Your Base Branch : PUDUCHERRY - LAWSPET

BRANCH, ICICI BANK LTD., NO:1A, AGATHIAR

STREET ANNAL GANDHI THOTTAM, 100 FT.
ROAD, LAWSPET 605008
Account Number: 150401506522
MS.SIVAPRIYA S
NO,ANANTHAPURAM,12,PAKKAMUDAIYANPET,LAWSPET Account Number:150401506522
PONDICHERRY
PONDICHERRY - INDIA - 605008
IFSCode:ICIC0001504

Never share your OTP, URN, CVV or passwords with anyone, even if the person claims to be a Bank employee.

STATEMENT SUMMARY for Customer ID : XXXXX8245 as on January 31, 2023

ACCOUNT DETAILS - INR

ACCOUNT TYPE ACCOUNT BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) NOMINATION
Savings A/c XXXXXXXX6522 8,551.15 0.00 8,551.15 Registered

TOTAL 8,551.15 0.00 8,551.15

Statement of Transactions in Savings Account XXXXXXXX6522 in INR for the period January 01, 2023 - January 31, 2023

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

01-01-2023 B/F 2,673.99
UPI/300238862772/for event/ishwariyaporche/Union Bank of
02-01-2023 3,600.00 6,273.99
I/HDF0e921b35518448e9937e23faf8476301
02-01-2023 DEBIT CARD VPS/WESTSIDE /202301021231/300207345410/PUDUCHERR 698.00 5,575.99
UPI/300295094229/UPI/suvethasris27-1/ICICI
02-01-2023 14,000.00 19,575.99
Bank/ICIaf7f5085635a49adb92c0b690b42b243
UPI/300348114545/UPI/msmanikandan24@/Kotak Mahindra
03-01-2023 14,000.00 5,575.99
/ICIe23fc9c88b35400d9f013d18ebb4e201/
03-01-2023 DEBIT CARD VPS/SRI VENU CO/202301040354/300322651260/PONDICHER 2,601.52 2,974.47
UPI/300442672004/food parcel/banusaima94@okh/Indian
04-01-2023 100.00 2,874.47
Bank/ICIea81c60434db459893aa5fe0f0a5327e/
04-01-2023 APBS/Credit Through PFMS/C012300608916 2,400.00 5,274.47
UPI/300406582960/UPI/appleid.dec@okh/CSB Bank
04-01-2023 487.00 4,787.47
Ltd/ICI8b3e4428928e47e9bd7b0d769d029a0b/
04-01-2023 DEBIT CARD IPS/MG FOODS /202301042134/000000003091/PONDICHER 319.00 4,468.47
06-01-2023 DEBIT CARD VPS/MORE /202301061030/300605749232/PUDUCHERR 3,022.90 1,445.57
UPI/300687119976/UPI/hemamalinisomu7/State Bank Of
06-01-2023 3,000.00 4,445.57
I/SBId3715aaf277d465b915c3b29180dec44
UPI/300618054138/gym/gpay-1117096504/Axis Bank
06-01-2023 2,500.00 1,945.57
Ltd./ICIf29f180277614ec4a8d4557ba13c7fea/
UPI/300777170310/UPI/naveenraj.mtech/HDFC BANK
07-01-2023 3,000.00 4,945.57
LTD/HDF4ddd48acab264bf98bacd50ae5c6ccfb
UPI/300790978294/UPI/paytm-66379170@/Paytm Payments
07-01-2023 2,234.00 2,711.57
/ICIc991f1e88c3d444e90e853c84914b37f/
07-01-2023 APBS/Credit/0123989558128 1,000.00 3,711.57
UPI/300791390192/UPI/gpay-1118025145/Axis Bank
07-01-2023 750.00 2,961.57
Ltd./ICIfa0ddabd1b5f47cba569bb12f4a08883/
UPI/300822603436/UPI/paytmqr28100505/Paytm Payments
09-01-2023 480.00 2,481.57
/ICI85492f0089544ff5824f038dc398d6e7/
UPI/300888116089/UPI/paytm-63811549@/Paytm Payments
09-01-2023 795.00 1,686.57
/ICIf67c7198d77f4b38bdd6e4a80fdaa6c7/
09-01-2023 DEBIT CARD IPS/S R S APPLI/202301091503/010923003942/PONDICHER 198.00 1,488.57
UPI/300900749223/UPI/mcdonalds.41378/HDFC BANK
09-01-2023 487.00 1,001.57
LTD/ICI49c6a24a990348a2886f01e80d847113/
UPI/300926833674/UPI/naveenraj.mtech/HDFC BANK
09-01-2023 3,000.00 4,001.57
LTD/HDF19f5865fddab46c3b25c6dda0fe42f38
UPI/300948751550/Payment for 500/pothyspondy@ybl/Yes
09-01-2023 1,622.00 2,379.57
Bank Ltd/ICI6be0ef98f3834c91b59455f490b8b060/
UPI/300927079905/UPI/naveenraj.mtech/HDFC BANK
09-01-2023 500.00 2,879.57
LTD/HDF09e02f25c8cc49cab6f5ad1591cdebe1
UPI/300914751586/Payment for 500/pothyspondy@ybl/Yes
09-01-2023 2,370.00 509.57
Bank Ltd/ICI21cc0256752e470cb6599e008ce1cf8a/
UPI/300972604758/naveenraj/as.prabuguptha@/State Bank Of
09-01-2023 5,000.00 5,509.57
I/SBI669891c3f9d1471da76dbe5289b6674f
UPI/300998060646/Payment for 500/a2bpondicherry@/Yes Bank
09-01-2023 366.00 5,143.57
Ltd/ICI6f3f5dacd55b4dceb6567fa6e2b7a768/
UPI/300915960103/UPI/trentw148005@sc/Standard
09-01-2023 797.00 4,346.57
Charte/ICI8ed062bd9d224ce185d9056cdfa29bf0/
UPI/300911164160/Shruti chirsma/thathu.m@okicic/ICICI
09-01-2023 800.00 5,146.57
Bank/ICI115b3917ba9a434e8ad3cc457fe8034a
Total: 36,300.00 33,827.42 5,146.57
 Page 2 of 3 M-76543125-1

