D BORROWER Co-BORROWER O GUARANTOR

COMPLIANCE OF KYC POLICY

1, Name of the Branch: hURGAON
2. Contract Number :
3. Customer Code
Tolo9o00 62
4. Name of the Customer
5. Constitution of the Customer
HR. PAOAN KUMAR
Individual Proprietorship D Partnership Company
O Overseas Corporate Body OSociety O Trust/ Foundation /Association D HUF
Signature of the Borrower / Co-Borrower / Guarantor
FOR OFFICE USE ONLY
Panon
6. Customer Risk Category
(Before choosing. please refer Risk perception RISK PERCEPTION MATRIX - CRITERIA FOR CHOOSING RISK CATEGORY
matrix) (Please refer KYC Policy on the Intranet)

Individuals and entities whose identies and sources of wealth can easily be identifed and transacions in whose acounts, by and large.
conform to the known profile come under this category.
LOW D
" Salaried employees whose salary structures are welldefined
People belonging to lower economic strata of society, where accounts refect smallbalances and low turnover.
" Government Departments, and Government owned Companies, Regulators and Statutory bodies etc.
Indviduals and entites with large volume of turmover /large number of high value transactions and also considering factors such as their
nature of business, sources offunds, profile, marketreports etc. shallbe categorised under this.
MEDIUM O
" People with range of business activities of smaller modules
Share brokers, real estate dealers, auto consultants, interior decorators etc.

HIGH D
7. For Individuals
(In addition to PAN Card, any one of the
OfficialyAadhaar Card
Valid Documents(OVDs)is acceptable as proof of
identity / address )
8. For Companies
(AIlthe said documents to be obtained)
9. For Partnership firms
AI the said documents to be obtained)
10.For Trust & Foundation/ Association
(All the said documents to be obtained)
11. For ProprietoryConcern
(in addition to OVD of the proprietor, any one
of the said documents in the name of
Proprietory concern would suffice)
12. For HUF
(AI the said documents to be obtained)
13.For Society
(All the said documents to be obtained)
Customer for whom sources of funds are not clear / are not convincing shall be categorized as High risk. Higher due diligence shall be
applied for such category of customers. This category includes, but is not limited to:
" Non-residents. " High Net-worth Individuals.
Trusts, Charities, NGO's and organizations receiving donations.
Companies having close family shareholding or beneficial ownership.
" Firms with Sleeping Partners'. " Politically exposed persons (PEPs) of foreign onigin.
" Non face-to-face customers. Those with dubious reputation as per public information available.
PAN CARD
DPassport OVoter's ldentity Card
ODriving License DNREGA Card
OCertificate of incorporation and Memorandum &Articles of Association
DResolution from the Board of Directors and power of attomey granted to managers, officers or employees to transact on its behalf
DAttorney
An ID andtoaddress proof (0VD as aplicable to individuals )in respect of managers, oficers or employees holding Power of
transact on its behalf
OCertificate of registration, if registered. O Partnership deed
O Power ofAtomey granted to aParther or an Employee ofthe firm to transact business on is behalf
O An Dandaddress proof (0VD as applicable to individualsin respect of the person holding Power of Attomey to transact on its behalf
OCertficate of registration, ifregistered. DTrust Deed
OAny OVD to identify the Founders/ Managers/ Directors and their addresses
DResolution of the managing body of the Foundation/Association
DPower of Attorney granted to transact business on its behalf
DAn lD and address proof (ovD as aplcabie to individuals) in respect of the person holding Power of Attorney to transact on its behalft.
OInformation that may be required to collectively establish the legal existence such an association or body of ndividuals
O An lDand address proof (0VD as applicable to individuals ) of the proprietor
O Registration certificate (in the case ofa registered concern)
OCertíficatelicense issued by the Municipal authorities under Shop &Establishment Act,
OSales and income tax returns D CSTAVAT certificate
OCertificate/registration document issued by Sales Tax/Service Tax/Professional Tax authorities
DLicense issued by the Registering authority like Certficate of Practice issued by Institute of Chartered Accountants of lndia, institute
of Cost Accountants of India, Institute of Comparny Secretaries of India, Indian Medical Council, Food and Drug Control Athorites.
registratonlicensing document issued in the name of the proprietary concern by the Central Govemment or State Government
Authority/ Department, etc.
O The complete Income Tax return (notjust the acknowledgment) in the name of the sole proprietor where the frm's income is refected
duly authenticated/ acknowledged by the Income Tax Authorities.
DUtility bills such as electricity, water, and landline telephone bills in the name ofthe proprietary concem
O PANof HUF
DDeclaration from Karta
DAn Dand address proof (0VD as applicable to individuals )of Karta
OCopy of Bye-laws (mandatory)
OCertficate of Registration (f Registered)

Date Signature of the Branch Staff

 NTRAL KYC REGISIRY |KnowYour Customer(KYo) Appllcation Fom|lhdlvidUa)
portant Instructions:
Act 1988 is available at the end
Fields marked with * are mandatorv fields E) List of State /UT code as per Indian Motor Vehicle
the end
A) Please fill the form in English and in BLOCK letters F) List of wo character ISO 3166 country codes is available at
C) Please fill the date in DD-MM-YYYY format G) KYC number of applicant is nmandatory for update application.

