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Page 1 of 6 M-87654321-1

004051/87654321-1/1-6/RESGB/03-17
Your Base Branch : MADHAPUR BRANCH, ICICI BANK
LTD., DOOR NO2-92-2/9, OPP. GOOGLE STONERIDGE
CENTER, MAIN ROAD, KONDAPUR, 500033
MR.K SUMAN KUMAR
FLAT NO:427A,6TH BLOCK,3RD PHASE ,
JANAPRIYA NAGAR,MIYAPUR : Visit www.icicibank.com
HYDERABAD Å Dial your Bank 1860 120 7777
TELANGANA - INDIA - 500049-500049

NEVER SHARE your Card number, CVV, PIN, OTP, Internet Banking User ID or Password with anyone, even if the person claims to be a
bank employee. Sharing these details can lead to unauthorised access to your account.

STATEMENT SUMMARY for Customer ID : XXXXX0805 as on October 31, 2019

ACCOUNT DETAILS - INR


ACCOUNT TYPE A/C. BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) NOMINATION
Savings A/c XXXXXXXX4445 40.47 0.00 40.47 Registered

TOTAL 40.47 0.00 40.47

Statement of Transactions in Savings Account XXXXXXXX4445 in INR for the period October 01, 2019 - October 31, 2019

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE


te Bank Of I/ 0.00
30-10-2019 UPI/930318748272/Payment from Ph/Q07679666@ybl/Sta 110.00 220.47
te Bank Of I/ 0.00
30-10-2019 UPI/930368620185/Payment from Ph/Q09379493@ybl/Sta 100.00 120.47
30-10-2019 UPI/930319119074/UPI/nirosha.kunduru/HDFC BANK LTD 520.00 640.47
30-10-2019 OTHER ATMS NFS/21831001/CASH WDL/30-10-19 500.00 140.47
31-10-2019 UPI/930408307379/UPI/cashfree@yesban/Yes Bank Ltd 100.00 40.47
01-10-2019 B/F 197.17
03-10-2019 MOBILE BANKING MMT/IMPS/927516186891/GamesKraft Tech/RAZORPAY S/Y 600.00 647.17
03-10-2019 UPI/927536986009/Payment from Ph/Q20284924@ybl/Pun 50.00 147.17
jab National/ 0.00
03-10-2019 UPI/927513306474/UPI/cashfree@yesban/Yes Bank Ltd 100.00 47.17
ES BANK LTD 0.00
03-10-2019 MOBILE BANKING MMT/IMPS/927516307731/NA/K Suman ku/ORBC0100706 645.90 1.27
/chgRs5.00GSTRs0.90 0.00
03-10-2019 UPI/927516448657/UPI/nirosha.kunduru/HDFC BANK LTD 3,550.00 3,551.27
03-10-2019 MOBILE BANKING MMT/IMPS/927517410628/NA/CASHBEAN/YESB0CMSNOC 3,455.90 95.37
/chgRs5.00GSTRs0.90 0.00
03-10-2019 MOBILE BANKING MMT/IMPS/927517434694/NA/K Suman ku/ORBC0100706 91.90 3.47
/chgRs5.00GSTRs0.90 0.00
03-10-2019 MOBILE BANKING MMT/IMPS/927609366764/PC FINANCIAL SE/RAZORPAY S/Y 4,800.00 4,803.47
ES BANK LTD 0.00
03-10-2019 UPI/927609067354/Kite deposit 71/zerodhabroking@/H 4,500.00 303.47
DFC BANK LTD/ 0.00
03-10-2019 UPI/927611192594/UPI/cashfree@yesban/Yes Bank Ltd 100.00 203.47
03-10-2019 UPI/927612383620/UPI/cashfree@yesban/Yes Bank Ltd 100.00 103.47
03-10-2019 UPI/927614334920/UPI/cashfree@yesban/Yes Bank Ltd 100.00 3.47
04-10-2019 MOBILE BANKING MMT/IMPS/927713325827/MB: SUMAN/KUNDOORI /KOTAK M 3,800.00 3,803.47
AHINDRA 0.00
04-10-2019 UPI/927728820324/Payment from Ph/Q20284924@ybl/Pun 100.00 3,703.47
jab National/ 0.00
04-10-2019 UPI/927714243612/UPI/cashfree@yesban/Yes Bank Ltd 250.00 3,453.47
04-10-2019 UPI/927714334608/UPI/cashfree@yesban/Yes Bank Ltd 250.00 3,203.47
04-10-2019 UPI/927730697876/Payment from Ph/Q20284924@ybl/Pun 130.00 3,073.47
jab National/ 0.00
04-10-2019 DEBIT CARD VPS/BANGARAM WI/201910041904/927713549835/HYDERABA 654.00 2,419.47
Total: 13,270.00 11,337.70 2,419.47
Page 2 of 6 M-87654321-1