Statement of Transactions in Savings Account XXXXXXXX6522 in INR for the period January 01, 2023 - January 31, 2023

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/301021082639/jan month/madhuwantibhask/ICICI
10-01-2023 2,000.00 7,146.57
Bank/ICIacf0355040d449d3b5e94e8a29f3a74c
11-01-2023 MOBILE BANKING MMT/IMPS/301110479371/GOKILA V /Kotak Mahindra 100.00 7,246.57
11-01-2023 MOBILE BANKING MMT/IMPS/301114916666/GOKILA V /Kotak Mahindra 25,000.00 32,246.57
11-01-2023 MOBILE BANKING MMT/IMPS/301114919168/GOKILA V /Kotak Mahindra 14,900.00 47,146.57
UPI/301204854672/UPI/gpay-1118038662/Axis Bank
12-01-2023 224.00 46,922.57
Ltd./ICI82a2d1c535144145a52dc96af84e1936/
12-01-2023 APBS/Credit Through PFMS/C012321047271 500.00 47,422.57
UPI/301323079447/UPI/9791852986@payt/Karur Vysya
13-01-2023 49.00 47,373.57
Ban/ICI3ca60a15578346cdb396a0025ce06c9d/
UPI/301379395070/UPI/revathysathish0/Union Bank of
13-01-2023 2,600.00 44,773.57
I/ICI81ec997e89924a64b9e461d13a71143f/
14-01-2023 DEBIT CARD VPS/G R THANGAM/202301141506/301409291952/PONDICHER 13,000.00 31,773.57
14-01-2023 DEBIT CARD VPS/NALLI SILK /202301141534/301410316304/PUDUCHERR 2,203.00 29,570.57
14-01-2023 DEBIT CARD VPS/AL AJWA /202301142126/301415720888/Pondicher 360.00 29,210.57
UPI/301498428437/UPI/paytmqr28100505/Paytm Payments
14-01-2023 300.00 28,910.57
/ICIa01ed9b703294f5b9450bdf49dd5722b/
14-01-2023 OTHER ATMS NFS/BN179101/CASH WDL/14-01-23 2,000.00 26,910.57
14-01-2023 DEBIT CARD VPS/MORE /202301141954/301414584461/PUDUCHERR 501.58 26,408.99
14-01-2023 DEBIT CARD VPS/SRI GOPAL G/202301142039/301415010825/PONDICHER 788.40 25,620.59
16-01-2023 DEBIT CARD VPS/MORE /202301151027/301504795116/PUDUCHERR 158.55 25,462.04
UPI/301730424379/UPI/sambandamthiru./State Bank Of
17-01-2023 15,000.00 10,462.04
I/ICIe9779b123f974061813e127685787ef7/
UPI/301828969108/UPI/naveenraj.mtech/HDFC BANK
18-01-2023 5,000.00 15,462.04
LTD/HDF237efb75bb404ff18df1853095b980c7
18-01-2023 DEBIT CARD IPS/POTHYS PRIV/202301181624/000000000032/PONDICHER 390.00 15,072.04
UPI/301835743228/UPI/naveenraj.mtech/HDFC BANK
18-01-2023 2,000.00 17,072.04
LTD/HDF737230c274184986ae0a03da2aa9c960
UPI/301889762785/UPI/trentw148002@sc/Standard
18-01-2023 4,959.00 12,113.04
Charte/ICId28eebad157845dfa7fb797a8ec0e599/
18-01-2023 DEBIT CARD VPS/SRI GOPAL G/202301182047/301815033337/PONDICHER 561.16 11,551.88
18-01-2023 CASH DEPOSIT CAM/15042SRY/CASH WDL/18-01-23 10,000.00 1,551.88
