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MHW1/181D/1-1/WBF-M/03-12
MR.SEGARJI M.C.
46,BEERANGI KULAM STREET,
TRICHY-620008
TIRUCHIRAPALLY
TAMIL NADU - INDIA - 620008
Visit www.icicibank.com
Dial your bank 09894478000
Did you know? It's mandatory to be KYC compliant as per RBI guidelines. If you have not submitted your KYC documents, please visit the nearest
branch or contact your Relationship Manager to complete the KYC details for your Account.
Summary of Accounts held under Cust ID: 70731198 as on December 31, 2013
ACCOUNT DETAILS - INR
ACCOUNT TYPE
4,452.67
0.00
4,452.67
TOTAL
4,452.67
0.00
4,452.67
NOMINATION
Registered
Statement of Transactions in Savings Account Number : 613201198576 in INR for the period October 01, 2013 - December 31, 2013
DATE
MODE**
01-10-2013
03-10-2013
PARTICULARS
DEPOSITS
WITHDRAWALS
08-10-2013
12,573.10
IPS/SPENCERS RE/20131002184620/0
By Cash
BALANCE
973.00
6,500.00
11,600.10
18,100.10
08-10-2013
ICICI ATM
ATM/CASH WDL/08-10-13/19:30:14/0
09-10-2013
CASH DEPOSIT
CAM/CASH DEPOSIT/09-10-13/13:37:03/0
09-10-2013
ICICI ATM
ATM/CASH WDL/09-10-13/20:52:15/0
15,000.00
29,900.10
09-10-2013
ICICI ATM
ATM/CASH WDL/09-10-13/20:53:22/0
15,000.00
14,900.10
11-10-2013
CREDIT CARD
ATD/4477460415272006/20131011122504
300.00
14,600.10
15.00
14,585.10
17-10-2013
SMSChgsJul13-Sep13+Stax1.65
23-10-2013
24-10-2013
ICICI ATM
ATM/CASH WDL/24-10-13/10:56:26/0
25-10-2013
NFS/CASH WDL/25-10-13
28-10-2013
To:6143CNANWCHG,6143SL00STAX
08-11-2013
By Cash
11-11-2013
CREDIT CARD
12-11-2013
6,000.00
32,800.00
44,900.10
6,331.46
20,916.56
10,000.00
10,916.56
5,000.00
5,916.56
184.00
4,500.00
ATD/4477460415272006/20131111092309
12,100.10
5,732.56
10,232.56
300.00
9,932.56
6,331.46
13-11-2013
CASH DEPOSIT
CAM/CASH DEPOSIT/13-11-13/12:59:12/0
39,350.00
13-11-2013
NFS/CASH WDL/13-11-13
10,000.00
45,614.02
13-11-2013
NFS/CASH WDL/13-11-13
10,000.00
35,614.02
13-11-2013
NFS/CASH WDL/13-11-13
10,000.00
25,614.02
13-11-2013
NFS/CASH WDL/13-11-13
10,000.00
15,614.02
221.00
15,393.02
20-11-2013
To:6143CNANWCHG,6143SL00STAX
21-11-2013
23-11-2013
ICICI ATM
27-11-2013
SMSChgsOct13-Dec13+Stax1.65
55,614.02
32,615.73
ATM/CASH WDL/23-11-13/11:18:05/0
26-11-2013
16,264.02
48,008.75
3,000.00
6,331.46
45,008.75
51,340.21
15.00
51,325.21
500.00
50,825.21
02-12-2013
NET BANKING
BIL/000518640498/OXIGENPMR/9940870972
02-12-2013
NET BANKING
BIL/000518643498/OXIGENPMR/9443529651
700.00
50,125.21
09-12-2013
ICICI ATM
ATM/CASH WDL/08-12-13/19:33:40/0
15,000.00
35,125.21
09-12-2013
ICICI ATM
ATM/CASH WDL/08-12-13/19:34:25/0
15,000.00
20,125.21
11-12-2013
CREDIT CARD
ATD/4477460415272006/20131211115403
290.00
19,835.21
19-12-2013
23-12-2013
By Cash
ICICI ATM
ATM/CASH WDL/22-12-13/10:12:29/0
6,500.00
26,335.21
15,000.00
11,335.21
Page 2 of 3
MR.SEGARJI M.C.
Statement of Transactions in Savings Account Number : 613201198576 in INR for the period October 01, 2013 - December 31, 2013
DATE
MODE**
PARTICULARS
23-12-2013
CASH DEPOSIT
CAM/CASH DEPOSIT/23-12-13/13:14:00/0
32,200.00
43,535.21
19,831.46
63,366.67
24-12-2013
DEPOSITS
WITHDRAWALS
BALANCE
26-12-2013
OTHER ATMS
NFS/CASH WDL/25-12-13
4,000.00
59,366.67
26-12-2013
ICICI ATM
ATM/CASH WDL/26-12-13/10:13:02/0
20,000.00
39,366.67
26-12-2013
ICICI ATM
ATM/CASH WDL/26-12-13/10:13:53/0
20,000.00
19,366.67
26-12-2013
ICICI ATM
ATM/CASH WDL/26-12-13/10:14:51/0
9,000.00
10,366.67
30-12-2013
30-12-2013
613201198576:Int.Pd:01-09-2013 to 29-12-2013
OTHER ATMS
267.00
NFS/CASH WDL/30-12-13
30-12-2013
To:6143CNANWCHG,6143SL00STAX
TOTAL
1,93,558.57
10,633.67
6,000.00
4,633.67
181.00
4,452.67
2,01,679.00
4,452.67
SAVINGS ACCOUNT
NUMBER
LINKED PAYBACK
NUMBER
MySavings REWARDS
DEBIT CARD
613201198576
9401152668055903
POINTS BALANCE*
To get current reward points balance and for other queries visit www.icicibank.com
54
*As on December 20, 2013, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the total point balance
ACCOUNT NUMBER
MICR CODE
IFSC CODE
NAME OF NOMINEE
Savings
613201198576
620229005
ICIC0006132
Authorised Signatory
Page 3 of 3
MR.SEGARJI M.C.
As per prevailing guidelines of the Income tax Act, 1961 if a valid PAN is not provided by the
Customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher.
As per guidelines issued by CBDT on May 13, 2011, Form 16A (TDS Certificates) will be generated
through the Income tax website for which the PAN of the customer needs to be necessarily updated
in Bank's record.
REGD ADDRESS: LANDMARK, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA
This is an authenticated intimation/statement.
Customers are requested to immediately notify the Bank of any discrepancy in the statement
MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1
In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
In case your PAN is not updated in our record, please visit the nearest branch and provide a
copy of the PAN card along with the original PAN card for verification.
The address of the customer in Form 16A will be the last updated address in the data base of
the Income tax department.
www.icicibank.com
Category of service: Banking & Financial Services.
Registration No. MIV/ST/Bank & Finc/4.
PAN Based STC No. AAACI1195HSST001.