ooo o of Oo ob) KNOW YOUR CLIENT (KYC) Application Form - For Individual CINEW 1] CHANGE REQUEST (Phse ck vin spoepre) PID: iNsonsst es Pease fl his form n ENGLISH and in BLOCK LETTERS ~ (Pb ick 26 xen a margin of sopoprato row where CHANGEICORRECTION is equred and provide tha dlls he coresgndrg row) __ Acknowledgement No. TDENTITY DETAILS 1 Name ofthe Applicant 2 Father siSpouse Name 3a Gender (Ise ClFerale 38 Marital status C)Sirge Clvariee 36 Date of ith ! ! 44. Natonaty [Indian C] ote Pose spe your recat passport 4. Status CIResidentinviual C1 Non Restart CoFoeign Natonal ‘sinacrossit 52. PAN ‘5b, Unique entiation Number {U0 Axéaa any 6. Speci Proof of Ment submittd —C] PAN cart ‘ADDRESS DETAILS 4 Address for Correspondence Cy Ton age Pr cade site Canty 2. Specify the Proof of Address submitted for Correspondence Address: 3. Contact Details a0) ex Ts Fs) Moola Eval 4. Permanent Address (diferent from above or overseas adress, mandatory for Non-Resident Applicant) (iy Tom ios sate Cauiry 5. Specify the Proof of Address submitted for Permanent Address: ‘OTHER DETAILS 4. Gross Annual Income Dtals (Pease Spec Income anges arum: Bow @ tac eis ORSi0le Oe 10 Cader thane 25 ass oR Networh (Net woh should rote adertan 1 year) Amount © 1s on (date) I 1 2. Occupation (Please tick Vany one and give brie tae Private Sector [Public Sector [Government Service [Business [Professional] Agrcuturst Rates THousewite C] Sudort Ly Others(Peasespeciy 3. Pleaso tick, applicable: Pollcally Exposed Person (PEP) 1H Relates toa Paltcaly Exposed Person (PEP) 4. Any other information: DECLARATION o ‘hare daca hth dels used above ae tue and crac othe bet of my kno Undatakot arm youolany changes erin, Incase a ‘rurraermiscadng or msropresaig, am anaretal may bali Date: Ll Ll Signature of te Applicant FOR OFFICE USE ONLY In Person Verification (PV) Detalls: Name oft person who has done the PY Desgnaton: Empaye 0: Name ofthe Organization Date o PY ! 1 Sirius othe pron who fas heiPv SealStanp of ha ne (Originals Vertes) True copes of Docurants received (Set atestos) Sef Certfied Document copies reosived Date Saraiva othe Avbsd SratoyINSTRUCTIONSICHECK LIST FOR FILLING KYC FORM AmpoRtanr pons Gol aosad copy of PAN card Is manda fr all cents, ncing PromolrsPatnerearaluoes and wie one sarah pero fuhoredt dean sestosonbonal carpages, 2. Expect al coc sites ye egpea stulbe se-atested ane {canparedby rg vraion incase ciate cocuerts rt Protas er eran, he th pe sos be ope atest 5 eves Suihossacloratesinga docunane arper bebo mensones st 2. Tanypsttdentyeadoes afore langage mentansaton ia gis sewed 4 Namb hares oft appcan-nanonaan KC fm sou mae wine cue petsubies 5. Teorespondine pear aes acter hn root ave abe ‘soni Selepropito ust nak apicaton i sleiualrane capa Feenentesdens are gn none, lowed tae soe Rand FEMA usin), nyo paesger 2 CarlOG Cat ara oversae ares proc = franca 4 Farergh ents CN i opr andi th absonc of Na. fre dees, ‘expostoarcony shale gen, 4. Inesne a Hernort Navy Neve Maar dcaraon a aed spy of COC (Caninaue iene Ceres itobe bres 10. For pening an azn wih Dpostony parca or Mutual Fund, fa mir phony tte S00 Lenin Cereal she sundby Har Socendey Boop North Geese mut oa 11, Palen Etposed Posen (PP) a dena sll vo re orhave ben sie ih prin pub rconenarepeuriye9, Hesse test {f Covermert, sei plicins,snor Goveneeriseal mila ocr ‘Snorexecitvet ae ned corprton eotatpalcapayoSaak et. 8 Prooff deny PO -Latt rumen admisie as Proof en re ria Hensteien Norbr (UD) (Atha! Paso! Wa I carl Daing 2. PANNardwit photograph, 4 Ignty'caddocurent wit apolcans Photo, sued by any ofthe folowing CenvaSite Govormat and fs Deparment, Salon Ropuatoy Auboste, Public Secor Undertakings, Scheduled Commocal Barks, Puli Fiance isttens,Coleges afte io Univstes, Professoal Bodes such a CN, TWN! 08 BarCoure oc, tother Manbrs: and Cred cardDob caresses byBanis, Prof ot Adsress(POA)-Listof documents amasible Proof ofAdérost: (Oocumentshaing an ex) dat shold valdon he dieu sori. Bankhcconl SttaanPessbok--NotmorebanSmoihs Sef-decaraion by HighCout and Supreme Cou does, ging tenew adéesin respetolthe om accouns 5. Proof of adores Issued by ry of te folowing: Bark Managers of Sohec Commercs| BanksiSchaduled Co-Operave BanklMultnatonal Farign Banis\Gezetad OficetNolay publoeced cepavetatves‘o