Statement of Transactions in Savings Account XXXXXXXX4445 in INR for the period October 01, 2019 - October 31, 2019

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE


D 0.00
hra Bank/ 0.00
04-10-2019 UPI/927776667353/Payment from Ph/Q40321410@ybl/Axi 230.00 2,189.47
s Bank Ltd./ 0.00
04-10-2019 UPI/927776772581/Payment from Ph/Q93239959@ybl/And 122.00 2,067.47
04-10-2019 UPI/927776805488/Payment from Ph/Q93239959@ybl/And 30.00 2,037.47
hra Bank/ 0.00
04-10-2019 DEBIT CARD VPS/BANGARAM WI/201910042222/927716334643/HYDERABA 356.00 1,681.47
D 0.00
04-10-2019 DEBIT CARD VPS/THE FOUR SE/201910042244/927717342673/HYDERABA 296.00 1,385.47
D 0.00
05-10-2019 UPI/927827617165/Payment from Ph/Q98842534@ybl/Sta 100.00 1,285.47
te Bank Of I/ 0.00
05-10-2019 UPI/927836275066/Payment from Ph/Q98842534@ybl/Sta 50.00 1,235.47
te Bank Of I/ 0.00
05-10-2019 NEFT-N278190945975028-ZERODHA BROKING LTDCLIENT AC 900.00 2,135.47
COUNT-04102019 DS7217-57500000301592-HDFC0000240 0.00
05-10-2019 UPI/927833224914/Payment from Ph/paytmqr28100505/P 50.00 2,085.47
aytm Payments/ 0.00
05-10-2019 UPI/927822305145/Verified Mercha/BHARATPE.910004/I 55.00 2,030.47
CICI Bank/ 0.00
05-10-2019 UPI/927812012585/UPI/cashfree@yesban/Yes Bank Ltd 500.00 1,530.47
05-10-2019 UPI/927812220241/UPI/cashfree@yesban/Yes Bank Ltd 500.00 1,030.47
05-10-2019 UPI/927813368058/UPI/cashfree@yesban/Yes Bank Ltd 500.00 530.47
05-10-2019 UPI/927814043703/UPI/cashfree@yesban/Yes Bank Ltd 250.00 280.47
05-10-2019 UPI/927819427342/UPI/cashfree@yesban/Yes Bank Ltd 250.00 30.47
05-10-2019 UPI/927821231803/UPI/chammalasandeep/ICICI Bank 4,000.00 4,030.47
05-10-2019 UPI/927821263884/Payment from Ph/Q93239959@ybl/And 110.00 3,920.47
hra Bank/ 0.00
05-10-2019 UPI/927822479083/UPI/cashfree@yesban/Yes Bank Ltd 500.00 3,420.47
07-10-2019 ICICI ATM ATM/SACWB657/CASH WDL/06-10-19 1,500.00 670.47
07-10-2019 UPI/927823173174/UPI/cashfree@yesban/Yes Bank Ltd 500.00 2,920.47
07-10-2019 UPI/927904300042/UPI/cashfree@yesban/Yes Bank Ltd 500.00 2,420.47
07-10-2019 UPI/927907381857/UPI/cashfree@yesban/Yes Bank Ltd 250.00 2,170.47
07-10-2019 UPI/927907349052/Payment from Ph/Q60771600@ybl/IND 100.00 570.47
USIND BANK/ 0.00
07-10-2019 DEBIT CARD VPS/ONUS PETRO /201910061003/927904262548/HYDERABA 200.00 370.47
D 0.00
07-10-2019 MOBILE BANKING MMT/IMPS/927912416358/GamesKraft Tech/RAZORPAY S/Y 1,500.00 1,870.47
ES BANK LTD 0.00
07-10-2019 UPI/927920056721/Payment from Ph/Q95833030@ybl/And 145.00 1,725.47
hra Bank/ 0.00
07-10-2019 DEBIT CARD VPS/SRI RAJKAMA/201910070319/927921863665/WARANGAL 260.00 1,465.47
07-10-2019 OTHER ATMS NFS/C0482701/CASH WDL/07-10-19 500.00 965.47
07-10-2019 ECSRTNCHG051019_SR639215710 413.00 552.47
07-10-2019 UPI/928044571023/Payment from Ph/Q59430157@ybl/Sta 101.00 451.47
te Bank Of I/ 0.00
08-10-2019 UPI/928109087617/UPI/cashfree@yesban/Yes Bank Ltd 250.00 201.47
10-10-2019 UPI/928311393533/UPI/cashfree@yesban/Yes Bank Ltd 100.00 101.47
10-10-2019 UPI/928312002784/UPI/cashfree@yesban/Yes Bank Ltd 100.00 1.47
11-10-2019 VISA REF ONUS PETRO SERVICES 1.50 2.97
14-10-2019 UPI/928517166149/From frnd/sravankumar.kay/ICICI B 20,001.00 20,003.97
ank 0.00
14-10-2019 MOBILE BANKING MMT/IMPS/928520679377/Cc payment/K Suman ku/UTIB00 10,005.90 9,998.07
00553/chgRs5.00GSTRs0.90 0.00
14-10-2019 MOBILE BANKING MMT/IMPS/928520690885/NA/K Suman ku/UTIB0000553 2,205.90 7,792.17
Total: 26,402.50 21,029.80 7,792.17
Page 3 of 6 M-87654321-1

