Central KYC Registry | Know Your Customer (KYC) CAMSKRA Pax el Wes EUs eeu aeu uC ie Important Instructions: A. Fields marked with “” are mandatory fields, B. Tick ‘v' wherever applicable. C. Please fill the date in DD-MM-YYYY format. D. Please fill the form in English and in BLOCK letters. E. KYC number of applicant is mandatory for update application. F. List of State/U.T code as per Indian Motor Vehicle Act, 1988 is available at the end G. List of two-character ISO 3166 country codes is available at the end. H. Please read section wise detailed guidelines/instructions at the end |. For particular section update, please tick () in the box available before the section number and strike off the sections not required to be updated. For office use only ‘Anplcstion type New UI ee ses ename CLCELOLLLLLILD tenner ct rere 1. Entity Details* (Please refer instruction A at the end) Gramer [ssesesseessesssessssesssessssesssesssesss) SSeeesseessessssesssesssesnseesseessseses) EntityConstitution Type" © Cners tsnecit ) [piease refer instruction Bat the end Dateofincorperatianirarmation lal wll WOO) Date of Commencement of Business GLOW Place of Incorporation/Fatmation” O) countryotneaporationormationt (JL) rivor equivalent issuing Country JL) Pan essescsess) aiN/csTRegistation Number #2. PROOF OF IDENTITY (POI)* (Please refer instruct 9 Officially valid document(s) in respect of person authorised to transact GO certteateotncorporation/Farmation et ee ) {© Memorandumand Articles of Association Gi Partnership Deed OTs Ove Resolution of Boara/ Managing Commitee Power of Attorney granted to its manager, officers or employees to transact on its behalf Qarstutyprecl 1 FersoiePrepratonne orl 5 Activity proof -2 (For Sole Proprietorship Only) Pes Nee Mea atone ea ULe)) 53.1 Registered Office Address/Place of Business* root ot addres Dceriestect nepcrton/Formaton Region Ceeste QOther Document 5 unr COOCONOCONDOCONCCCODeCOROCONSOCONoCConeCCSOCCOSo3 ua COOCODOCCADOCOBSCCOBECCRSCCADECSASECSSSCSSSESESSSE5 Lines C cays town/vitiage” pstiet OOOO 0000000 Pin /post coset QO0000; state/ UT Cooet OL) Iso s166Country Cone CL) 3.2 Local Address in India (If different from above)* Line. Lines iy Town vlage? piste OOOO O00 OOD ein post coder QOD state/uTcodee CL) 's066Country code CL)eae tag elie wen 000 CLDODD00 CL00-OOLOOLO esr | ite Ril NAL oO ear ao Elle) aes eM Tiassa Coreen yao Gitar) . |hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and | undertake to inform you of any changes therein, immediately. Incase any of the above information is found to be false or untrue or misleading or misrepresenting. | am aware that | may be held liable for it : hereby declare that | am not making this application for the purpose contravention of any Act, Rules, Regulations or any statute of legislation or any notifications/directions issued by any governmental or statutory authority from time to time - hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address. | also providing consent to MF/AMC/KRA to share this KYC data with CKYCR, download the information from CKYCR and other participating intermediaries as mandated by PMLA Act/Rules/SEBI guidelines. PUcoe eam a Documents Recehed |) erties Copies) Eguhslente-decument Place eve dacuments verification carried aut ty Institution details Identity verification [Joone date [2[5) -[m]) - [eT ]¥[¥] name (TTT TTTT TIT I TIT ttt) Emp Name OTT rr ttt rt rr sae Emp code CTT ttt ttt) empoesignation CLT TTTTTTITT TTT TTT) Emperench COT T TTT Tt ttt itt sett ML LU aAnnexure A2 | Legal Entity | Other than are Te ELS Central KYC Registry | Know Your Customer (KYC) Application Form | Related Person CAMSKRA KYC Services Important Instructions: A. Fields marked with ‘* are mandatory fields. B. Tick '/' wherever applicable. C. Please fill the date in DD-MM-YYYV format D. Please fill the form in English and in BLOCK letters. E. KYC number of applicant is mandatory for update application. F. List of State/U.T code as per Indian Motor Vehicle Act, 1988 is available at the end G. List of two-character ISO 3166 country codes is available at the end. H. Please read section wise detailed guidelines/instructions at the end |. For particular section update, please tick (/) in the box available before the section number and strike off the sections not required to be updatedee OS a ES {1a ley Soancinettsin) vevenurmber TT TT TTT 11) anton for ere upsire and dette request) Ue aL Mace cea ao re eam RISTad Cer efolA (CD adaton ofReatec Person (D Deetonet Rete Person (0 Uodere Rested Person Det 1 Number of Rtted Person rman) COCCI sre numter eee on etd Pron ioe Hee mend) plated Porton Type orecer ~ QPromater” G)Rara CO Trsice Parner C)CourApeiniment OM Poprctor Qsereiany QAdhorced Signatory Qencicalouner —_CPoverot Attorney Holder Othe Please spect DIN (Director Klentfeation Number) (Manclatay f Related Petzan Types Direct) Pref Fist Name Middle Name: Last Name Name" (Same as 0 proof) Maidan Name Father/spouse Name” Mother Name Date of Bier Glo Tl etette) condor © sesate O Fremele —@ Tanegender Nationale © Nindan Others (SOsI6@County code I) Pant 0000000003 1.2 Proof of Identity and Address* (Please TaSsaat Coola erator) 1 conitasicopy ct ovo craquivlente-dccument af var OVD aetna! through stalk proces: need tobe zubmited [anjanectthe flesing °° sree @APassport Number OOOO0COD GBreteripers —§ QOOO000000 coriving Licence IT IO openers Driving Licence Expry bate (all Laalaal Se Lelale) QD. NREGA ob Cara G_ENational Population Register Letter G)F-Proot of Possession of achar NQE-KYC Authentication I QoFFine vericaton oF Aadhaar Address Line Line tires QUO CORO CORR OOOO OO OREO O00 ¢iy7Fown vias CODO000000, pwr OOCCODOCODOD einspest cose” OOOO siaesurcose CO sso nsscountry coder OO) CTT Uae aisle! 