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Kyc Annexure A': State Bank of India Branch Please Affix Your Photograph Here

The document is a self-declaration form for KYC updation from an individual with no changes to their KYC information. It contains fields for personal details like name, DOB, address, occupation, income sources, and a declaration that their KYC information has not changed since opening the account or last update.

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kusumindjpr
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9K views1 page

Kyc Annexure A': State Bank of India Branch Please Affix Your Photograph Here

The document is a self-declaration form for KYC updation from an individual with no changes to their KYC information. It contains fields for personal details like name, DOB, address, occupation, income sources, and a declaration that their KYC information has not changed since opening the account or last update.

Uploaded by

kusumindjpr
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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KYC ANNEXURE ‘A’

STATE BANK OF INDIA BRANCH


Please affix your
photograph here
SELF DECLARATION FORM FOR KYC UPDATION
(ONLY FOR INDIVIDUALS: NO CHANGE IN KYC INFORMATION)
Account Number*

KYC submitted to Bank YES NO Date of Expiry of KYC


are valid/not expired (as (if No, please obtain (If applicable)
on date) * Revised cif / a/c update forms/ KYC docs
Name*
Father ‘s Name* Mother’s Name

D.O.B Spouse Name

TIN (If available)


Current Address* Line 1:
Line 2:
City/Town/Village: District:
State: PIN:
Country:
Occupation*
Monthly Income*
Sources of Funds (Please
tick all that are Salary Business Income Investment Income Pension Others
applicable) *
Mobile Number
Email ID

CUSTOMER’S DECLARATION
I hereby declare that there is no change in existing status of my KYC Information which was provided at the time of opening the account
/ last KYC updation. I undertake the responsibility to declare, disclose and provide immediately and in no case beyond 30 days from
the date of change, any changes that may take place in the information provided herein/or otherwise, as well as in the documentary
evidence provided by me or if any certification becomes incorrect or undergoes a change. In case 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.

Date:………………………. Signature/Thumb Impression of Customer


Place:……………………… Name ……………………………………………………..
For Office Use only
1. Certified that KYC Documents of the Customer available with the Bank are as per current Customer Due Diligence (CDD)
Standards.
2. CKYCR Number of the customer is available in Bank records.
3. PAN details (if available) have been verified from database issuing authority.
4. Information submitted by the customer verified & KYC updation date entered in CBS.

Maker……………………….. Checker……………………………
User ID.......................... (User ID )

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