Page 1 of 4

MHW1/181D/1-1/WBF-M/03-12

142801532959??PALT0506 515812

MR.PALTHURU CHAND Your Base Branch: ICICI BANK LTD., GMR PLAZA, SYNO:
59/2B,,OPP NARSIMHA HONDA, RAM NAGAR,,515001
331,9/3/331 INDIRA NAGAR,3RD LINE,URAVAKONDA,
URAVAKONDA,NEAR AMBEDKAR SCHOOL
ANANTHAPUR Visit www.icicibank.com
ANDHRAPRADESH - INDIA - 515812 Dial your Bank B479

Did you know? It's mandatory to be KYC compliant as per RBI guidelines. If you have not submitted your KYC documents, please visit the nearest
branch or contact your Relationship Manager to complete KYC details for your Account.

Summary of Accounts held under Cust ID: 560117733 as on February 02, 2024
ACCOUNT DETAILS - INR
ACCOUNT TYPE A/c BALANCE(I) FIXED DEPOSITS (LINKED) BAL.(II) TOTAL BALANCE(I+II) NOMINATION
Savings A/c 142801532959 3,225.75 0.00 3,225.75 Not Registered
TOTAL 3,225.75 0.00 3,225.75

Statement of Transactions in Savings Account Number: 142801532959 in INR for the period November 02, 2023 - February 02, 2024
DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE
02-11-2023 B/F 352.40
UPI/367377871484/You are
03-11-2023 paying/amazonpay@apl/Axis Bank 295.00 57.40
Ltd./APL018b95e7c0cbc9b8afd0a69975804c96/
UPI/330814369809/NA/7396684653@payt/Axis
04-11-2023 Bank 416.00 473.40
Ltd./PTM587138E2DB6C4DEBAFB326492ED74544
UPI/330883894095/Payment from
04-11-2023 Ph/chandjk113@ibl/HDFC BANK 400.00 73.40
LTD/IBLa574e218ba794754899f2ffdc23c6109/
UPI/330847379249/NA/7396684653@payt/Axis
04-11-2023 Bank 2,325.00 2,398.40
Ltd./PTMCA3B6111A52E4E178F3989937624591F
UPI/330847387007/NA/9037119126@payt/Federal
04-11-2023 Bank/PTM92ce77b702754d62b52a29eb7a609f40 2,449.00 4,847.40
UPI/330854360472/Payment from
04-11-2023 Ph/chandjk113@ibl/HDFC BANK 4,700.00 147.40
LTD/IBL3aca2315952f4794854ef6a144d98998/
UPI/331186825610/Payment from
07-11-2023 Ph/chandjk113@ibl/HDFC BANK 60,000.00 60,147.40
LTD/IBL7e756383b9d5460fbe2bb4c6ae06c401
BIL/000750449369/ICICI BANK CREDIT
07-11-2023 NET BANKING CA/437551373246 60,000.00 147.40
UPI/331206220950/NA/7396684653@payt/Axis
08-11-2023 Bank 2,648.00 2,795.40
Ltd./PTMCFF3943F2BBB4046B19FE674D3ADDC0D
UPI/331206498927/NA/9037119126@payt/Federal
08-11-2023 Bank/PTM6e43d4844dd84b0dbceddfeb0d16af6c 21.00 2,816.40
UPI/331253241742/Payment from
08-11-2023 Ph/chandjk113@ibl/HDFC BANK 2,800.00 16.40
LTD/IBLdc08e7325bc848e689cfc29a8e06f206/
UPI/332145101190/NA/9037119126@payt/Federal
17-11-2023 Bank/PTMfe16ac3a4a0547edad1c1903148d0956 880.00 896.40
UPI/368854654751/NA/paytm-66490784@/Paytm
18-11-2023 Payments 521.00 375.40
/PTMae189a36612a491083fcf4144c3c9abe/
UPI/332241846233/NA/7396684653@payt/Axis
18-11-2023 Bank 517.00 892.40
Ltd./PTMAB3D291476B84CAF83B4FA1C1E2FED97
20-11-2023 NET BANKING VIN/Zomato Onli/202311191330/332308959528/ 707.54 184.86
 Page 2 of 4

