Customer Updation Form for

ReKYC & Profile Update -

RMA BAR CODE

The Branch Head Axis Bank Ltd.

Resident Indian/ HUF
(All f ields are mandatory)
Branch Sol ID CKYC ID if available Date D D M M Y Y Y Y

Applicant Details
First Name Middle Name Last Name
*Customer Name

First Name Middle Name Last Name

*Name as per ID
Proof (in case of HUF, fill
HUF name as per HUF PAN card).

*Customer Id *A/C No. *Gender Male Female Transgender

*Occupation Salaried Self Employed Retired Student Housewife Unemployed Politician * Occupation Code
(To be filled by branch Official)

Trust/Association/
If Salaried Pvt Ltd Public Ltd Proprietorship Partnership f irm Public Sector Government Multinational
(To be ticked only when Society/Club
Occupation is Salaried)
Employer's Name _____________________________________________________________________________ Designation ____________________________________________
Information Bullion/
If Self Employed Professional Service provider Agriculture Stock Broker Real Estate Trader Money Lender
(To be ticked only when Technology Gold Jewellery
Occupation is Self Employed)

*Education Non-Matric Undergraduate Grad./Post Grad Gen Grad./Post Grad Profession *No of years in Business/Employment
*Date of Birth/Date of Incorporation D D M M Y Y Y Y *Annual Income (Only Absolute & numeric
Values to be entered)
(Please tick mark occupation and reason)

Sr. No. Occupation Code Occupation Name Sr. No. Occupation Code Occupation Name

1 N104 Ancillary Services Attendant 10 N113 Ancillary Services Waiter

2 N105 Ancillary Services Caretaker 11 N114 Ancillary Services Watchman

3 N106 Ancillary Services Carpenter/Plumber/Electrician 12 N115 Ancillary Services Worker/Labour/Operator/Helper

4 N107 Ancillary Services Clerk 13 N127 Individuals Housewife

5 N108 Ancillary Services Cook 14 N130 Individuals Student

6 N109 Ancillary Services Driver 15 N131 Individuals Unemployed

7 N110 Ancillary Services Maid 16 N294 Student higher education

8 N111 Ancillary Services Mason 17 N128 Individuals_Minor

9 N112 Ancillary Services Tailor

If the customer's annual income is above ₹ 5 lakhs for the occupation codes mentioned in the above table, please select the appropriate reason for higher income from the following list.
Reason for Income 1.Interest Income through FD/RDs maintained with Banks/Financial Institutions 2.Rental income through own/inherited property 3.Agricultural income
Occupation Mismatch 4.Income through Mutual Fund/Shares/PF/Pension/Other investments 5.Freelancing assignments such as Teaching at home/blogging/artwork/consulting etc.
6. Income earned through declared occupation itself but higher than ₹ 5 lakhs p.a. Specify reason_________________________________________________________________
*Source of Funds Salary Business Income Investment Income Agriculture Others ____________________________________________
(Only Alphabetical characters allowed)
*Is the Customer having links with any Politically Exposed Persons Nationality : Indian
Contact Details
*COMMUNICATION ADDRESS (Please leave space between two words)

Address

Landmark City

Pin code State Country I N D I A

*PERMANENT ADDRESS (Please leave space between two words) Same as communication address
Address

Landmark City

Pin code State Country I N D I A

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 *Mobile Number + 9 1 Landline # (R) (O):

Email id

Note: Incase you would like to update your PAN in the Bank's records, please fill the below PAN details

*Permanent Account Number (PAN) Or Form 60 DOB as per PAN Card D D M M Y Y Y Y

Name as per PAN Card First Name Middle Name Last Name

Note: Details of demographics would be captured across all your relationships. Incase you would like to update in specific relationship, please select below.
Savings & FD Current A/cs Loan A/cs Credit Cards

Additional Details
First Name Middle Name Last Name
Maiden Name (If any*)

First Name Middle Name Last Name

Father’s Name*
Or

First Name Middle Name Last Name

Mother’s Name*
Or

Spouse’s Name First Name Middle Name Last Name

Declarations (Tick as Applicable)

Form 60
Date of Birth D D M M Y Y Y Y

Form of declaration to be f iled by a person who does not have a PAN and who enters into any transaction specified in rule 114B
If applied for PAN and it is not yet generated enter date of application D D M M Y Y Y Y and acknowledgement number

