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Re Kyc Format

This document is a KYC (Know Your Customer) verification data sheet that collects personal information such as account number, name, addresses, and identification details. It includes consent for downloading KYC records and updating information in the CKYCRR database. The document must be signed by the customer and verified by an officer or manager.

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GODWIN WILSON
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86 views1 page

Re Kyc Format

This document is a KYC (Know Your Customer) verification data sheet that collects personal information such as account number, name, addresses, and identification details. It includes consent for downloading KYC records and updating information in the CKYCRR database. The document must be signed by the customer and verified by an officer or manager.

Uploaded by

GODWIN WILSON
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Annexure – I to Cir No IC/………………

Periodic KYC verification (Re-KYC) DATA SHEET


Photograph
Account Number: ______________________________

Name __________________________________________ Customer ID _______________________________________

Father’s Name _______________________ Mother’s Name ___________________ Spouse’ Name _____________________

Gender: Male Female Transgender Date of Birth ________________ Nationality Indian /_________

Annual Income ₹ ___________________ Mobile Number ____________________ Email ID _______________________

Mailing Address 1 (House Name/Flat No/Door No) ____________________________________________________________

Mailing Address 2 (Street /Post Office) _______________________________________________________________________

Mailing Address 3 (Locality) ________________________________________________________________________________

District / City ____________________________________ State _____________________________________

Country ____________________________________ PIN Code _____________________________________

Permanent Address 1 (House Name/Flat No/Door No) _________________________________________________________

Permanent Address 2 (Street /Post Office) ____________________________________________________________________

PermanentAddress 3 (Locality) ____________________________________________________________________________

District / City ___________________________________ State ______________________________________

Country ___________________________________ PIN Code _______________________________________

KYC Document Details:

Aadhar ______________________PAN _______________ Form 60Voter’s ID ______________________

Driving License ________________________ Issue Date __________________ Expiry Date ______________________

Passport________________________ Issue Date __________________ Expiry Date _______________________

Other OVD:OVD Name _______________________________ OVD Number ________________________________

The details submitted above are true. Kindly update the above details in your records.

 I hereby consent to download my kyc records from CKYCRR, only for the purpose of verification of my identity and address from
the database of CKYCRR.
 I understand that my KYC record includes my KYC records/ Personal information such as my name, address, DOB, PAN etc.
 I Agree to the updation of my KYC information in CKYCRR.

Date: _______________

Place: _______________ Signature of Customer

KYC Documents/OVDs verified with Original.


Updated in CBS.

Officer/ Manager.

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