MR.PALTHURU CHAND

DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/369004473485/NA/9037119126@payt/Federal
20-11-2023 Bank/PTM9d4fa476d00d47789fa9af10f1c363a8 880.00 1,064.86
UPI/332564580886/Oid202311211618/paytmqrtfswq
21-11-2023 229/Paytm Payments 28.00 1,036.86
/PTMe46f12121b0d4021aaa8b21bc1c495be
UPI/333419389617/NA/9037119126@payt/Federal
30-11-2023 Bank/PTMeebc10ec77c145d5956b91c027b31bc4 515.00 1,551.86
UPI/334701918358/Request from
13-12-2023 Am/amazonpayrechar/Axis Bank 707.00 844.86
Ltd./APLef173e41203d4abdb1fd9ce6147aa521/
UPI/371416372232/Payment from
14-12-2023 Ph/chandjk113@ibl/HDFC BANK 800.00 44.86
LTD/IBLabc9f6bfac3f4bdfbd0e8b622a10ed3a/
UPI/371642147687/Payment from
16-12-2023 Ph/chandjk113@ibl/HDFC BANK 5,000.00 5,044.86
LTD/IBL62c85b0bca044545bed570ea1e1a1901
BIL/000768595418/ICICI BANK CREDIT
16-12-2023 NET BANKING CA/437551373246 5,000.00 44.86
UPI/372476058032/Payment from
25-12-2023 Ph/JIOINAPPDIRECT@/Yes Bank 15.00 29.86
Ltd/IBL992439a5e7df4e3b98072f51c24931c7/
BIL/773350720/INSTAPLCC/00028313904000040501
28-12-2023 NET BANKING 8290/ICICI BANK LTD-CREDIT CARD WIT 1,00,000.00 1,00,029.86
UPI/336205805678/cred/credclub@icici/ICICI
28-12-2023 Bank/MNOMLrzJEqjgN578WM8Jew2/ 89,067.01 10,962.85
UPI/372891075305/Payment from
28-12-2023 Ph/chandjk113@ibl/HDFC BANK 8,000.00 2,962.85
LTD/IBLebe3962e14234c77be864c6d0ae2490c/
NEFT-312272176816-BNY MELLON
29-12-2023 INTERNATIONAL OPERATIONS-SAL FOR DEC 2023 74,366.00 77,328.85
-04860330000037-HDFC0004989
UPI/372930263743/Payment from
29-12-2023 Ph/chandjk113@ibl/HDFC BANK 32,241.00 45,087.85
LTD/IBL5c5d815e82b944a28ee4d0fb9b6c8fef/
30-12-2023 142801532959:Int.Pd:30-09-2023 to 29-12-2023 7.00 45,094.85
UPI/336420982143/Pay to
30-12-2023 BharatPe/BHARATPE.900692/Federal 20.00 45,074.85
Bank/IBL3b69654c954347b9ab1578775c31df2f/
UPI/336437456918/Payment from
30-12-2023 Ph/9845070598@axis/Axis Bank 92.00 44,982.85
Ltd./IBL38b120641b054ac694cf1d89984b1ef0/
UPI/373013332030/Payment from
30-12-2023 Ph/chandjk113@ibl/HDFC BANK 40,000.00 4,982.85
LTD/IBL34f89773021c47ec9f5bc78d53bbba74/
UPI/373004930958/Payment from
30-12-2023 Ph/chandjk113@ibl/HDFC BANK 4,800.00 182.85
LTD/IBL21662ebff847462891e814613c090ccc/
UPI/400106074581/Pay To
01-01-2024 RUDRAGOU/BHARATPE.600037/ICICI 20.00 162.85
Bank/IBL0ea4676ef48b4637a2ae08d08bdee894/
UPI/400284514094/Payment from Ph/gpay-
02-01-2024 1116608352/Axis Bank 30.00 132.85
Ltd./IBL7dd2576db1fd4265b80e2e79d7d83faf/
UPI/400296082312/Payment from Ph/gpay-
02-01-2024 1116608352/Axis Bank 40.00 92.85
Ltd./IBL6563369018244925807a2f386cfadc0b/
UPI/400203902169/Payment from Ph/paytm-
02-01-2024 33345433@/Paytm Payments 28.00 64.85
/PYTM4010224059293365269/
UPI/438031541033/Payment from
15-01-2024 Ph/chandjk113@ibl/HDFC BANK 30,000.00 30,064.85
LTD/IBL8d72faabdd89451fa206ad9df9a154cc
VPS/VIVO STORE
15-01-2024 DEBIT CARD /202401141939/401414239880/CHENNAI 26,999.00 3,065.85
UPI/401615577920/PayviaRazorpay/swiggy.rzp@hd
16-01-2024 fc/HDFC BANK 317.00 2,748.85
LTD/IBLb858e161f65c44a69526a07b5d5d312a/
 Page 3 of 4

