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Know Your Cu Tomer (KYC) Form For Individual: Government of Kerala

This document is a KYC form for individuals opening a savings bank account with the Treasury of Kerala, India. It requests basic customer details like name, address, ID details, occupation, and nominee details. The customer must sign declaring the information is true.

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Vinayaraj MV
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2K views3 pages

Know Your Cu Tomer (KYC) Form For Individual: Government of Kerala

This document is a KYC form for individuals opening a savings bank account with the Treasury of Kerala, India. It requests basic customer details like name, address, ID details, occupation, and nominee details. The customer must sign declaring the information is true.

Uploaded by

Vinayaraj MV
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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Treasury 200,000 471917112016 GPE © Govt.

Of Kerala -

ANNEXURE

SB FORM No. I (a)

GOVERNMENT OF KERALA
Treasury Savings Bank
Know Your Cu;tomer (KYC) Form for Individual

(I;o be filled up by the customer)

` [Rule67(a)Of RTCvol.Ill ` .

Customer ID Passport size


photo

(Tb be assigned by the Treasury)

BranchTreasury

Customer Details (to be filled in capital letters)

First Name .

Middle Name a

Last Name

Date of birth*

dd -mm yvyy

Marital Status

Name of
Father/Spouse

Identirlcation Details (Furnish a copy of one valid ID)*

AADHAR

PAN

vo;er ID

Driving Licence
IDGi8#.es#t.
Other Details
SelfEmployed
Occupation ` State Govt. Central Govt. Business Professional othe`rs

If State Govt.
Employee

Qualification B]owss](I-s=(TILL:;¥:I:o]TcriTl=tilg±=itL']i=[]|iofro-l=]]
_ __ I

Present Address (To be filled up in capital letters)

House Name*

StreetELocality*

City*

Name of Post
office*
State*

District*
\

Pin Code*
',

Phone Mobile

STD Code Phone No.

E-mail ID

Permanent Address (To be filled up in capital letters) - '

House Name*

StreetELocality* .+

• City*

Name of Post
Office*
State*

District*
*`

Pin Code*

Phone Mobile

` STD Code Phone No.


Nominee Details

Date Of . JBirth
Sl.Nb. Name Rblationship Address Of the Nominee

.
3

4`

do hereby declare that the information


furnished above is true to the bes`t of my knowledge and belief.

Place :

Date. :

Sigrrature Of the ctistomer

IVofc. +olumns marked* are mandatory.

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