UPI/301936070134/UPI/jayalakshmiraje/IDBI Bank
19-01-2023 4,900.00 6,451.88
Limit/AXI8fdaa008b5e54a7ab42743a1f2646076
UPI/301996392644/petrol/paytmqr28100505/Paytm Payments
19-01-2023 300.00 6,151.88
/ICI80831ed0c5c84c2d9cdd33cf44ea1def/
19-01-2023 DEBIT CARD VPS/WESTSIDE /202301192121/301915660604/PUDUCHERR 3,705.00 2,446.88
UPI/302034923098/UPI/myntra.payu@axi/Axis Bank
20-01-2023 1,519.00 927.88
Ltd./MdpbdunUTD05GtmsGviM/
UPI/302083966767/UPI/naveenraj.mtech/HDFC BANK
20-01-2023 1,000.00 1,927.88
LTD/HDF2e453aa2b4b140b1b5649411e0878447
UPI/302075631537/UPI/npghere@oksbi/State Bank Of
20-01-2023 795.00 1,132.88
I/ICIb98d71e22dc64266b5891cefecd78da2/
21-01-2023 DEBIT CARD IPS/HI STYLE IN/202301211956/012123010822/PONDICHER 1,000.00 132.88
UPI/302357040064/UPI/manidhanusri198/Indian
23-01-2023 1.00 133.88
Bank/AXIcc2142035fe44eada3cdc9712d8029ae
UPI/302357122029/UPI/manidhanusri198/Indian
23-01-2023 10,000.00 10,133.88
Bank/AXI71b0c025e7da433cb9bfa74e552bf14d
UPI/302341617242/UPI/gpay-1117096504/Axis Bank
23-01-2023 10,000.00 133.88
Ltd./ICIae6ed5e1c33c487c95ad97d77e89a80b/
UPI/302383805056/UPI/gpay-1117096504/Axis Bank
23-01-2023 1.00 132.88
Ltd./ICIab3f1b1b614a4a8b83f66c12bf7eeaba/
UPI/302304416015/UPI/gpay-1117097006/Axis Bank
23-01-2023 40.00 92.88
Ltd./ICIa62964a0533c4fef84e457991b39b150/
24-01-2023 APBS/Credit Through PFMS/C112228810230 531.45 624.33
UPI/302592112526/UPI/naveenraj.mtech/HDFC BANK
25-01-2023 10,000.00 10,624.33
LTD/HDFf3d1906cad2b414180ad7fa89845f485
UPI/302524091564/UPI/paytm-68154644@/Paytm Payments
25-01-2023 1,406.00 9,218.33
/ICIa2b5ca6620f74367a1d1f460205ef03f/
UPI/302550659229/NA/9442009829@payt/ICICI
25-01-2023 750.00 9,968.33
Bank/PTM399b8e13a49e47568cace42a522dbb10
UPI/302552189121/NA/9442009829@payt/ICICI
25-01-2023 1,000.00 10,968.33
Bank/PTMe3e547eea30c4eecae4113501e49e3ad
UPI/302559993312/UPI/paytm-68154644@/Paytm Payments
25-01-2023 1,233.40 9,734.93
/ICIfa01184f687e4f6a93ab9bce672e069f/
UPI/339162560595/NA/9442009829@payt/ICICI
25-01-2023 500.00 10,234.93
Bank/PTM45561e107857446b895b9ad04658ea29
UPI/302523203993/UPI/q789921513@ybl/Yes Bank
25-01-2023 6,432.00 3,802.93
Ltd/ICId7ca69dc291c49f690e6628580ff0770/
UPI/302564205524/paytm UPI payme/paytm-69309282@/Paytm
25-01-2023 845.00 2,957.93
Payments /ICI267ca0e2bdb743719b645273ec304855
27-01-2023 DEBIT CARD VPS/JANANI TRAD/202301260831/302603000183/PONDICHER 135.00 2,822.93
Total: 78,182.45 80,506.09 2,822.93
 Page 3 of 3 M-76543125-1

