) TAMIL NADU GRAMA BANK | cir (Customer information File) Opening Form for = rnon- Personal CIF (Full KYC) 1/Wie request the Bank to open aecounts)/provde services opted by me/us & the required entty/individual details are given below: Customer Name & Address (lin block letters please) Pariiulars etal OF ApHTCATT Other Details Constitution — | Proprietary Partnertip bel) Pet td Public Ue. [UP ature oF Ary Trust/HUF/SHG/NGO “Adress Registered Office Date ot eae: {fo be entered in C85) Phone no. City & Pin code Phone no. state Fax NO, EMail PANN, Address TAN No. re ‘GST no, (Factory) ‘Annual INCOME Particulars of identification / Introduction A. Ust of KYC documents obtained for identity and address proof (Branches shall refer to SOP on KYC/ AMC guidelines for documents tobe obtained) 1 2 3 4 B. Introduction from an existing account holder of the Branch Name ofthe introducer. type of account and ae no Address of the introducer. Pin Code Phone no. | hereby introduce the above named applicants) and certify that | know M/s. forthe ast.-»n«months/year and confirm his/her occupation and address as stated in this application also attest his/her signatures) Signature ofthe Introducer / KYC particulars ae verified by me. ‘AF (Customer Infor mation File) for this customer may be opened. Signature ofthe verifying oficial Signature of the Introducer] Name ofthe verifying officer with SR no. Details of Beneficial Owners/Authorised Signatories Name. Designation Personal GE Ne, Branch Use ‘Annual Income:__ Threshold timit__ risk category:tow(-] Medium] High] Date: —/_/__ (rested by Appovedby: ana. | Shino — SRino,