Statement of Transactions in Savings Account XXXXXXXX4445 in INR for the period October 01, 2019 - October 31, 2019

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE


/chgRs5.00GSTRs0.90 0.00
14-10-2019 BIL/ONL/001822023248/Capital Fi/CAPITALFIRST_RI 3,150.00 4,642.17
14-10-2019 BIL/ONL/001822026083/Paysense S/gopaysensecom92 2,735.60 1,906.57
14-10-2019 UPI/928604179173/UPI/goog-payment@ok/Axis Bank Ltd 14.00 1,320.57
14-10-2019 UPI/928520423080/UPI/cashfree@yesban/Yes Bank Ltd 100.00 1,806.57
14-10-2019 UPI/928520472834/UPI/cashfree@yesban/Yes Bank Ltd 250.00 1,556.57
14-10-2019 UPI/928522340579/UPI/cashfree@yesban/Yes Bank Ltd 250.00 1,306.57
. 0.00
14-10-2019 UPI/928613063843/UPI/cashfree@yesban/Yes Bank Ltd 250.00 1,070.57
14-10-2019 MOBILE BANKING MMT/IMPS/928619372074/MB: CHIKKI /KUNDOORI /KOTAK 200.00 1,270.57
MAHINDRA 0.00
14-10-2019 UPI/928676760678/Payment from Ph/paytmqr28100505/P 100.00 1,170.57
aytm Payments/ 0.00
14-10-2019 UPI/928676429745/Payment from Ph/Q20284924@ybl/Pun 100.00 1,070.57
jab National/ 0.00
14-10-2019 UPI/928736863461/Payment from Ph/9177332740@okbi/A 33.00 1,037.57
xis Bank Ltd./ 0.00
14-10-2019 UPI/928736592838/Payment from Ph/9177332740@okbi/A 100.00 937.57
xis Bank Ltd./ 0.00
14-10-2019 UPI/928776449165/Payment from Ph/9177332740@okbi/A 100.00 837.57
xis Bank Ltd./ 0.00
14-10-2019 MOBILE BANKING MMT/IMPS/928720403064/POT157106616444/RAZORPAY S/Y 4,000.00 4,837.57
ES BANK LTD 0.00
14-10-2019 UPI/928744526507/NA/walletmoneytoba/Paytm Payments 5,050.15 9,887.72
14-10-2019 UPI/928720352325/UPI/cashfree@yesban/Yes Bank Ltd 250.00 9,637.72
14-10-2019 UPI/928721422510/UPI/cashfree@yesban/Yes Bank Ltd 500.00 9,137.72
14-10-2019 UPI/928723314333/UPI/cashfree@yesban/Yes Bank Ltd 500.00 8,637.72
14-10-2019 UPI/928723675522/UPI/goog-payment@ok/Axis Bank Ltd 5.00 8,642.72
