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| Annexure At Important instructions: |A) Fas mackas wth" are mandatory fl F) Please read secon wise dtaled guises /nstucsers atthe ar. 8) “Tk "wherever apoeabe 6G) Ust of Sita UT code as per nan Motor Veh Act, 1088 (©) Plaseft the form in Engish and in BLOCK ltrs. _avalabe ate er )_ Pleat iho dato in DD-MM-YYYY format Hy Ust of wo charactor ISO 3168 country codes is valle at he end )_Frpartoularcocton update, paso ok 7) nth 1) KYCrnomber ef applicant is mandstory for update appli, box secton number and se of the seckons ot requis o be updates For office use only Application Type New (1Update Delete {To be filed by fnancialinsttaion) KYC Number (Mandatory for KYC update request) [1] Adeition of Related Porson [Deletion of Related Person |") Updation KyCMinberot snes Parent aula) Rolated Porson Type «1 Guardian of Minor “lAssignce 1 Authorized Roprosentative Name Prefic First Name. Middle Name. Last Name LTT I (t¥e7¢ nurber and name are provided, below details are opin) Maiden Name LI I I I Father Spouse Name LI [ I I Mother Name LU i l I Date of Bith™ Gonder* Me Male 1 F Female [D Hiransgender ane [1 Form 60 tarishod |e oO outset OD OVD chart aK pose ner be sma yo own YOR) A: Passport Number © eiternces Boren 2 cea ore 5 DNREGAJob Card Pope ager © FPP ctr 4 BKYC Authentication 10 Ofertas Address Une Une2 Lunes ‘ay ow vitae Dstict Pin / Post Cade ‘tate UT Coe 1503168 Coury Code" Same a above mentored adress (such cases acess cea as below nes not be provided) | Cortes copy of OVD or equivalent document of VO oF OVD obained through cal KV proces needs tobe submitted (angen of th folowing OVDs) A. Passport Number ser Card Diving Leenca [NRE Jb Cad National Ppuion Registrate F - Proofof Possession of Aah E-KYCAdthentcaion 1 Ofte vesoaton of achat IO Deemed Poa of Adress -Doeunent Type code VO serpectraton oagpo8 Line 1” LI I Line 2 Li L L T I Lines LU [ ity Town Vilage LI District” I Pin Post Code" UI State / U.T Code" 180 3166 Country Code* | Tal. (om Email i "arab dar that te tal umiehed above ar ue an coma athe ba fn krona and ban undertake infor youct any changes thoi, mostly. Incase any af the abewe efaton is found obs falso or unt or misleading ‘rrsrepesseding | amie thoy be ed Bal for hereby consent to ecaling nfermaton fom Caria KYC Registry trough SISIEmal an the stove ‘agora ruber aes. Date: —e—| i Prce: | | | ‘Signature Thumb Impression of Applicant Dames Remiet [Corie copes | Cl EKYE data resved rom UIDA! I Daa eee fom One vention 1 Dig KYC Prose ‘Equivalent €-document |") Video Based KYC {YC VERIFICATION CARRIED OUT BY “INSTITUTION DETALS Date (a) Hees. LOTT LT LLL Emp. Name LITTLE TTT) soe ii TTT T11 TTT Emp. Code EEL _pAaac_Y\_I oe Emp. Designation TTTt ttt ttt) DIT TT Trt tr)

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