If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per a Agricultural income (`)
section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is held b Other than Agricultural income (`)

Verification
I, __________________________________________________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I
do not have a Permanent Account Number and my/ our estimated total income (including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in
accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction is held will be less than maximum amount not chargeable to tax. Verified
today, the _____________________________________ day of___________________________20____
Date D D M M Y Y Y Y Place __
Signature _____________________________

*FATCA- CRS DECLARATION Please tick the applicable tax resident declaration (Any one)*

I am a tax resident of India and not resident of any other country

I am a tax resident of the country/ies mentioned in the table below

Please indicate the country/ies in which the entity is a resident for tax purpose and the associated Tax ID Number below:

City of Birth* Country of Birth*

Address Type For Tax Purpose : Residential Business Registered Office
Address For Tax Purpose: Communication Address Permanent Address

Sr. No. Country of Tax Residence Tax Identification Number (TIN) Identification Type
(TIN or Other, please specify)

FATCA- CRS Certification: I have understood the information requirements of this Form (read along with the FATCA/CRS Instructions and Terms & Conditions) and hereby
confirm that the information provided by me/us on this Form is true, correct, and complete and hereby accept the same.

Signature _____________________________

*HUF Declaration & Mandate

We, the undersigned, for ourselves and _______________________________________________________________________________as Manager/Karta and Ejaman of the family, also guardian of

*____________________________________________________________ request you to take notice that we are members of Hindu Undivided Family/firm.

The joint family/firm is carrying business under the name and style of M/s. _______________________________________________________, which is our joint family trade
(Applicable for Current Account only)
The Hindu Undivided Family is engaged in_______________________________________________ activity/occupation not in the nature of the business or trade.

We, the undersigned, hereby authorize (Karta/Manager)____________________________________ to operate upon the Bank account severally, jointly and all transactions entered into
and obligations incurred or to be hereafter incurred by them will be binding on all of us. Any acts done/to be done to comply with Bank's rules which are in force or as amended from
time to time in the matter of maintaining and conduct of such accounts will be binding on us.

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Please treat this as a mandate from us to:
Collect/ Credit Cheques/ remittances/ Warrants/ Refund orders/ ECS/ RTGS/ NEFT/ instruments issued in favour of ________________________________________, being the karta in the
account in the HUF A/c No______________________________________of ____________________________________ HUF

We hereby undertake to indemnify the Bank in case of any loss/claims/damages/penalty/charges etc suffered by the Bank, on account of our aforesaid instruction/mandate.

Place: Date: D D M M Y Y Y Y Name : Signature :_____________________________

Place: Date: D D M M Y Y Y Y Name : Signature :_____________________________

Place: Date: D D M M Y Y Y Y Name : Signature :_____________________________

Place: Date: D D M M Y Y Y Y Name : Signature :_____________________________

*Here state the name of the children of each of the family members stating their parentage and state also the name of guardians by whom they are represented.

Terms & Conditions

• In case of Joint A/c., separate form is required.
• All information provided by me of any nature (including personal & sensitive information) can be shared with agencies/service providers who have an agreement business
purpose and on need to know basis.
• In compliance with Rule 9B of Prevention of Money Laundering (Maintenance of Records) Rules, 2005 as amended vide notification dated March 7, 2023, financial entities are
required to maintain and update customer details and identification documents submitted at the time of opening the account with the Bank. As required by regulation, in case of
any changes to the underlying details, you are kindly requested to submit latest documents for updating the Bank's records within 30 days from the date of change.
• I hereby acknowledge and consent to the change of my name across all relations of the Bank in accordance with the Officially Valid Document submitted with ReKYC updation form.
• Axis Bank shall always strive to comply with the rules and regulations as applicable from time to time on this context in accordance with the bank's Privacy policy my consent
to the sharing of the data, the products/services available to me, pursuant to the consent provided earlier, shall no longer be available to me, and initiate closure of such
products/ services.
• All the terms and conditions, processes and alternatives have been explained to me in local language as well.

Customer Declaration

E-Aadhaar Declaration

There is no change in the Aadhaar Detail after the date of download of e-Aadhaar submitted to the Bank.