Statement of Transactions in Savings Account XXXXXXXX6522 in INR for the period January 01, 2023 - January 31, 2023

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/302642233979/UPI/kamleshshakthiv/Bank of
27-01-2023 767.00 2,055.93
Baroda/ICI10534cf702484714a762657c30926b56/
UPI/302884901993/UPI/suvethasris27-1/ICICI
28-01-2023 2,000.00 55.93
Bank/ICI68b93c2db290432d8085b8bae2981a61/
UPI/RVSL302884901993/UPI/suvethasris27-1/ICICI
28-01-2023 2,000.00 2,055.93
Bank/ICI68b93c2db290432d8085b8bae2981a61
28-01-2023 DEBIT CARD VPS/JSVM FOODS /202301282150/302816015555/PONDICHER 537.00 1,518.93
30-01-2023 MOBILE BANKING MMT/IMPS/302914346405/Expenses/NAVEEN RAJ/HDFC Bank 10,000.00 11,518.93
UPI/339553299111/Payment from Ph/madhuwanti25@ax/State
30-01-2023 500.00 12,018.93
Bank Of I/AXLe1a4091024cc4a37a5cd076a0db29add
UPI/302905921320/UPI/suvethasris27-1/ICICI
30-01-2023 2,000.00 10,018.93
Bank/ICIea3bdb50ccf244dcab9c84e85b6f80c3/
UPI/339568927394/NA/9944446005@payt/HDFC BANK
30-01-2023 50,000.00 60,018.93
LTD/PTMf9a417a9f16f4e8788a1a7d1cd010224
30-01-2023 ICICI ATM ATM/S1CNQ387/CASH WDL/29-01-23 20,000.00 40,018.93
30-01-2023 CASH DEPOSIT CAM/15042SRY/CASH WDL/29-01-23 20,000.00 20,018.93
30-01-2023 CASH DEPOSIT CAM/15042SRY/CASH WDL/29-01-23 10,000.00 10,018.93
30-01-2023 MOBILE BANKING MMT/IMPS/303010346591/Expenses/NAVEEN RAJ/HDFC Bank 50,000.00 60,018.93
UPI/303055157561/paint/9443898041@okbi/Axis Bank
30-01-2023 480.00 59,538.93
Ltd./ICIa25e9b18382647a0abb09bb27028e215/
UPI/303094361609/UPI/paytmqr28100505/Paytm Payments
30-01-2023 100.00 59,438.93
/ICI63c32a81bf7242a3adc075a1e9ee4892/
30-01-2023 DEBIT CARD VPS/PINK FASHIO/202301302058/303015806131/PONDICHER 503.00 58,935.93
UPI/303018866202/UPI/paytmqr28100505/Paytm Payments
30-01-2023 160.00 58,775.93
/ICI5ac682765f344cdeaa87b10ac492ed5e/
UPI/303127379460/UPI/mohanmohan50209/Indian
31-01-2023 200.00 58,575.93
Overseas/ICI119800c6590c4f70b297208505556053/
31-01-2023 CASH DEPOSIT CAM/15042SRY/CASH WDL/31-01-23 25,000.00 33,575.93
31-01-2023 CASH DEPOSIT CAM/15042SRY/CASH WDL/31-01-23/Fee Rs21.00 GST Rs3.78 25,024.78 8,551.15
Total: 1,12,500.00 1,06,771.78 8,551.15