. 0.00
14-10-2019 UPI/928760654002/RupeeMaxRepayAm/kudos.razorpay@/H 5,083.54 3,559.18
DFC BANK LTD/ 0.00
15-10-2019 UPI/928836740490/Payment from Ph/Q20284924@ybl/Pun 120.00 3,439.18
15-10-2019 UPI/928857192447/Fcc/9640420150@ybl/Corporation Ba 7,000.00 8,830.18
jab National/ 0.00
15-10-2019 BIL/ONL/001824073451/IVL Financ/923699430 1,610.00 1,829.18
15-10-2019 UPI/928857826520/Tfv/9640420150@ybl/Bank of India 1.00 1,830.18
n 0.00
15-10-2019 UPI/928876093367/Gg/9640420150@ybl/Bank of India 2,000.00 10,830.18
15-10-2019 MOBILE BANKING MMT/IMPS/928819372385/NA/CASHBEAN/YESB0CMSNOC 5,525.90 5,304.28
/chgRs5.00GSTRs0.90 0.00
15-10-2019 MOBILE BANKING MMT/IMPS/928819149107/PC FINANCIAL SE/RAZORPAY S/Y 6,000.00 11,304.28
ES BANK LTD 0.00
15-10-2019 UPI/928820446173/Kite deposit 12/zerodhabroking@/H 10,800.00 504.28
DFC BANK LTD/ 0.00
15-10-2019 UPI/928880578905/Payment from Ph/Q20284924@ybl/Pun 100.00 404.28
jab National/ 0.00
15-10-2019 UPI/928822086282/UPI/cashfree@yesban/Yes Bank Ltd 250.00 154.28
16-10-2019 UPI/928926461232/Payment from Ph/Q20284924@ybl/Pun 50.00 104.28
jab National/ 0.00
16-10-2019 UPI/928913236309/UPI/cashfree@yesban/Yes Bank Ltd 100.00 4.28
16-10-2019 UPI/928984918834/Bh/9640420150@ybl/Corporation Ban 5,000.00 5,004.28
16-10-2019 UPI/928921037452/UPI/cashfree@yesban/Yes Bank Ltd 250.00 4,754.28
16-10-2019 UPI/928922250503/UPI/cashfree@yesban/Yes Bank Ltd 250.00 4,504.28
17-10-2019 UPI/929001032184/UPI/cashfree@yesban/Yes Bank Ltd 500.00 4,004.28
17-10-2019 UPI/929001048211/UPI/cashfree@yesban/Yes Bank Ltd 500.00 3,504.28
17-10-2019 UPI/929001051644/UPI/cashfree@yesban/Yes Bank Ltd 1,000.00 2,504.28
Total: 29,270.15 34,558.04 2,504.28
Page 4 of 6 M-87654321-1

Statement of Transactions in Savings Account XXXXXXXX4445 in INR for the period October 01, 2019 - October 31, 2019

