SELF cenTineaTiONFoRw Fon KYCUPDATION STATE BANK OF INDTALNT..fBMQAMMNTA., RANCH LLACCOUNTNO.DONAASATISR. 2,panuno. BEALCE.RA2 (Clans pride fom 6 ely ignad WPAN cot oul) 3. CUSTOMER'S DECLARATION herby decare tht here sno change nesting stats of my ide and adress which were provided atthe tine of pening the acount lost KYCupdation.undeaket infer yous any changes therein meaty. Incase the above information is found to be false or untrue or misleading or misrepresenting, lam aware that may beheld lable fort nae Ao|a\n0.0 Slgature/ um pression of cer Place:_champal. Name TARY OL..CU AT RAISON | arent Adress. Maen Ay MEAS. SLAG COLONY, GAORAKEDR VITAR PRADEO-AROOT Mobile No. AGARINARLO nat, maxi dalichtxanskintt dap @ qrra’l: For Office Use only a Wen Information suite by the ustomer vere & KY ution date entered in C85 Mike nme coed. (This forms tobe sent to LPC for sptsation and storage) ‘ACRNOWEDGEMENT TO BEGIVENTO THE CUSTOMER “The etatchav bem ype in YOU SECURE Nonna ne Branch Managerstave naNK oF MOUILT Sapna AKT BRAN 1 AccOUNT NO LERAADSASER 2.pANNo-REARCERALP... | (Pease pre Fom 6 ay Sere PAN Non aot) 2. ocupation POAWATE..AABI anna! nomen Gt D1. P A 5. RVC DOCUMENT SuBNaTED (ELF ERTINED) ‘Mkany ene ofthe allowing) Tira Rhone Gy nena aa rc Oscomert Wonber-SIA4-ASID-* ROS ‘6 SUSTOMENS DECLARATION rey decre tht he dts suited by me fret and aires ae tru to the est of my knowledge ard bol authorise the Banko uate my etal adres 5 per ifrmaton provided tyme indent oinfarm you a ay changes ere, edt n cae te above formations founda fase or unre or mean or mibepesenting a avare that mayb el ater Sipsehon npeion fatanet oe: 240} AY e620 sane BARABOO CHATRLANLS) mee chara. Core Aas Ano = A AREAL NAGAR COLON, GORKEA POR, STAR PRADEON@.aNkOo7 Nobiene AGATA tk made ch ranching ged cam ferofce uso ‘Aenea abt by the stoner verted & NYC upton date entered in ES. Matt chee. (Th form alongwith RYE documents ete sent to LEPC egtsation ana rage) ‘Te 4c dts have oan upte In your secant nm 09 nnnAadhaar-Aam Admi ka Adhikar|