D) Please read section wise detailed guidelines / instructions
at the end
H) For particular section update, please tick ()in the box avalable
before the
section number andstrike off the sections not required to be updated
CERSAI

For office use only Application Type* New Update

(Tobe flled by financial institution) KYC Number (Mandatory for KYC update rquast)

Account Type Normal Simplified (for low risk customers) Small

D1. PERSONAL DETAILS (Please refer instruction, Aat the end)

Pretx First Name Mcie N
Name* (Same as ID proo)
Maiden Name (lf any')
Father i Spouse Name
Mother Name*
Date of Birth
Gender* M- Male \F- Female ||T-Transgender
Marital Status* Married Unmarried Others
Cit1zenship IN- Indian |Others (ISO 3166 Country Code
Resident1al Status* Resident Individual Non Resident Indian
Foreign National Person of Indian Crigin
Occupat1on Type* S-Service ( Private Sector Public Sector |Govemment Sector
|0-0thers ( Professional |Self Employed IRetired Housewite Student)
|B-Business
X- Not Categorised

O2. TICK IE APPLICABLE ÜRESIDENOE FOR TAXPURPOSES IN JURISDICTION(S) oUTSIDE INDIA (PIan (ter intnuctian athe nd)
ADDITIONAL DETAILS REQUIRED (Mandatory only if section 2 is ticked)
ISO3166 Country Code of Jurisdiction of Residence*
Tax ldent1ification Number or eguivalent (If issued by jurisdiction)*
ISO 3166 Country Code of Brth
Place /City of Birth

3, PROOF OF IDENTITY (Pol) (Please rofer instructlon. Catthe end)

(Cotthed copy of any one of the follow1ng Proof of ldent1ty|Pol] needs to be submitted)
A Passport Number PasspOt Expiry Date

B Voter ID Card
C. PAN Card

) Duvng Licence Divng Icence Npuy Date

| UID(Aadhaar)
| NR GA Job Card
Others (any document noified by tthe central govenment) ldentiicaton Number
7
DoCUment l ype code ldenitiCation Numbo
5 SimplifedMeasures Acount

4. PROOF OF ADDRESS (PoA)'

(0Please see inatruchon Dat the end)
4 1 CURRENT /PERMANENT / OVRSTASADDRE S9 DEALS
nopds lo be submitted)
(Ceithod copy of any one ot th tollowng Poot otAddress |/oA|
Resdental7Bnes6 Residental RounteedOo
Athe lype*
Pasiport |Dtving |icenc
NIRI GA ob Cad
Vote ldentily Gmd
mplified Meues AcCoDnt Docmout Iype (odes

City / own/Villaj
 one

sèeinstruction Eat the end) please fill 'Annexure

A1')
CORRESPONDENCE/LOCALADDRESs DETAILs (Please correspondence / local addresses,
U4.2 of multiple
Address detals (Io cAse
Permanent / Overse2s
Same as Current
Line 1*
City / Town / Village
Line 2 Code*
State /U.T Code ISO 3166 Country
Line 3
Pn / Post Code*
ticked)
PURPOSES Applicable if section 2 is
District*
APPICANT IS RESIDENT OUTSIDE INDIA FOR TAX
JURISDICTION DETAILS WHERE Local Address details
U43 ADDRESSIN THE Same as Correspondence /
details
Same as Current Permanent / Overseas Address
Line 1*
Line 2 City / Town / Village
Code
Line 3 ISO 3166 Country
ZIP/Post Code*
State
instruction Fat the end)
Os. cONTACT DETAILS (A Oòmmunicatons wil ba 'sent on provded Mobile no. / EmaistD) (Please refer
Mobile
Tel. (Off) Tel. (Res)
FAX Email ID

D& DETALS OF RELATED PERSON(ncàs£ o» soticna relatd pbreohsplease ml AnexoreB1)(please tefer instracion Gat theend
iAddition of Related Person Deletion of Relàted Person KYC Number of Related Person (if available)
Related Person Type Guardian of Minor Authorized Representative
Prefix First Name
OAssignee Middle Name
Last Name

Name*
(If KYC number and name are provided, below details of section 6 are optional)

PROOF OF IDENTITY [Pol] OF RELATED PERSON (Please see instruction (H) at the end)
A- Passport Number Passport Expiry Date
B- Voter ID Card
C- PAN Card

D- Driving Licence Driving Licence Expiry Date

E- UID (Aadhaar)
F- NREGA Job Card

Z- Others (any document notified by the central government) ldentification Number