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE


17-10-2019 UPI/929040128643/Payment from Ph/Q93239959@ybl/And 106.00 2,398.28
hra Bank/ 0.00
17-10-2019 UPI/929010866826/Payment from Ph/9676732859@okbi/A 200.00 2,198.28
xis Bank Ltd./ 0.00
17-10-2019 NEFT-N290190303233542-RAZORPAY SOFTWARE PVT LTD NO 3,000.00 5,198.28
17-10-2019 NET BANKING VIN/EQX Analyti/201910172141/929016539089/ 1.02 5,198.43
DAL AC-YESB0000001-002261100000070-YESB0000001 0.00
17-10-2019 MOBILE BANKING MMT/IMPS/929016683811/362809/Razorpay S to K SUMAN 1.17 5,199.45
KU 0.00
17-10-2019 NET BANKING VIN/EQX Analyti/201910172149/929016559210/ 1.02 5,197.41
17-10-2019 UPI/929064277654/Payment from Ph/Q20284924@ybl/Pun 100.00 5,097.41
jab National/ 0.00
17-10-2019 UPI/929017204207/UPI/cashfree@yesban/Yes Bank Ltd 250.00 4,847.41
17-10-2019 MOBILE BANKING MMT/IMPS/929018726821/KAYETHA SU/Paytm Payments 1,310.00 6,157.41
17-10-2019 BIL/ONL/001825568539/RedCarpet/DV9VKEBQ6T4RG9 5,819.22 338.19
17-10-2019 UPI/929019093472/UPI/cashfree@yesban/Yes Bank Ltd 250.00 88.19
17-10-2019 UPI/929060371079/Payment from Ph/Q60771600@ybl/IND 50.00 38.19
USIND BANK/ 0.00
18-10-2019 NEFT-N291190957255012-ZERODHA BROKING LTDCLIENT AC 500.00 538.19
COUNT-17102019 DS7217-57500000301592-HDFC0000240 0.00
18-10-2019 UPI/929122313480/Payment from Ph/Q84493042@ybl/And 101.00 437.19
hra Bank/ 0.00
18-10-2019 UPI/929111375902/UPI/cashfree@yesban/Yes Bank Ltd 250.00 187.19
18-10-2019 UPI/929112092905/UPI/cashfree@yesban/Yes Bank Ltd 100.00 87.19
18-10-2019 MOBILE BANKING MMT/IMPS/929120287853/NA/K Suman ku/ORBC0100706 85.90 1.29
/chgRs5.00GSTRs0.90 0.00
21-10-2019 MOBILE BANKING MMT/IMPS/929407864078/MB: SUMAN /KUNDOORI /KOTAK 204.00 205.29
MAHINDRA 0.00
21-10-2019 UPI/929424530671/Payment from Ph/Q73797959@ybl/HDF 56.00 149.29
C BANK LTD/ 0.00
21-10-2019 UPI/929408327654/UPI/cashfree@yesban/Yes Bank Ltd 100.00 49.29
21-10-2019 MOBILE BANKING MMT/IMPS/929420242658/NA/K Suman ku/ORBC0100706 40.90 8.39
/chgRs5.00GSTRs0.90 0.00
22-10-2019 DEBIT CARD VPS/FOUR SEASON/201910221856/929513541675/HYDERABA 526.00 3,682.39
22-10-2019 NEFT-N295190960858507-AKARA CAPITAL ADVISORS PRIVA 5,000.00 5,008.39
TE LIMI-1021890-50200017946230-HDFC0000240 0.00
22-10-2019 UPI/929518003473/Love/gade.saikiran@o/Andhra Bank 800.00 4,208.39
D 0.00
22-10-2019 DEBIT CARD VPS/FOUR SEASON/201910221913/929513570679/HYDERABA 184.00 3,498.39
D 0.00
22-10-2019 DEBIT CARD VPS/FOUR SEASON/201910221952/929514108656/HYDERABA 449.94 3,048.45
D 0.00
22-10-2019 UPI/929566680569/Verified Mercha/BHARATPE.904017/I 50.00 2,998.45
CICI Bank/ 0.00
23-10-2019 UPI/929606416447/Kite deposit 87/zerodhabroking@/H 2,500.00 498.45
DFC BANK LTD/ 0.00
23-10-2019 UPI/929612124960/UPI/cashfree@yesban/Yes Bank Ltd 250.00 248.45
23-10-2019 UPI/929613228759/Payment from Ph/Q20284924@ybl/Pun 101.00 147.45
jab National/ 0.00
23-10-2019 UPI/929628851750/Payment from Ph/Q20284924@ybl/Pun 30.00 117.45
jab National/ 0.00
23-10-2019 UPI/929615486567/UPI/cashfree@yesban/Yes Bank Ltd 100.00 17.45
25-10-2019 MOBILE BANKING MMT/IMPS/929819986518/KAYETHA SU/Paytm Payments 3,620.00 3,637.45
25-10-2019 UPI/929857399605/Payment from Ph/9398866115@ybl/In 3,600.00 37.45
dian Overseas/ 0.00
25-10-2019 UPI/929838105689/Payment from Ph/9966668773@ybl/An 500.00 537.45
Total: 14,135.17 16,102.00 537.45
Page 5 of 6 M-87654321-1

