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Ckyc 2

This document is a KYC/Re-KYC application form for individuals to provide their personal details to Central KYC Registry. The form requests for name, father/spouse name, date of birth, gender, nationality, occupation, address details, contact details, identity and address proof. It also contains applicant's declaration that the details provided are true and consent to receive information from Central KYC Registry via SMS/email. The form will be used for in-person verification by bank official who will verify original documents and signatures.

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55 views1 page

Ckyc 2

This document is a KYC/Re-KYC application form for individuals to provide their personal details to Central KYC Registry. The form requests for name, father/spouse name, date of birth, gender, nationality, occupation, address details, contact details, identity and address proof. It also contains applicant's declaration that the details provided are true and consent to receive information from Central KYC Registry via SMS/email. The form will be used for in-person verification by bank official who will verify original documents and signatures.

Uploaded by

Cyber Cafe HUB
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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KNOW YOUR CUSTOMER (KYC / Re-KYC)

Individuals | CENTRAL KYC REGISTRY


APPLICATION FORM

Application Type √ New KYC Number (if already existing)


Account Type Normal Minor

1. PERSONAL DETAILS

Prefix First Name Middle Name Last Name


Name (As per PAN)
Father/Spouse Name
Mothers Name
Date of Birth Marital Status: Single Married
Gender Male Female PAN
Nationality Indian Others (Please Specify: ______________________________) PHOTO
Residential Status: Resident Non Resident
[To be signed across]
Occupation Government Service Private Sector Business Agriculturist
Retired Public Sector Professional Housewife Student
Others (___________________)

2. PROOF OF IDENTITY AND ADDRESS (Please tick any of the below OVDs and mention the corresponding ID Number)
1.
Aadhaar Voter ID Card Driving Licence Passport NPR Letter MG-NREGA Card
ID Number

3. ADDRESS DETAILS
2.
Permanent Address

District State/UT Country PIN

Correspondence Address (Specify the proof of address submitted for correspondence address) If same as permanent address: Yes No

Correspondence Address

District State/UT Country PIN

4. CONTACT DETAILS (All communications will be sent to Mobile number/ Email ID provided)
3.
Mobile Number Email ID

5. DECLARATION

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein,
immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
Further I hereby consent for receiving information from Central KYC Registry through SMS/Email on the above registered number/email address.

DATE
PLACE [Signature of the Applicant]

FOR OFFICE USE ONLY

IN PERSON VERIFICATION [IPV] BY J&K BANK/JKBFSL OFFICIAL

Name of the person who has done the IPV


Designation Date of IPV
Emp Code
Originals verified and self-attested documents received.

[Signature of the person who has done the IPV]

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