9 Same as above mentioned address (In such cases address details as below need not be provided) Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the following OVDs) @Avesspornumser QOCOOO0O0, @eveeioerd — QOCOOOOCD Gcorving tence —§ QOOODO0050000009 @owrecajeb care — COCOCOCOCOCOCOCOCOCOCOoD, GENatona:Popuition Regier eter GF Prootot Possession of Aadhaar HOEK Authentiaton W © Offine version of Aachaor WV Beomed Poa yO SeltDeclaration Addressumes QOOO ODO ODDO SOOO CONE CONAN DAD ety te0n wages COODDO0002D, petit OOOO 0000000 Pn joose cose III, CD somsscountry cou OD) (Telia byte ema OOOO 00030303 PY : hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and | undertake to inform you of any changes therein, immediately. Incase any of the above information is found to be false or untrue or misleading or misrepresenting. | am aware that | may be held liable for it. . [hereby declare that | am not making this application for the purpose contravention of any Act, Rules, Regulations or any statute of legislation or any notifications/directions issued by any governmental or statutory authority from time to time « hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address. | also providing consent to MF/AMC/KRA to share this KYC data with CKYCR, download the information from CKYCR, and other participating intermediaries as mandated by PMLA Act/Rules/SEBI guidelines Date EW ame Documents Received Certified Copies CEC data received tom VIDA) Datareceivedirom Offine verification ©) Dighal KC recess © Equivalent document YC documents verfestion carried out by Insteuion tals Date (oc) seme CTT TTT TTT TTT rr) Emaame Coorg Emp Code COT TTT Tr Trt ttt) empoesignation (CIT TTTTITIT TTT) EmpBranch OO TIT rt rr ttt) |eee EA 1. Entity Constitution Type A- Sole Partnership B— Partnership Firm C- HUF D - Private Limited Company E~ Public Limited Company F -Society G—Association of Persons (AOP)/Body of Individuals (BO!) H-Trust |- Liquidator J-Limited Liability Partnership K~ Artificial Liability Partnership L- Public Sector Banks M-Central/State Government Department or Agency N~Section 8 Companies (Companies Act, 2013) O~ Artificial Juridical Person P— International Organisation or Agency/Foreign Embassy or Consular Office, etc. Q-Not Categorized R- Others S Foreign Portfolio Investors B, Clarification / Guidelines on filling ‘Proof of Identity [POI] section A. Activity Proof -1 and Activity Proof -2 are applicable for accounts in case of proprietorship firms. Please refer to relevant instructions issued by the Reserve Bank of India in this regard. B, Please refer to the relevant instructions issued by the regulator regarding applicable documents for the legal entity. C. Certified copy of document or equivalent e-document or OVD obtained through Digital KYC process to be submitted D. ‘Equivalent e-document’ means an electronic equivalent of a document, issued by the issuing authority of such document with its valid digital signature including documents issued to the digital locker account of the client as per rule 9 of the Information Technology (Preservation and Retention of Information by Intermediaries Providing Digital Locker Facilities) Rules, 2016.2. Copies of all documents that are submitted need to be compulsorily self-attested by the applicant and accompanied by originals for verification. In case the original of any document is not produced for verification, then the copies should be properly attested by entities authorized for attesting the documents, as per the list mentioned under [F]. 3. If any proof of identity or address is in a foreign language, then translation into English is required duly attested by the official as indicated above 4, Name & address of the applicant mentioned on the KYC form, should match with the documentary proof submitted. 5, If current & permanent addresses are different, then proofs for both have to be submitted. 6. Sole proprietor must make the application in his individual name & capacity. 7, For non-residents and foreign nationals, (allowed to trade subject to RBI and FEMA guidelines), copy of passport / PIO Card /OCI and overseas address proof is mandatory. 8, In case of Merchant Navy NRI's, Mariner's declaration or certified copy of CDC (Continuous Discharge Certificate) is to be submitted, codes as per Indian Motor Vehicle Act, 1988 Be ‘crate ca Maat Pradesh me ‘eure mR Daman 8 Dis 00 Maniour my ‘uxarathand UA tee Baek: Country Code Doran (AE DomincanFeouble 0 teva 1 SansRereandhiuson| Pu nasto Be hoe 9 unre Ly sin sarino oe nein samen 25 Caton cine © Mocao No SoeTome andrincoe 7 Sarees 29 Fenian otis) Fk hae MY Syenle me ‘Agua abuse fc Fae ange FO nace Sermon a ron aa FH Ma Me Siroare Pa 1 Frente BF saurtans Mm Sloman = 188 Carmary De Motors Rouble! NO Seen eS 1 Green 1 Monset Me Sastorenddun seen s BT cunselune P Memmbue Me Sacer se 80 Guam (y saninar i Setters on onde sin utter abs 80 Comer cr nombia Na Srna Rouble wv