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MHW1/181D/1-1/WBF-M/03-12

022501533332??SHEF0610 201010

MRS.SHEFALI KOUL Your Base Branch: A-34, LAJPAT NAGAR-II,,110024

902 9TH FLOOR PEARL

COURT RAMPRASTHA GREEN VAISHALI
GHAZIABAD Visit www.icicibank.com
UTTAR PRADESH - INDIA - 201010 Dial your Bank 33667777

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 KYC details for your Account.

Summary of Accounts held under Cust ID: 531191822 as on May 12, 2017

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 KYC details for your Account.

Summary of Accounts held under Cust ID: 531191822 as on May 12, 2017
ACCOUNT DETAILS - INR
ACCOUNT TYPE A/c BALANCE(I) FIXED DEPOSITS (LINKED) BAL.(II) TOTAL BALANCE(I+ II) NOMINATION
Savings A/c 022501533332 1,26,276.38 0.00 1,26,276.38 Registered
TOTAL 1,26,276.38 0.00 1,26,276.38

Statement of Transactions in Savings Account Number: 022501533332 in INR for the period April 01, 2017 - May 12, 2017
DATE MODE* * PARTICULARS DEPOSITS WITHDRAWALS BALANCE
01-04-2017 B/F 1,17,305.34
03-04-2017 DEBIT CARD MPS/MOTI RAM DH/20170402205457/0 605.00 1,16,700.34
04-04-2017 BY CASH - DEFENCE COLONY (6300) 80,000.00 1,96,700.34
04-04-2017 000024844678 NEFT Chrgs: AJAY KUMAR SINGH/SYB 5.75 1,96,694.59
04-04-2017 CHEQUE 019913 NEFT:000024844678/AJAY KUMAR SINGH 22,000.00 1,74,694.59
04-04-2017 000024844738 NEFT Chrgs: SALMAN KHAN/BOB 2.88 1,74,691.71
04-04-2017 000024844738 NEFT:000024844738/SALMAN KHAN 1,700.00 1,72,991.71
05-04-2017 DEBIT CARD MPS/98.4 /20170405211747/0 580.00 1,72,411.71
07-04-2017 OTHER ATMS NFS/CASH WDL/07-04-17 10,000.00 1,62,411.71
07-04-2017 OTHER ATMS NFS/CASH WDL/07-04-17 10,000.00 1,52,411.71
07-04-2017 OTHER ATMS NFS/CASH WDL/07-04-17 10,000.00 1,42,411.71
BIL/001185736603/INDIAIDEAS .COM
10-04-2017 NET BANKING LIMI/AIRTUPMOB_0 2,685.00 1,39,726.71
10-04-2017 DEBIT CARD MPS/KEMPS PHARM/20170408131245/0 1,900.00 1,37,826.71
10-04-2017 DEBIT CARD MPS/FOOD BAZAAR/20170408191545/0 12,849.00 1,24,977.71
BIL/001187658028/INDIAIDEAS .COM
10-04-2017 NET BANKING LIMI/AIRMOBOB_00 1,946.00 1,23,031.71
11-04-2017 DEBIT CARD MPS/GLOBUS STOR/20170411162416/0 10,578.00 1,12,453.71
11-04-2017 DEBIT CARD IPS/Future Reta/20170411164925/0 2,819.00 1,09,634.71
11-04-2017 DEBIT CARD MPS/SITA FABRIC/20170411180922/0 4,892.00 1,04,742.71
11-04-2017 DEBIT CARD MPS/MOTI RAM DH/20170411181929/0 560.00 1,04,182.71
11-04-2017 DEBIT CARD IPS/KRISHAN LAL/20170411192616/0 990.00 1,03,192.71
15-04-2017 BY CASH - DEFENCE COLONY (6300) 35,000.00 1,38,192.71
17-04-2017 CHEQUE 19916 PRIMAL FACILITY MANAGEMEN 6,215.00 1,31,977.71
17-04-2017 OTHER ATMS NFS/CASH WDL/17-04-17 10,000.00 1,21,977.71
19-04-2017 DEBIT CARD IPS/WELLBEING C/20170419175637/0 3,221.00 1,18,756.71
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MRS.SHEFALI KOUL