Statement of Transactions in Savings Account XXXXXXXX4445 in INR for the period October 01, 2019 - October 31, 2019

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE


dhra Bank 0.00
25-10-2019 UPI/929863411503/Payment from Ph/9398866115@ybl/In 3,600.00 4,137.45
dian Overseas 0.00
25-10-2019 UPI/929821353223/UPI/nirosha.kunduru/HDFC BANK LTD 3,600.00 537.45
25-10-2019 UPI/929884855837/Payment from Ph/Q20284924@ybl/Pun 100.00 437.45
jab National/ 0.00
28-10-2019 UPI/929900400580/UPI/cashfree@yesban/Yes Bank Ltd 100.00 337.45
28-10-2019 UPI/929918582500/Payment from Ph/AMZN0002362056@/I 30.00 7.45
28-10-2019 UPI/929901013805/UPI/cashfree@yesban/Yes Bank Ltd 100.00 237.45
28-10-2019 UPI/929901024449/UPI/cashfree@yesban/Yes Bank Ltd 100.00 137.45
28-10-2019 UPI/929823378690/UPI/cashfree@yesban/Yes Bank Ltd 100.00 37.45
NDUSIND BANK/ 0.00
28-10-2019 UPI/929920641962/UPI/nirosha.kunduru/HDFC BANK LTD 200.00 207.45
28-10-2019 UPI/929980692522/Payment from Ph/AMZN0002362056@/I 100.00 107.45
NDUSIND BANK/ 0.00
28-10-2019 UPI/930001125304/UPI/cashfree@yesban/Yes Bank Ltd 100.00 7.45
28-10-2019 UPI/930010409452/UPI/nirosha.kunduru/HDFC BANK LTD 100.00 107.45
28-10-2019 UPI/930011409552/Verified Mercha/BHARATPE.910050/I 55.00 52.45
CICI Bank/ 0.00
28-10-2019 UPI/930011825035/Verified Mercha/BHARATPE.910050/I 10.00 42.45
CICI Bank/ 0.00
28-10-2019 UPI/930044454138/Payment from Ph/AMZN0002362056@/I 40.00 2.45
NDUSIND BANK/ 0.00
28-10-2019 MOBILE BANKING MMT/IMPS/930022694524/KAYETHA SU/Paytm Payments 290.00 292.45
28-10-2019 UPI/930066560640/Payment from Ph/Q20284924@ybl/Pun 101.00 191.45
jab National/ 0.00
28-10-2019 UPI/930023296686/UPI/cashfree@yesban/Yes Bank Ltd 100.00 91.45
28-10-2019 UPI/930151743819/Payment from Ph/Q09379493@ybl/Sta 90.00 1.45
te Bank Of I/ 0.00
29-10-2019 UPI/930232863996/NA/walletmoneytoba/Paytm Payments 310.01 311.46
29-10-2019 UPI/930224354798/Payment from Ph/Q07679666@ybl/Sta 101.00 210.46
te Bank Of I/ 0.00
29-10-2019 UPI/930208401618/UPI/cashfree@yesban/Yes Bank Ltd 100.00 110.46
29-10-2019 UPI/930208425620/UPI/cashfree@yesban/Yes Bank Ltd 100.00 10.46
30-10-2019 UPI/930330167069/NA/walletmoneytoba/Paytm Payments 320.01 330.47
Total: 4,820.02 5,027.00 330.47

