> KYC Details Change form ff (For Individuals Only) on Please fill this update / modification form in ENGLISH and in BLOCK LETTERS (Please strike off Sections that are not used). ‘A Name of Applieant (As per onlgnal RYC recor) ‘Application N Tile Cle Cs, Cotes pada any Name Please Provide the new KYC ‘updated in your KYC records 1B. Mandatory fields for KYCs done before 1" January 2012 1. Fathersspouse Name 2.Cament Maal status ing varie 3. Caren Nationality Cnn CJother 4. Gurent Gross Annual Income Detal (ese tk i CBeow 1 Lc OVSLae 5-10 lve | 1025 lac E> 25 Las OR Netavorth in (et worth souls pote oer tho5 tyes) ag om fate) / / “FOR OFFICE USE ONLY" Columns at the bottom ofthe form is MandatorysPV fo all KYCs done before 1st January, 2012 & (Original Seen and Verified for change in Kentity & Address Details. . Identity Details (please see guidelines overleaf) 1. New Name 8s apoening in supparig ier etn document, ane 2. New Status Pease ck (v7) Chesder dal Non Reser Passat Cony Many fr Nis & Faregn Natona apa Pree ers a dy atest cony of our PAN Cad 4 Poot of Ident submited for PAN exempt eres le Tick) Cu (chan CoPaspart Veter Caring Lien Clothes Pree se idee "overall 1. Address Detalls (please see guidelines overleaf) 1. New Adres for Conespondence eyo age sa County 2. Contact Details ‘eLfomy| 80) | sr Wes) (30) | aie ) Fx] 050) | Enid 3. Prof ef addres tobe povided by Applicant Please submit ANY ONE of the following vad documents & tick (v) against the document atached. Pasport Citzion Cart CikepstendleseSaeAgeament of Ressence C1Drveg License Clete ery Card CILatet dak Ac SatementPasoock (tae lephone il ony Lan Line) Isaest Becta! sates Gas Bl lots ase eh "i ran} Wont ol aly apy ate of proof iss ubited / 7 4. New Permanent Address of Resident Applicant different from above C1 OR Overseas Address (Mandatory) fr Non-Resident Applicant Cope age in cade Sa Cosy Proof of address to be provided by Applicant. Pleate submit ANY ONE ofthe follwing valid documents & tick (V) against the document attached, Passport Cokaton Cad. Liter Leasefole Agreement of Residence C1Drving Lense. Cte Wentiy Card [atest Bank Ae SttemensPasook states Bephone 28 (only Landline) Cates Cec il C*Latest Gar Bll Clothes ene see ‘Net mare tan 3 Maris Valen date of prt of adres submited 7 7 E, Other Details (please see guidelines overleai) 2. New Occupation (ease lick(v} any one and give brief deals): Li Prvate Sector Service Public Sector C] Government Sevice Business Profesional CiAgricultrst Cte TiHousenife Cl Student Forex Dealer C1 Others Pease soecfy) 13. Please tick, if applicable: [1] Poltcaly Exposed Person] Related to a Poitcaly Exposed Person For definition of PER pease refer guide ne overleat 4. Any other information: DECLARATION SIGNATURE OF APPLICANT ner declare tha the deta furmished above are rue anscorect the bes’ of myfour knowledge and beet and | Undertake to inform you ot any changes tere, immediately Incase any ofthe above information found tobe {alge oruntruearmiseading orm stepresentinglamfve are aware thet Wwemay beheld able fort ce ate FOR OFFICE USE ONLY PV Doneti on J aulcntrediny name OR code Seaiiamo of he ntemrciny srolé Seatstap ofthe interme sod contain Staff Nae Sat Nae (orgs verte Se ceed Docent ops eened Designs Designation 1 tse Tur capes of documents eeved Name ofthe Organ ofthe Organization signatwe Nan inemedin, oeINSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM, ‘A. IMPORTANTPOINTS: 1. Self attested copy of PAN card is mandatory oral clentsin alltype of change request. Copies ofall the documents submited by the applicant should be safatesed and accompanied by ariginals for verification. In case ‘the orginal of ary document isnot produced for verfation, then the copies shoulé be propel atested by entes authorized for attesting the documents, asperthebelow mentioned. If any prof of identity or address is in a foreign language, then translation nto English is required, Name &addressof the applicant mentioned on the KYC form should match withthe documertary proof submited, Hfcorespondence& permanent address are citferen, then proofs for bothhaveto be submited Sole proprietor must make the application in his individual name & capacity, For nonresidents ad foreign