Change or Addition of Contact Information: Additional Information:

(Please use Capital Letters only. Use one cell for one letter and leave a blank Date of Birth:
between words)
Account No.: - -
(DD-MM-YYYY)
Name of Base Branch where you maintain your Account: Annual Income:
Up to 3 lac 3 lac to 5 lac 5 lac to 10 lac
10 lac to 20 lac 20 lac to 30 lac
Customer’s Name: 30 lac to 50 lac More than 50 lac

PAN No.:
Occupation:
Business Self-employed Professional CA
Mobile No.:
Doctor Lawyer IT Service Pvt Sector
-
(ISD Code, e.g. 91 for India, 44 for UK, 971 for UAE etc. Followed by Mobile No) Govt/PSU/Public Sector Agriculture Other
Tel. No.:
-
(STD Code, e.g. 011 for Delhi, 022 for Mumbai followed by Landline No) Optional Information:
Do you own a House in your name: Yes No
E-mail:

Do you own a Car Yes No

Address:
House/Flat No.: Do you own a Debit Card Yes No

Road/Building/Colony/Locality/Area: Do you own a Credit Card Yes No

Do you have an Internet Banking A/C Yes No

Please submit duly signed form to your branch for

Landmark: updation.
_______________________________________________
For Office Use:
City:
Form Received on - -
Pin Code:
Customer Identified / Documents verified: Yes No

State: Customer’s Signatures Verified: Yes No

KYC Compliant Yes No
Country:
Account Opened on: - -
(Please submit documentary evidence for change in information )

Transaction alerts on Mobile ? Yes No

Information on Bank’s products & services by E-mail and/or Mobile
Yes No Signature of Verifying Officer

Specimen Signature No. : -

Signature
Important Note: Use separate form for Joint Account Holder
Please give 24 to 48 hours for information to be updated in your account
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