he Legis PesealyParamensDocimentesuedby any Got or Sissy Author Ident eaddosonant wih aeaes, ese by nyo a fling: Centres Govarent ard fs Deparment, SlaoryRequsioy Atos, Pole Sector UUndraings Scheded Commerce Bene, Pubic neneainstons Colepee| sfiatd to Unersies and Protessonal Sodas sich av CN. (CWA ICS), Ber Counc, othe Marbes 7. For Flsb azoun, Power of Atomay oven by Flsubarcout othe Custodians [which are dy rotarzed andlor apostles or corsuarised) ha geste regres ress shold elaken 5, _Theprotofadeess inthe namacfihe spausemaybe: . Exemptinsilariieations to PAN (Suticordocunanaryevidenceln supportefsuchclanstobecoleced) ‘Incase of ransachons underaan on bane Cane! Government andlor Site Goverrant and by ofcis appt by Cours eg. Oi Iquistar, Cout fecavaral Investrsresisng inthe sate o Skim, UNenitesinuhisealapercies xem torpayngtnesingtaxreunsin iis SIPoIMuiual Funésupio R50 000! p a In case of istiuionl clans, namely, Fs, MFs, VCFS, FVCIs, Scie Conmarial Sank, Vulleral ane Bt! Development Fran Ins Site Indstial Development Coperatons, Insurance Conpanes registers wih IRDA.nd Pubic nano Inetsln as cafes nar scion éhcf ne Compares Pc 1856, Caedan shal vey PAN cad dels win he orignal PAN card ane roid ly cerviad copies of sich veiled PAN eta he itemeday E Listofpaoplesuthorisedto atest the documents: 1 Notary Publ Gazeta fier Marageofs Scheduled Conmarcia Cooperate Banker tnetnal Foreign Banks (Nore, Designation Sea shouldbe afixedon hhecopy) 2. ImeaseafNRis, authorised offal of versess ranches o Scheduled Comarca Banks reghteredin nda, Notary Publ, Cour Magia, Judge, Insan Embassy IConsuate Gnera inh county where the cles eis ae pemied atest he secures F Incase of Nanda, atonal documents oe obnes tom narnia, over {Labovethe POIRPOA ssmantanestelow ed 1 Benepe Votes daily Card Raton Car! Registered Laase cr Sole Agreement ResdenclDringLieeralFlatMaitenane til Iewaree Cop. 2 Use Teephene il (onl anne), Eaceeyallar Gas il-Netmore than Senne Types of entity | Documentary requirements Corporate Copy ofthe balance sheeis for the lat 2 financial years (abe subilled avery yea Copy olatest share holding pattem including Isto al those holding conto), efter directly orindirecty nthe company interms. of SEB! takeover Reguiations. duly certied by the company socrotaryfWhole ime diectorIMO (lobe Submitted every year) Pholograph, PO), POA, PAN and DIN numbers of wn Pholograph, POI, POA, PAN of incvidual promoters nolaing conto - either drecty o indirectly. Copies ofthe Memorandum and Acie of Association and cerca of incorporation, Copy ofthe Board Resoluton for investment in securities market Authorised signatories list with specimen signatures ole Lime drectorstwo directors in charge of day to day operations. Partnership frm Copy ofthe b Copy of partnership dood. Photograph, POI, POA. PAN of Partners. 39co shoots forthe last 2 fnancial years (fo be submited every year. Gorticate of registration (fr registred partnership fms only) Authorised signatories lst with specimen signatures Trust Copy of Trust deed, Photograph, POI, POA, PAN of Trustess Copy ofthe balance sheets for the last? fnancial years (abe submitied Certicate of registration (fr registered tust any) List of trustees certited by managing tusteesiCA ran year). HUF PAN of HUF. Photograph, POI, POA, PAN of Kart Deed of declaration of HUF List of coparceners Bank pass-book/bank statement in he name of HUF. Proof of Existance/Consttuton document Unincorporated goo)ooo0o/o000q\c0000|o0000 oo Resolution ofthe managing body & Power of Atlorey granted to transact business on ts behalf Authorised signatories list with specimen signatures, ao Copy ofthe consitaioniregisvaton or annual reporUbalance sheet forthe last 2 nancial years ‘Authorised signatories lst wih specimen signatures Copy of SEBI registration certeate Investors (Fl Authorised signatories st with specimen signatures ‘Army! Government Bodies Self-carification on leterhead, Authorised signatories lst win specimen signatures Registered Society List of Managing Commitee memoers. oooolooloo Copy of Registration Cerificate under Societies Regisvation Ac. Committes resolution for persons authorised to act as authorised signatories with specimen signature. ‘True copy of Society Rules and Bye Laws certified by the ChaimaniSecretary.