nationals alowed to ade subject to Bl and FEMA guidlines), copy of passporvPlOCardiOCICard and overseas adstessprootismandatory. For foreign ents, IN is optional ann the absence of DIN no. fo ‘the directors, ther passpor copy should be given In case of Merchant Navy NR's, Maine’ declaration or ceried ‘copy of CDC (Continuous Discharge Ceticae is tobe submited 10.Foropering an account wth Depository pricipanto Mutua Fun, for amincx photocopy ofthe School Leaving CrifcateMark sheet issued by Higher Seconda BoardPasspot. of MinoxBith Confcate mustbe provided Polticaly Exposed Persons (PEP) are defined as ncviuals who are “orhavebeen entrusted with prominent publicfunctionsinaforign county, eg, Heads of States or of Governments, senior poitians, senior Governmensjuccaimitary ofcrs, senior ‘executives of state owned corpratons, important politcal party officials ete Proof of Identity POH): List of documents admissible as Proof of Identity: 1. PAN card with photograph. Tis is a mandatory requtement forall applicants excep those who are spectically exempt rom obtaining PAN (lstedin Secon), Unique denification Number (UID) (Aad>ear / Passport! Voter ID cara Dring cans, entity card document with applicant’ Photo, ssued by any ofthe following: ContalState Government and its Departments, StatutoryRegulatoy Authorities, Public Secor Undertakings, Scheduled Commercial Banks, Pubic Franciallnstttions, Colleges affliated to Uivestes, Profesional Bods suchas ICA, ICWAL, ICSI Ba Cound et, to thei Members and Creat cardiDebit cards issuedby Banks Proof of Address (POA): List of documents admissible as Proof of Address: “Documents having an expiry date should be valid onthe date of submission) 1. Unique Idetticaton Number (UID) (RadhaaPassparNotes Idenssy CaiRaton CardRegstred Lease or Sale ‘Agreement of Resdenceriving LicensefFlat Maintenance billinsurance Copy sly ils ike Telephone il (only landline), Eleciity bilo Gas ill Not more than 3 months old Bank Account StatementiPassbook-Not more than3 months a4 Se dearation by High Cou and Supreme Court judges ging the ‘new adressinrespecto ther onm accounts Proof of address issued by any ofthe following: Bank Managers of Scheduled Commercial Barks!Scheduled Co-Operative BanilMutinatonal Foreign BanksGaveted —OffceNotay publiciElected representatives tothe —_Legiltive AscemblyPariament/Documents issued by any Govt, or Statutory Authority Identity carldecuren with ade, issued by any ofthe fllawing CCenralState Government. ands. Department, SatutoniReguatory Authortis, Public Sector” Underakings, ‘Scheduled Commercial Banks, Public Financial Institutions, Colleges aflated to Universes and Professional Bodies such as ICA ICWAL ICS Bar Counce, osheir Members, For Flsub account, Power of Attomey given by Flisub-account to the Custodians (which are duly notarzed andor apostied or . Exemptions/ clarifications to PAN (Sufficient documentary evidence in support of such claims tobe collected.) 1. Incase of vansatons undertaken on behalf of Central Government andlor State Government and by officals appointed by Courts eg ttl liquidator, Courtreceiver et, Investors residingin he stat of Sikkim. UNentesimuttlateral agencies exempt rom paying axestiingtax retursinindia, ‘1 of Mutual Funds upto Rs $0,0001-pa, In case of institutional cents, namely Fs, Mis, VCES, FYCIs, Scheduled Commercial Barks, Multlateral and Bilateral Development Financial Insttutions, State Industial Development Corporation, surance Compares registered wth RDA and Pubic Financial Insttution as defined under section 4A ofthe Companies ‘Act, 1956, Custodians shall very the PAN card detais withthe ctginal PAN care and provide duly certified copes of such verted PANetalsto the intermedia, . Listof people authorized to attest the documer 1. Notary Publ, Gazetted Office, Manager of a Scheduled CommercllCo-opertve Bark of Mutnational Foreign Banks (ame, Designation & Seal shouldbe afixedon the copy) 2. In case of NRs, authorized officials of overseas branches of Scheduled Commercial Barks registered in Incia, Notary Public, ‘Court Magistrate, Judge, Irian EmbassylConslate General in the county where the clent resides are permitted to attest the ocuments ese Submit the KYC Documents on At Sze Paper On,