DATE MODE* * PARTICULARS DEPOSITS WITHDRAWALS BALANCE

19-04-2017 DEBIT CARD MPS/CAFE COFFEE/20170419205434/0 710.00 1,18,046.71
20-04-2017 DEBIT CARD MPS/LAZEEZ AFFA/20170420224041/0 4,021.00 1,14,025.71
21-04-2017 DEBIT CARD MPS/YOGESH STOR/20170421143737/0 5,250.00 1,08,775.71
21-04-2017 DEBIT CARD MPS/LIBERTY DRY/20170421164129/0 1,740.00 1,07,035.71
21-04-2017 OTHER ATMS NFS/CASH WDL/21-04-17 8,000.00 99,035.71
26-04-2017 DEBIT CARD MPS/MAX SUPER S/20170426120834/0 8,290.00 90,745.71
26-04-2017 DEBIT CARD MPS/MAX SUPER S/20170426155229/0 2,983.00 87,762.71
26-04-2017 DEBIT CARD IPS/INDIAN SPIN/20170426203051/0 4,675.00 83,087.71
26-04-2017 DEBIT CARD IPS/INDIAN SPIN/20170426221423/0 20,000.00 63,087.71
NEFT-N117170281877855-SAJAD AHMAD
27-04-2017 SHUNGLOO--5020006300118-HDFC0002418 2,00,000.00 2,63,087.71
27-04-2017 DEBIT CARD IPS/INDIAN SPIN/20170427172516/0 10,479.00 2,52,608.71
27-04-2017 DEBIT CARD MPS/Indian Spin/20170427184114/0 3,859.12 2,48,749.59
28-04-2017 RwdRdmFee/905668268/21-03-17 28.75 2,48,720.84
01-05-2017 OTHER ATMS NFS/CASH WDL/01-05-17 8,000.00 2,40,720.84
03-05-2017 DEBIT CARD MPS/AN PLATINUM/20170503154652/0 2,100.00 2,38,620.84
03-05-2017 000026254692 NEFT Chrgs: AJAY KUMAR SINGH/SYB 5.75 2,38,615.09
03-05-2017 000026254692 NEFT:000026254692/AJAY KUMAR SINGH 22,000.00 2,16,615.09
03-05-2017 DEBIT CARD MPS/FOOD BAZAAR/20170503190621/0 15,491.67 2,01,123.42
BIL/001203314858/INDIAIDEAS .COM
04-05-2017 NET BANKING LIMI/AIRLLOB_001 1,784.00 1,99,339.42
06-05-2017 DEBIT CARD IPS/NEEDS THE S/20170506143721/0 1,617.00 1,97,722.42
06-05-2017 ICICI ATM ATM/CASH WDL/06-05-17/0 8,000.00 1,89,722.42
08-05-2017 DEBIT CARD IPS/IBAAS /20170507175358/0 42,700.00 1,47,022.42
08-05-2017 DEBIT CARD MPS/BALAJI MEDI/20170508135718/0 800.00 1,46,222.42
08-05-2017 DEBIT CARD MPS/BALAJI MEDI/20170508143939/0 4,544.04 1,41,678.38
08-05-2017 OTHER ATMS NFS/CASH WDL/08-05-17 8,000.00 1,33,678.38
08-05-2017 DEBIT CARD IPS/WELLBEING C/20170508152817/0 6,474.00 1,27,204.38
BIL/001208371463/INDIAIDEAS .COM
10-05-2017 NET BANKING LIMI/AIRMOBOB_00 928.00 1,26,276.38
TOTAL 3,15,000.00 3,06,028.96 1,26,276.38

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFSC CODE NAME OF NOMINEE
Savings 022501533332 110229031 ICIC0000225 -

Nominee name is displayed only on specific consent of customer.

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MRS.SHEFALI KOUL

For ICICI Bank Limited

Authorised Signatory

Legends for transactions in your account statement

VAT/MAT/NFS - Cash Withdrawal at other bank's ATM INF - Internet funds transfer in Linked accounts
EBA - Transaction at ICICIDirect BIL - Internet bill payment or Funds transfer to third party
VPS/IPS - Debit card transaction TOP - Mobile Recharge
RTGS - Real Time Gross Settlement (Instant Transfer of Rs 2 Lakh and up to Rs 10 Lakh) NEFT - National Electronic Fund Transfer (Up to Rs 10 Lakh)
• * * Mode is available only for transaction done after August 6, 2013.

• 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.
• 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.

REGD ADDRESS: LANDMARK, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA www.icicibank.com
This is an authenticated intimation/statement. Category of service: Banking & Financial Services.
Customers are requested to immediately notify the Bank of any discrepancy in the statement Registration No. MIV/ST/Bank & Finc/4.
MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1 PAN Based STC No. AAACI1195HSST001.