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFS CODE NAME OF NOMINEE*
Savings XXXXXXXX6522 605229006 ICIC0001504 -

* Nominee name is displayed only upon specific consent of the customer.

Sincerely,
Team ICICI Bank Legends for transactions in your Account Statement
VAT/MAT/NFS- Cash Withdrawal at other bank's ATM INF - Internet funds transfer in linked accounts
EBA-Transaction at ICICIDirect BIL - Internet bill payment or funds transfer to third party
VPS/IPS-Debit Card transaction TOP - Mobile Recharge
RTGS-Real Time Gross Settlement (Instant transfer above Rs 2 Lakh) NEFT - National Electronic Fund Transfer

This is a system-generated statement. Hence, it does not require any signature.

You can now download the Account Statement using the iMobile Pay app and Internet Banking.

l There is a revision in the service charge for domestic Savings Accounts w.e.f. Oct 01, 2022. l Do not fall prey to fictitious offers about winning prizes, money circulation schemes, cheap
For details, please visit https://www.icicibank.com/notice-board.page funds, etc. through SMS, e-mails and calls.
l There is a change in the Terms and Conditions for Salary Accounts. For details, visit l As per the prevailing guidelines of the Income Tax Act, 1961, if a valid PAN is not provided by
www.icicibank.com/managed-assets/docs/terms-condition/tnc-savings-account.pdf (Clause XV). the customer, then the Form 15G/15H shall not be treated as valid and tax shall be deducted at
l Bank’s Code of Commitment to its Customers and Micro and Small Enterprises (MSE): the prevailing rate or at 20%, whichever is higher. PAN can be updated online or at the nearest
Please visit www.icicibank.com > ‘About Us’ > ‘Notice Board’ > ‘Code of Commitment’. branch.
The Code has been framed in line with the guidelines provided by Banking Codes and l The address of the customer in Form 16A will be the last updated address in the data base of the
Standards Board of India (BCSBI). income tax department.
l As per the guidelines issued by CBDT on May 13,2011, Form 16A (TDS Certificates) will be l PMJJBY Insurance: The insurance premium is collected on behalf of ICICI Prudential Life
generated through the Income tax website for which the PAN of the customer needs to be Insurance Company Limited plus administration charges are collected by ICICI Bank (including
necessarily updated in the Bank's record. GST), in line with the existing laws. Effective Sep 01, 2018, a premium is charged on a pro-rata
l Each depositor is insured by the Deposit Insurance and Credit Guarantee Corporation basis for all new enrolments in the scheme. It is noteworthy that the renewal premium for all
(DICGC) up to a maximum of Rs. 5 lakh, for both principal and interest amount held by existing customers shall be charged for a period of one year (i.e. Rs 330) between May 25 and
him/her in the same right and same capacity. May 31, every year. For details on the premium structure, refer to the Terms & Conditions under
the Pradhan Mantri Social Security Schemes at www.icicibank.com .
www.icicibank.com
Corporate Office: ICICI Bank Ltd., ICICI Bank Towers, Bandra-Kurla complex, Mumbai - 400051, India. Category of service: Banking & Financial Services.
Registered Office: ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, Gujarat. Pin – 390 007. Registration No. MIV/ST/Bank & Finc/4.
CIN : L65190GJ1994PLC021012
This is an authenticated intimation/statement.
Customers are requested to immediately notify the Bank in case of any error in the statement. SR224512319