To be filled by financial institution)Application Type*CKYC Number (KIN)

Know Your Customer (KYC) Application Form | Individual Important Instructions: A. Fields marked with ‘*’ are mandatory fields. B. Tick ‘’ wherever applicable. C. Please fill the form in English and BLOCK letters. D. Please fill the date in DD-MM-YY format. E. For particular section update, please tick in the box

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Transcription of (Please refer instruction A at the end)

1 know your customer (KYC) application form | IndividualImportant marked with * are mandatory wherever fill the form in English and BLOCK fill the date in DD-MM-YY particular section update, please tick () in the box section number and strike off the sections not required to be read section wise detailed of code as per Indian Motor Vehicle Act, 1988 is available at the of two character ISO 3166 country codes is available at the number of applicant is mandatory for update OTP based E-KYC check box is to be checked for accounts opened using OTP based E-KYC in non-face to face modeFor office use Details (Please refer instruction A at the end)(To be filled by financial institution)Application Type*CKYC Number (KIN)

2 NumberAccount Type*NewUpdateNormalMinorAadhaar OTP based E-KYC (in non-face to face mode)Name* (Same as ID proof)Maiden NameFather / Spouse Name*Mother NameDate of Birth*Gender*PAN*PrefixDD-MM-YYYYM- MaleF- FemaleFirst NameMiddle NameLast NameT- OF IDENTITY AND PERMANENT ADDRESS* (Please refer instruction B at the end) PHOTO*A-Passport NumberB-Voter ID CardC-Driving LicenceD-NREGA Job CardE-National Population Register LetterF-Proof of Possession of AadhaarE-KYC AuthenticationOffline verification of AadhaarIIIIIA ddress [For other than resident Individual, please mention Overseas Address]Line 1*Line 2 Line 3 District*Pin/Post Code* Code*ISO 3166 Country Code* ADDRESS DETAILS (Please refer instruction B at the end) Same as above mentioned address (In such cases address details as below need not be providedI.)

3 Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the following OVDs)A-Passport NumberB-Voter ID CardC-Driving LicenceD-NREGA Job CardE-National Population Register LetterF-Proof of Possession of AadhaarE-KYC AuthenticationOffline verification of AadhaarDeemed Proof of Address Document Type codeIIIIIIVA ddressLine 1*Line 2 Line 3 District*Pin/Post Code* Code*ISO 3166 Country Code*City/Town/Village*City/Town/Village *MaritalStatus*MarriedUnmarriedOthersCit izenship*IN- IndianOthers Country _____ Country CodeResidential Status*Resident IndividualNon Resident Indian Foreign National Person of Indian OriginPassport Expiry DateDriving Licence Expiry DateNo

4 Need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customerNo need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customerNo need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customerDD-MM-YYYYDD-MM-YYYYS ignature /Thumb Impression across photo without covering the faceNo need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customerNo need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customerNo need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customer (Mandatory for KYC update request)I Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the following OVDs) Details (All communications will be sent to Mobile number/Email-ID provided) (Please refer instruction Cat the end)Tel.

5 (Off)Email ID-Tel. (Res) (If any) DeclarationI herebydeclarethatthedetailsfurnishedabov earetrueandcorrecttothebestofmyknowledge andbeliefandIundertaketoinformyouofanych angestherein,immediately. Incaseanyoftheaboveinformationis foundtobefalseoruntrueormisleadingormisr epresenting. I amawarethatI herebydeclarethatI amnotmakingthisapplicationforthepurposec ontraventionofanyAct,Rules,Regulationsor anystatuteoflegislationoranynotification s/directionsissuedbyanygovernmentalorsta tutoryauthorityfromtimetotimeI herebyconsenttoreceivinginformationfromC entralKYCR egistrythroughSMS/ :DD-MM-YYYYP lace:[Signature/Thumb Impression]Signature/Thumb Impression of / For Office Use onlyDocuments ReceivedCertified CopiesEquivalent e-documentE-KYC data received from UIDAIV ideo Based KYCData received from Offline verificationDigital KYC ProcessKYC documents verification carried out by ( refer instruction E)Institution detailsDate:DD-MM-YYYYEmp.

