CUSTOMER DUE DILIGENCE FORM

E-KYC BASED ACCOUNT OPENING

Customer Name:
Customer ID: Account Number:
I wish to inform that I have opened an IndusInd Bank Fixed Deposit / Savings account through OTP based account opening and wish to complete the
customer due diligence.
I further declare that I am submitting proofs to comply with the requirement as per the guideline.
Address Proof Tick
Sr. No. Officially Valid Documents Identity Proof Signature Proof
(Only in case address is being updated) Appropriate Box

1. Pan Card Yes Yes No

2. Passport Yes Yes Yes

3. Driving License Yes Yes Yes

4. Voter ID/ Election Card Yes No Yes

Aadhaar Card (UID)/ Letter issued by Unique Identi cation

5. Yes No Yes
Authority of India (UIDAI)

Job Card issued by NREGA duly signed by an officer of the

6. Yes No Yes
State Government

7. Others___________________________________________

CHEQUE BOOK REQUEST

I request the Bank to issue a cheque book (as per the account variant) as soon as this Savings Account is converted into a Full KYC account post due
diligence basis this form and documents submitted.

ACCOUNT UPGRADE
I hereby consent to upgrading my account to the following variant and have been explained the features and bene ts of the same.

Indus Exclusive Indus Select Indus Maxima

Indus Privilege Indus Privilege Max Indus Max Active Signature
Indus Multiplier Max Indus Diva Others________________________

ADDITIONAL FUNDING DETAILS

NEFT/IMPS `______________________ with Reference No. _____________________________
Cheque No. _________________________ on ___________________________ Bank for ` _________________ [On IndusInd Bank Ltd. A/c (Account Title)]

COMMUNICATION ADDRESS DETAILS (Only if address is being changed)

I wish to update my mailing address /contact details as mentioned below and for which address proof is also attached: (please tick) Yes No
Communication Address: Residence Permanent Office
Address:
Flat No. and Bldg. Name:
Road Name & Area Landmark:
City and State:
Country: PIN:
Tel .No. Resi.: S T D Off.: S T D
Mobile No:
E-Mail ID:

DECLARATION
I declare that the information provided above with respect to my account is correct. I submit a self-attested photocopy of the
documents along with photograph. I have read and understood all of Bank’s terms and conditions and Schedule of Charges of
the account variant that I hold.
Recent Passport
Size Photograph
Customer Signature* (Sign Across)

Date: D D M M Y Y Y Y
*This signature will also be used as your specimen signature.

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Consent to Use, Share and Disclose Registered Communication Contact Details
I/We hereby ACCEPT, AUTHORISE, CONFIRM AND PERMIT IndusInd Bank Limited (“Bank”) to USE, SHARE AND DISCLOSE any/all of my/our registered communication contact addresses/details
(postal, e-mail, mobile number, social media platforms/channels etc.), that I/we have willingly registered/shared with the Bank for the purpose of (A) receiving information, either from the Bank, Central
KYC Registry and/or through any of the Bank’s authorised Service Providers / Agency(ies)/Professional Advisors related to the operations of my/our account(s)/services availed by me /us from the Bank;
and/or (B) API based authentication where my/our details are being auto fetched/ populated to process my banking requests/applications on/throughthe Bank’s Web Applications/Systems; and/or (C) any
kind of promotional/research/feedback based exercise about the Bank’s products/services that I/we must/may be made aware for general consumption or to provide feedback as an existing customer of the
Bank; until such time I request/notify the Bank to stop sending communication to any/all of my/our registered communication addresses/details as per the Bank’s defined process and knowing that the Bank
will ensure security and confidentiality to all my communication contact details provided by me/us. If I am /we are or become a Non Resident Indian (NRI) / foreign national, I confirm that the following
consent is well within my capacity as a Non-Resident Indian and by doing so I do not violate or breach in any manner the regulations or statutes of the country of my residence as are applicable to me.
Notwithstanding anything contained herein above, in case I/we opt out from the aboveand tick‘NO’below, the Bank shall be entitled to use/share/disclose my communication contact addresses/details to send
me/us all communication either through select/mandated communication channels, those that are deemed necessary for the (A) smooth processing of my/our account operations/service request(s) (B) for
general awareness and/or (C) any statutory action required to be undertaken by me/us as per the applicable laws and guidelines/ regulations/directions/notifications prescribed by the Reserve Bank of India,
Ministry of Finance India, government/quasi-government authorities and any other authorities governing the financial and banking operations whether in India or outside India.
ü Yes No
DISCLAIMER: This material is for general informational purposes only and is not investment advice nor does it constitute an offer, recommendation or solicitation to buy or sell a particular financial
instrument. It does not have regard to the specific investment objectives, financial situation, risk profile or the particular needs of any specific person who may receive this material. No representation is
made that the information contained herein is accurate in all material respects, complete or up to date. Recipients of this document are to contact the representative in their local jurisdiction or contact
details given in this document with regard to any matters or questions arising from, or in connection with, the document. The information contained herein is not intended for distribution to, or use by,
any person in any jurisdiction where such distribution or use would be contrary to applicable law or regulation or which would subject IndusInd Bank to additional licensing or registration
requirements. It may not be copied, reproduced, posted, transmitted or redistributed in any form without the prior written consent of the Bank. This publication is for general information only, without
addressing any particular needs of any individual or entity, and should not be relied upon without obtaining specific advice in the context of specific circumstances.