S- Simplified Measures Account Document Type code ldentification Number

D7. REMARKS (If any)

8. APPLIGANT DECLARATION
Ihereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of anychanges
therein, immedately In case any of the above informat1on is found to be false or untrue or misleading or misrepresenting, Iam aware that Imay be held liable
forit

Date
hereby consent to receinng information from Central KYC Reg1stry through SMS/Email on the above reg1stered numberlemail address Pouson
Signature / Thumb Impression of Applicant
Place

9. ATTESTATION I FOR OFFICE USE ONLY

Documents Received Certified Copies
KYC VERIFICATION CARRIED OUT BY NSTITUTION DETAILS
Date Name
Emp. Name Code
Emp Code
Emp Designation
Emp Branch
 Annexure B1

CENTRAL KYC REGISTRY 1Know Your custoner (KY©) Applicaton #om

Important Instructions: indivldunL Roatod Porson
a)elds marked with ate mAndatory fietde
E) List of State /UTcoxde as pet tndhan Motot
) Plense fill the Vehcle Act 1998 4 avalabte af the end
fon in Enotish and in BLOCK tettere )ist of two charactet IS0 3166 coUitry coxdes is avaitable at the erd
)Plea5e fill (he date in DDAM. VYYY tormat
G) KYC number ADpicant is mandatory fot upxlate appication
)) Please reed sectio wise
detoiled Quidelines /instuions )For particular section update pteate hck in the box aAilabie hefore the
at the end
Socion Dumber and strike of the sectons not teguirod to be
updated
CERSAI,

For office use onty Application Type New |Update

(To be fled by fnanc1al institutron) KYC Number
(Mandatory for KYC update request)
D DETAILS OF RELATED PERSON (Plbaso reter instruction Gatthe end)
Addition of RelaBed Person Deletion of Related Person KY Number of Related Person (if aváilable)
Related Person Type* Guardian of Minor
Fust Nare
Assignee Authorized Representative
Iàst Na:ne
Name*
(If KYC number and name are provided below details of section 1 are
optional)
PROOF OF IDENTITY (Pol)) OF RELATED PERSON' (Please see instruction (H) at the end)
A- Passport Number
Passport Expiry Date
B- Voter ID Card
C- PAN Card

D- Driving Licence
Driving Licence Expiry Date
F-UID (Aadhaar)
F-NREGA Job Card
Z- Others (any document not1fied by the central government)
Identification Number
S- Simplified Measures Account -Document Type code ldentification Number

2. APPLICANT DECLARATION
Ihereby dedlare that the detals turn1shed above are true and correct to the best of my knowiedge and belief and Iundertake to nform you of any changes
theren, immediately in case any of the above nformation 1s found to be false or untrue or misleading or misrepresenting, lam aware that imay be held
Ihable for i

Date Place laom

Signature /Thumb Impression of Applicant

3.ATTESTATION FOR OFFICE USE ONLY

Documents Received Certified Copies
KYC VERIFICATION CARRIED OUT BY INSTITUTION DETAILS
Date Name

Emp. Name Code

Emp. Code
Emp. Designation
Emp. Branch
MYOAA As

INDIA
OF
GOVT.

Panion
DEPARTMENT
TAX
INCOME
Number
Paent
Account

KUMAR
PAWAN EOMPK3457P
SINGH
ATTAR
05/06/1980
Sigetut VerifiedName...kS..
Emp.No.......l/....e
Emp.

&
Secn
Orieinai
Sign...
 3TETR Government of tediA AADHAAR

niaue ldentification Authorityof ndia

Government of India
4j41 hH/ Enrolment No.: 2093/93111/02633 INFORMATION
To
Aadhaar is a proof of identity, not of citizenship.
Download
Date Pawan Kumar Toestablish identity, authenticate online.
SO: Attar Singh This is electronically generated letter.
Kakroli Hatti(25)
Kakroli Sardara
Bhiwani Haryana - 127308
9813445633

Aadhaar is valid throughout the country

Aadhaar will be helpful inavailing Government
2016 n
17/02
Date: and Non-Government services in future
ValiditAknown
Do
OUEahcnoN
Dy 2017 F.412

3IT4HT 3HTEJTT hHlch Your Aadhaar No.

9879 9356 8884

Government of India Unique fdentification Authorityof india

Address: 4GT:
Pawan Kumar S/O: Attar Singh, Kakroli Hatti(25), S/O: Attar Singh, Kakroli Hatti(25),
H
fa/DOB: 05/06/1980 Bhiwani, Bhiwani,
yg/ MALE Haryana - 127308 Haryana - 127308

9879 9356 8884 9879 9356 8884

www
oou.in ww.uldai.gov.

Pouton Original Seen & Verified

Sign....
Emp. Name..SINKA
Emp. No...4..sstastas