CUSTOMER UPDATION FORM FOR

KYC - RESIDENT INDIAN

All fields are mandatory
The Branch Head Axis Bank Ltd. BARCODE

Branch Sol ID Date D D M M Y Y Y Y

Customer Name Prefix First Name Middle Name Last Name

Customer Id Or A/C No.

Occupation Salaried Self Employed Business Retired Student Housewife Other * Occupation Code
(To be filled by branch Official)

Self-Annual Income Upto 1 lakh 1 - 5 lakhs 5 - 10 lakhs 10 - 15 lakhs 15 - 25 lakhs Above 25 lakhs
Source of Funds Salary Business Income Investment Income Agriculture Others Please Specify
*Mandatory fields
COMMUNICATION ADDRESS (Please leave space between two words)
Document Attached A) Correspondence i) Residence ii) Office B) Permanent

Address

Landmark City

Pin code State Country

Residence Type Owned Rented/Leased Ancestral/Parental Company Provided
*For change of address in Demat A/c, please submit a seperate CKYCR form along with this form.
PERMANENT ADDRESS (Please leave space between two words)
Address

Landmark City

Pin code State Country

Residence Type Owned Rented/Leased Ancestral/Parental Company Provided

*Mobile Number Telephone (R) (O):

EMAIL ID
*Permanent Account Number (PAN) Or form 60 (overleaf)

*Aadhaar Number *Date of Birth D D M M Y Y Y Y

AFFIX
*Mandatory fields RECENT
PHOTO
*FATCA CRS Certification -
I am a tax resident of India and not resident of any other country OR I am a tax resident of the country/ies mentioned in the table overleaf:
I do hereby solemnly declare that the information provided above is up to date and correct. I accept all the Terms and Conditions mentioned overleaf and
hereby submit my recent photograph and self-attested photocopy of the following
Customer Signature
Address Proof
Identity Proof
Signature:
Nationality
This form is for resident individual for all his relationships maintained with the Bank

FOR BRANCH OFFICE USE ONLY

Request Received Date D D M M Y Y Y Y Request Accepted By
Signature
Forwarded To CPU Date D D M M Y Y Y Y Employee Number

Certified that this Form is complete in all respect & all relevant documents are obtained & verified with Mode of operation and signatures of
the A/c. The request may please be processed. For AXIS BANK LTD.
Signature
Designation OH BH S.S No

ACKNOWLEDGEMENT TO CUSTOMER
Customer Name Prefix First Name Middle Name Last Name

Date of Request Received D D M M Y Y Y Y Request Option No,

Name of Branch Official

Signature
Employee Number of Branch Official
ADDITIONAL DECLARATIONS

FORM 60
Form for declaraton to be filled by an individual or a person (not being a company or firm) who does not have a permanent account number and who
enters into any transaction specified in rule 114B of Income Tax Act, 1961
If applied for PAN and it is not yet generated enter date of application D D M M Y Y Y Y
and acknowledgement number
If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is held

a. Agricultural income (Rs.) b. Other than Agricultural income (Rs.)

Verification
I, _
do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I do not have a Permanent Account Number and my/our estimated total income
(including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in accordance with the provisions of Income-tax Act, 1961 fo the financial year in which the
above transaction is held will be less than maximum amount not chargeable to tax. Verified today, the ________________ day of _______ 20

Signature
Date Place

FATCA-CRS DECLARATION Please tick the applicable tax resident declaration (Any one)
I am a tax resident of the country/ies mentioned in the table below:
Please indiate the country/ies in which the entity is a resident for tax purpose and the associated Tax ID Number below:
City of Birth* Country of Birth*

Address Type for Tax Purposes Residential Business Registered Office

Tax Identification Identification Type Address For Tax Purpose

Country#
Number% (TIN or Other, please specify)% Communication Address Permanant Address Please note the address below

Landmark
Pin State Country

#To also include USA, where the individual is a citizen/green card holder of USA % In case tax Identification Number is not available, kindly
provide functional equivalent$ Signature
FATCA-CRS Certification: I have understood the information requirements of this Form (read along with the FATCA/CRS Instruction and Terms &
Conditions) and hereby confirm that the information provided by me/us on this Form is true, correct and complete and hereby accept the same

VALID LIST OF DOCUMENTS FOR INDIVIDUALS

Documents for establishing proof of identity and address: (submit any one)
1. Valid Passport
2. Pan card (separate address proof required)
3. E-Aadhaar letter downloaded from UIDAI site/Aadhaar card issued by government of India.
4. Valid Permanent Driving license
a. DL issued by state of Maharashtra not acceptable as address proof document.
b. Driving License, irrespective of the same being issued in any state, if it bears a notation "Not to be accepted as address proof" then the same will not be acceptable as address proof.
The same can still be accepted as identity proof
5. Election Card / Voter's ID card
6. Job card issued by NREGA

Terms & Conditions

• In case of Joint A/c., separate form is required.
• I hereby state that I have no objection in authenticating myself with Aadhaar based authentication system and consent to providing my Aadhaar number, Biometric Information and/or One Time Pin
(OTP) data(and/or any similar authentication mechanism ) for Aadhaar based authentication for the purposes of Re-KYC for updating my details in my accounts with Axis Bank.
• I understand that the Biometric Information and/or OTP and/or any other authentication mechanism, I may provide for authentication shall be used only for authenticating my identity through the
Aadhaar Authentication system and for obtaining e-KYC from UIDAI for that specific transaction and for no other purposes.
• I understand that Axis Bank shall ensure security and confidentiality of my personal identity data provided for the purpose of Aadhaar based authentication.I hereby state that I am physically present
and provided my Biometric Information for authenticating myself and for receiving e-KYC details from UIDAI for the purpose of Re-KYC for updating my details in my accounts with Axis Bank.
• All information provided by me of any nature (including personal & sensitive information) can be shared with agencies/service providers who have an agreement with Axis Bank for business purpose
and on need to know basis.
• Axis Bank shall always strive to comply with the rules and regulations as applicable from time to time on this context in accordance with the bank's Privacy policy.If I intend to revoke my consent to the
sharing of the data, the products/services available to me, pursuant to the consent provided earlier, shall no longer be available to me, and I shall be required to initiate closure of such
products/services.
• All the terms and conditions, processes and alternatives have been explained to me in local language as well.