REWARD POINTS SUMMARY

SAVINGS ACCOUNT LINKED PAYBACK Points earned for the month of September, 2019
POINTS BALANCE*
NUMBER NUMBER My Savings REWARD DEBIT CARD
XXXXXXXX4445 XXXXXXXXXXXX3106 0 21 418
To get current reward points balance and for other queries, visit www.icicibank.com or call ICICI Bank Customer Care.
* As on October 20, 2019, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the point balance.

Account Related Other Information


ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFS CODE NAME OF NOMINEE*
Savings XXXXXXXX4445 500229003 ICIC0000040 -

* Nominee name is displayed only on specific consent of customer.

Sincerely, 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
ICICI Bank Limited VPS/IPS-Debit card transaction TOP - Mobile Recharge
RTGS-Real Time Gross Settlement (Instant transfer above Rs 2 Lakh) NEFT - National Electronic Fund Transfer
Page 6 of 6 M-87654321-1

This is a system-generated statement. Hence, it does not require any signature.

l Do not fall prey to fictitious offers of winning prizes, money circulation schemes and cheap l There is a revision in the terms & conditions of your complimentary air accident insurance,
funds, etc. through SMS, e-mails and calls. personal accident insurance & purchase protection. It is linked to your bank account. For details,
l With effect from Dec 15, 2019, there is a revision in limits of Cash Transactions and please visit www.icicibank.com .
associated charges. For details, please visit www.icicibank.com/notice-board.page l As per prevailing guidelines of the Income tax Act, 1961, if a valid PAN is not provided by the
l Bank’s Code of Commitment to Customers and Micro and Small Enterprises (MSE): Please customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher.
visit www.icicibank.com > About Us > Notice Board > Code of Commitment. The code l In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
has been framed in line with the guidelines provided by Banking Codes and Standards l In case your PAN is not updated in our record, please visit the nearest branch and provide a
Board of India (BCSBI). copy of the PAN card, along with the original PAN card for verification.
l As per guidelines issued by CBDT on May 13,2011, Form 16A (TDS Certificates) will be l The address of the customer in Form 16A will be the last updated address in the data base of the
generated through the Income tax website for which the PAN of the customer needs to be income tax department.
necessarily updated in Bank's record.
l As per PMJJY, debit of Rs 289 is towards insurance premium collected on behalf of ICICI
l Each depositor is insured by the Deposit Insurance and Credit Guarantee Corporation Prudential & Rs 41 is towards administration charges by ICICI Bank (including Goods and
(DICGC) up to a maximum of Rs. 1 lakh, for both principal and interest amount held by him Services Tax (GST)). For details, refer Terms and Conditions at www.icicibank.com
in the same right and same capacity.
www.icicibank.com
Corporate Office: ICICI Bank Ltd., ICICI Bank Towers, Bandra-Kurla complex, Mumbai - 400051, India. Category of service: Banking & Financial Services.
Registered Office: ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, Gujarat. Pin – 390 007. Registration No. MIV/ST/Bank & Finc/4.
CIN : L65190GJ1994PLC021012
This is an authenticated intimation/statement.
Customers are requested to immediately notify the bank in case of any discrepancy in the statement. ROG_SR168104445_DB_SS_30042021

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