KYC ANNEXURE’A’
SELF CERTIFICATION FORM FOR KYC UPDATION
STATE BANK OF INDIA ………………………… BRANCH
1. ACCOUNT NO………………………………… 2. PAN NO. …………………………………..
(Please provide Form 60 duly signed if PAN No. is not available)
3.CUSTOMER’S DECLARATION
I hereby declare that there is no change in existing status of my identity and address
which were provide at the time of opening the account / last KYC updation. I undertake to
inform you of any changes there in , immediately. In case the above information is found to
be false or untiue or misleading or misrepresenting. I am aware that I may be held liable for
it.
Date:………………………………….. Signature/ Thumb Impression of Customer
Place:…………………………………. Name ……………………………………….
Current Address…………………………………….
……………………………………………………
…………………………………………………….
Mobile No……………………………………………….
Email: ……………………………………………………..
For Office Use Only
Information submitted by the customer verified & KYC updation date entered in CBS.
Maker……………………….. Checker………………………….
(This form is to be sent to LCPC for digitisation and storage)
…………………………………………………………………………………………………………………………………………
ACKNOWLEDGEMENT TO BE GIVEN TO THE CUSTOMER
The KYC details have been updated in your account no………………….on……………….(date)
Branch Maneger