CUSTOMER INFORMATION UPDATE FORM

RESIDENT INDIVIDUAL Please fill the form in BLOCK LETTERS only. *Fields are mandatory

Customer ID: Account No.*:

PERSONAL DETAILS For Joint Account Holder, please use a separate form for each account holder.

Name*:

Mothers Maiden Name*:

Date of Birth*: D D M M Y Y Y Y Gender*: Male Female Others

Nationality*:

PAN No./Form 60*: Aadhaar No: / /

COMMUNICATION ADDRESS
Residence Permanent Office

Address*:
Flat No. & Bldg. Name:

Road Name & Area Landmark:

City: State:

Tel .No. Resi.: S T D PIN:

Off.: S T D Mobile No:

E-Mail ID:

OCCUPATION DETAILS
Occupation*: Salaried Self-Employed Retired Housewife Politician Student Others ____________

Business/ Industry *: Manufacturing Service Provider Agriculture Stock Broker Real Estate Trader Others ____________

Source of Funds*: Salary Business Income Agriculture Investment Income Others (Pls. specify) ____________

Gross Annual Income* (`): <50,000 50,000 – 1 Lac 1 – 3 Lac 3 – 5 Lac 5 – 7 Lac 7 – 10 Lac 10 –15 Lac >15 Lac

Residence type*: Owned Rented/ Leased Family Company Provided

Nature of Private Ltd Partnership Public Sector Public Ltd Multinational

Organization :
Proprietorship Government Others (Pls. specify) ________________

If Self-employed - since: Years Months

Self-employed Doctor IT Consultant Lawyer Architect CA/CS

Professional:
Others (Pls. specify) ________________

Please turn overleaf

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 FATCA DECLARATION
Are you a tax resident of any country other than India? Yes No

Country TIN/SSN/ Functional Equivalent Identification Number (TIN or other please specify)

Details under FATCA-CRS/Foreign Tax Laws: Towards compliance with tax information sharing laws, such as FATCA and CRS, we would be required to seek
additional personal, tax and beneficial owner information and certain certifications and documentation from our account holders. Such information may be
sought either at the time of account opening or any time subsequently. In certain circumstances (including if we do not receive a valid self-certification from
you) we may be obliged to share information on your account with relevant tax authorities. If you have any questions about your tax residency, please contact
your tax advisor. Should there be any change in any information provided by you, please ensure you advise us promptly, i.e., within 30 days. Towards
compliance with such laws, we may also be required to provide information to any institutions such as withholding agents for the purpose of ensuring
appropriate withholding from the account or any proceeds in relation thereto. As may be required by domestic or overseas regulators/ tax authorities, we may
also be constrained to withhold and pay out any sums from your account or close or suspend your account(s).

If you are a US citizen or resident or green card holder, please include United States in the foreign country information field along with your US Tax
Identification Number. Foreign Account Tax Compliance provisions (commonly known as FATCA) are contained in the US Hire Act 2010. It is mandatory to
supply a TIN or functional equivalent if the country in which you are tax resident issues such identifiers. If no TIN is yet available or has not yet been issued,
please provide an explanation and attach this to the form.

DECLARATION
I do hereby declare that the information provided with respect to my account is up to date and correct. Details declared on this form will be
updated in bank records and treated as the latest data. I hereby attach the following self attested proofs:

Address Proof: _________________________________________

Identity Proof: _________________________________________ Signature of Account Holder

FOR BRANCH USE ONLY

All Documents Self-Attested and Verified Branch Code: _____________________________________________

Signature on the form/ documents matched bank records

Branch Name: ____________________________________________

Any other comments: ____________________________________________

______________________________________________________________ Name & ECN: _____________________________________________
______________________________________________________________
______________________________________________________________
Signature: ________________________________________________

CUSTOMER ACKNOWLEDGEMENT RECEIPT

Thank You
We have received your request for RE-KYC updation along with self-attested documents for your Customer ID____________________________________on
_________________(dd/mm/yyyy). Your request ID for all future reference and communication is ________________________________.

Once your Re-KYC is updated, an SMS will be sent to you on your registered mobile number updated in our system. If you do not receive any information in
3 working days from the date of request, please call 1860 267 7777 for more details.

Branch Official Stamp & Sign with ECN No. _______________________________________

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