6 NameEmp. CodeEmp. DesignationEmp. Branch[Employee Signature]NameCode[Institution Stamp]In-Person Verification (IPV) carried out by ( refer instruction F)Institution detailsDate:DD-MM-YYYYEmp. NameEmp. CodeEmp. DesignationEmp. Branch[Employee Signature][Institution Stamp] instruction / Check list / Guidelines for filling individual KYC Application / Guidelines on filling Personal Details : The name should match the name as mentioned in the Proof of Identity submitted failing which the application is liable to be of the following is mandatory: Mother s name, Spouse s name, Father s / Guidelines on filling Current Address details , thesubmittedPoldoesnothavecurrentaddress oraddressasperPolis invalidornotin CodeandPin/ , oneofI, II andIIIis tobeselected.

7 IncaseofonlineE-KYCauthentication,II is , oneofI, II,IIIandIVis tobeselected. IncaseofonlineE-KYCauthentication,II is DeemedProofofAddress Document CodeDescription01 Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water bill).02 Property or Municipal tax or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if they contain the of allotment of accommodation from employer issued by State Government or Central Government Departments, statutory or regulatory bodies, public sector undertakings, scheduled commercial banks, financial institutions and listed companies and leave and licence agreements with such employers allotting official (RE)shallredact(first8 digits)

8 OftheAadhaarnumberfromAadhaarrelateddata anddocumentssuchasproofofpossessionofAad haar, Equivalente-document meansanelectronicequivalentofa document,issuedbytheissuingauthorityofsu chdocumentwithitsvaliddigitalsignaturein cludingdocumentsissuedtothedigitallocker accountoftheclientasperrule9 oftheInformationTechnology(Preservationa ndRetentionofInformationbyIntermediaries ProvidingDigitalLockerFacilities)Rules, DigitalKYCprocess hastobecarriedoutasstipulatedin thePMLR ules, Guidelinesonfilling Contactdetails ( forIndianmobilenumbermention91-999999999 9) 0 in documentsis Incasetheoriginalofanydocumentisnotprodu cedforverification,thenthecopiesshouldbe properlyattestedbyentitiesauthorizedfora ttestingthedocuments,asperthelistmention edunder[F].

9 Anyproofof identityoraddressis in a foreignlanguage,thentranslationintoEngli shis addressof theapplicantmentionedontheKYCform, current& permanentaddressesaredifferent, ,(allowedtotradesubjecttoRBIandFEMA guidelines),copyofpassport/ PIOCard/OCIandoverseasaddressproofis caseof MerchantNavyNRI s,Mariner sdeclarationorcertifiedcopyof CDC(ContinuousDischargeCertificate)is to ,fora minor,photocopyoftheSchoolLeavingCertifi cate/MarksheetissuedbyHigherSecondaryBoa rd/ PassportofMinor/ ,in caseguardiandetailsareavailableforminor1 0yearsofage,thesame(orCKYCR numberofguardian)is (AMC). TransferAgent(R&T) ,GazettedOfficer,ManagerofaScheduledComm ercial/Co-operativeBankorMultinationalFo reignBanks(Name,Designation& Sealshouldbeaffixedonthecopy).

10 ,authorizedofficialsofoverseasbranchesof ScheduledCommercialBanksregisteredinIndi a,NotaryPublic,CourtMagistrate,Judge,Ind ianEmbassy/ConsulateGeneralin . ListofpeopleauthorizedtoperformInPersonV erification(IPV) (AMC). TransferAgent(R&T) ScheduledCommercial/Co-operativeBankorMu ltinationalForeignBanks(forinvestorsinve stingdirectly). ,a personpermittedtoattestdocuments,mayalso conducttheInPersonVerificationandconfirm thisin (includingSIPs),in MutualFundschemesuptoINR50,000/- ,byofficialsappointedbyCourts, , Officialliquidator,Courtreceiver, IndiaList of two digit state / codes as per Indian Motor Vehicle Act.


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