FOR BANK USE ONLY

Customer signed in presence of Customer ID, Name and Address verified by Customer ID, Name and Address verified by

(Signature with name and (Signature with name and (Signature with name and
ECN of Branch staff) ECN of Branch staff) ECN of CPU staff )

Identity, Address Proof and Photograph updated on

List of additional documents acceptable as address proof

Sr. No. Acceptable KYC Documents

1. Utility bill which is not more than two months old of any service provider (electricity, telephone, postpaid mobile phone, piped gas, water bill)

2. Property or Municipal Tax receipt (should be last paid receipt as per periodicity of payment)
Bank account or Post Office savings bank account statement. The Bank statement should be of the latest three completed months. The Bank
statement should be in the issuing Bank Stationary with the stamp and signature of the Bank official. Passbook should contain signature and
photograph (if available) of the applicant. The photograph (if affixed) should be affixed in a manner it bears the stamp of the issuing Bank. The first
3. page of passbook where name, address and other details are mentioned should be duly attested by the issuing authority. Other transaction pages
if not attested by the issuing bank should be self-attested by the customer and OSV done by the sourcing/bank official. There should be at least
three customer induced transaction appearing in the passbook/ statement of account.
Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if they
4.
contain the address.
Letter of allotment of accommodation from employer issued by State of Central Government departments, statutory or regulatory bodies, public
5. sector undertakings, scheduled commercial banks, financial institutions and listed companies. Similarly leave and license agreements with such
employees allotting official accommodation.

6. Documents issued by Government departments of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India

7. Ration Card/ House hold card issued by State Govt.

8. Photo ID Cards issued by Central/ State Government Ministries and Department/ Quasi Govt. Departments

9. Photo ID Cards issued by Statutory Regulatory Authorities

10. Photo ID Cards issued by Public Sector Undertaking (establishment under Central/ State Govt.)

11. Senior Citizen Card issued by (Central/ State Govt. of India)

12. PIO (Person of Indian Origin)/ OCI (Overseas citizenship of India) Card.

13. Photo ID Cards issued by Ministry/ Department of Defense for personnel & their Dependents

14. Member ID card issued by ICAI, ICWAI, ICSI, Bar Council

15. Arms license (issue by central and State Govt. of India)

16. Defense Ex- Service Man Card Issued by Zilla Sainik Boards

17. Photo Social Security Smart Card issued by Central/ State Govts.
Identity cards issued by Govt./ Quasi Govt. departments, Defense, Banks, Public Sector Undertakings and listed Public Limited Companies (at any
18. recognized stock exchanges) The identity card should be signed and stamped by the employer and the card should contain the signature of the employee

19. Certificate of Identification issued of Office of District Collector (only for the state of Sikkim)

20. Address proof card issued by India Post Photograph, name and address should match with AOF and the card should be valid on the date of application

21. Mutual Fund Identification Number (MIN) allotment letter

22. Domicile Certificate with Name, Photo and Communication address Issued by District Collector/ Deputy Commissioner/ District Magistrate or
equal rank officer along with FV report
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