Name Mismatch Declaration

I want to update Rekyc for Current/Savings/FD/OD/Loan Account with your Branch. I am submitting the following documents which carry variations in my name
First Name Middle Name Last Name
Name as per PAN:

First Name Middle Name Last Name

Name as per OVD:
Name is correct as per the OVD and both the names are one and the same. I request you to update Rekyc as per the OVD.
Name differ with PAN Card; kindly attach PAN copy.

Customer DOB Mismatch Declaration

Y Y Y Y
With reference to my request for Rekyc/Profile updation, I hereby affirm that date of birth D D M M as declared by me in the form is correct and request you to
kindly consider the same and make the necessary update in the Bank records.

Signature Mismatch Declaration

With reference to my request for Rekyc/Profile updation, I hereby affirm that my signature has changed from the one featured in my____________________________________(document)
over passage of time. My present signature is as under and I hereby confirm that all actions and transactions authorized/executed by me using the below signature shall be legally
binding on me.
First Name Middle Name Last Name
Name:

Previous Signature Present Signature

Profile Update Declaration

I agree to update my profile details to be linked with my account. I have read and agreed to the terms & conditions associated with the below mentioned scheme code.
Scheme code: Please fill as many ReKYC forms as the number of account holders when raising a Profile Update request in Saksham.

I hereby authorise Axis Bank to download the data from Central KYC Registry by using my CKYC number for the purpose of ReKYC updation

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 Inoperative Account Activation

I Would Like To Activate My Inoperative Account *Reason for not operating the account Not in state / country Using alternate account Others _________________________

*A/C No. *A/C No. *A/C No.

Customer Acknowledgement
• I hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I undertake to inform you
of any changes therein, immediately.
AFFIX
• In case any of the above information is found to be false or untrue or misleading or misrepresenting, I/We am/are aware that I/we may be held RECENT
PHOTO
liable for it. &
Customer Signature
• My personal / KYC details may be shared with Central KYC Registry Across Photo and
Branch stamp and signature
• I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address
• I hereby authorise Axis Bank to download the data from Central KYC Registry by using my CKYC number for the purpose of ReKYC updation
• I agree to indemnify and keep indemnified the Bank at all times from and against all costs, charges, damages, penalties (including attorney fees)
suffered and/or incurred by for any act done or omitted to be done on account of the above declaration.

Signature of Applicant

Branch Declaration - For Bank Use Only

Branch Declaration
• Customer DOB Mismatch Declaration: I certify that the customer has personally met and identified the customer. Kindly process the request.
• Signature Mismatch Declaration: I certify that the customer has personally met by me and I have identified the customer and he/she has signed in*my presence.
Kindly process the request.
• Customer Photo Mismatch Declaration: I confirm that the photo of the applicant affixed on CRF and that on OVD is of one and the same person.

V3/RI ReKYC/01-01-2025
• BH/OH Declaration : I have checked the due diligence parameters of the customer's declaration as mentioned in 'Reason for Income occupation mismatch' section
• Negative Declaration:
I have conducted necessary due diligence and confirm that the name of the customer for Rekyc updation is not part of negative database.
Certified that this Form is complete in all respect & all relevant documents are obtained & verified with Mode of operation and Signature & Branch Stamp
signatures of the A/c. The request may please be processed.
*Designation OH BH *S.S No *Constitution code Resident Individual HUF
*Documents Received Certified Copies E-KYC data received from UIDAI Data received from Offline verification Digital KYC Process Equivalent e-document

KYC VERIFICATION CARRIED OUT BY

• E-Aadhaar Declaration: E-Aadhaar downloaded in presence of me - wherever applicable.
• Name Mismatch Declaration: I certify that the customer has personally met and has signed in my presence. Kindly process the request.

*Identity Verification Done Place: *Date D D M M Y Y Y Y

S.S No
First Name Middle Name Last Name
*Emp. Name :

*Emp. Code:

*Emp. Designation : *Emp. Branch:

Employee Signature & Branch Stamp

Acknowledgement Copy
First Name Middle Name Last Name
Customer Name

Date of Request Received D D M M Y Y Y Y Service Request No.

Name of Branch Official

Signature & Branch Stamp
Employee Number of Branch Official