CUSTOMER INFORMATION UPDATE FORM
RE-KYC FORM - RESIDENT INDIVIDUALS Please fill the form in BLOCK LETTERS only. *Fields are mandatory
Application Date: D D M M Y Y Y Y
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 Third Gender
Nationality*: Aadhaar No: / /
PAN No./Form 60*: *If PAN is not available, fill Form 60
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
Private Ltd Partnership Public Sector Public Ltd Multinational
Nature of Organization:
Proprietorship Government Others (Pls. specify) ________________
If Self-employed - since: Years Months
Self-employed Professional: Doctor IT Consultant Lawyer Architect CA/CS Others (Pls. specify) ________________
Do you have any link with
Political Exposed person?: Yes No
COMMUNICATION ADDRESS (Please leave space between two words)
There is no change in my mailing address. I/We wish to change my/our mailing address/contact details as below.
(Note: Address proof to be provided) (Note: Address proof to be provided for address change)
Flat No. & Bldg. Name:
Road Name:
Landmark:
City: PIN:
State: Tel. (R): S T D
Tel. (O): S T D Mobile No:
E-Mail ID:
DECLARATION
I declare that the information provided above with respect to my account is up to date and correct. I submit a self attested photocopy of the following as:
Address Proof:
Identity Proof:
I have also attached my recent photograph alongside
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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. I/We acknowledge that, as per Prevention of Money
Laundering Rules, 2005, in case of any update in the documents submitted by me/us after CIF / account opening, I/We shall submit the updated documents to the Bank within 30
days to be updated in the Bank records. 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.
Recent Passport
Size Photograph
(Sign Across)
Place: Signature of Account Holder
Date: D D M M Y Y Y Y
INDICATIVE LIST OF ACCEPTABLE OFFICIALLY VALID DOCUMENTS
Sr. No. Name of the Document (Valid) Identity Proof Address Proof
1. Passport Yes Yes
2. Driving License Yes Yes
3. Aadhaar Yes Yes
4. Voter ID Yes Yes
5. Job card issued by NREGA Yes Yes
6. Letter issued by the National Population Register Yes Yes
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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