MR.PALTHURU CHAND

DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/401732103822/Payment from
17-01-2024 Ph/harislrig@oksbi/Axis Bank 150.00 2,598.85
Ltd./IBL12554c1e549c48b0a359ec7c780a0520/
UPI/401753460758/Payment from Ph/gpay-
17-01-2024 1116937775/Axis Bank 358.00 2,240.85
Ltd./IBLde383f582d9241b0910cdf2b550a5b72/
UPI/401764944827/Payment from
17-01-2024 Ph/8608817116@okbi/Axis Bank 20.00 2,220.85
Ltd./IBL01ca84948a6b4028b6990393ff99da30/
UPI/438386187471/Payment from
17-01-2024 Ph/Q470644283@ybl/Yes Bank 35.00 2,185.85
Ltd/IBLea1b0fdd7368416587e96a159d865334/
UPI/438447581441/Payment from
18-01-2024 Ph/Q772907769@ybl/Yes Bank 20.00 2,165.85
Ltd/IBL3826266c158346c7b1521483c43dba2b/
UPI/401892075294/Payment from Ph/paytm-
18-01-2024 66490784@/Paytm Payments 227.00 1,938.85
/IBLa852c875c49446efbda0635519aa9322
UPI/401938676793/Payment from
19-01-2024 Ph/paytmqrkihyhqs3/Paytm Payments 35.00 1,903.85
/IBL13e72360127e43fea03e51d25c64145f
UPI/401917281660/Payment from
19-01-2024 Ph/paytmqr10lhiv0s/Paytm Payments 130.00 1,773.85
/IBLe7549a2ed2d5434683d51a7e6818ebbd
UPI/401925007602/UPI/selvalakshmi.g1/State Bank
19-01-2024 Of I/ICIbe44193876ec42309d3bdbcb007fbdf0/ 33.00 1,740.85
UPI/402091720478/PaymentforZohoc/vishalmanoch
20-01-2024 aen/Axis Bank 99.00 1,641.85
Ltd./IBL8cc5dfec6330482ab03e91c48fc9d2ff/
UPI/439559494353/Payment from
29-01-2024 Ph/prakash1740@ibl/Indian 659.00 982.85
Bank/IBL609ba2bb2a144f15be8c9894c08549ff/
NFS/CASH
29-01-2024 OTHER ATMS WDL/402905561681/CUB02627/CHENNAI /29-01- 500.00 482.85
240519
NFS/CASH
29-01-2024 OTHER ATMS WDL/402906566544/CUB02627/CHENNAI /29-01- 300.00 182.85
240642
UPI/403086835071/Oid202401301641/paytm-
30-01-2024 78743944@/Paytm Payments 15.00 167.85
/PTMa9fa62e3a8a24db5b1822c18af34f071
UPI/403010609314/Payment from Ph/paytm-
30-01-2024 33345433@/Paytm Payments 9.00 158.85
/PYTM4013025714328184881/
UPI/403047434053/Payment from
30-01-2024 Ph/paytmqrkihyhqs3/Paytm Payments 50.00 108.85
/IBL5da75f784c6b415e9f472979448298aa
NEFT-401305693687-BNY MELLON
31-01-2024 INTERNATIONAL OPERATIONS-SAL FOR JAN 2024 1,95,715.00 1,95,823.85
-04860330000037-HDFC0004989
UPI/439757916963/Payment from
31-01-2024 Ph/chandjk113@ibl/HDFC BANK 60,000.00 1,35,823.85
LTD/IBLb2a5ea9f6c284486bf92c757609c52ae/
UPI/439771561754/payment on
31-01-2024 CRED/cred.club@axisb/Axis Bank 83,818.10 52,005.75
Ltd./ACDe0041fe288a64f6ebfe240aae5e2bb9f/
UPI/403136284034/Payment from Ph/paytm-
31-01-2024 33345433@/Paytm Payments 28.00 51,977.75
/PYTM4013123755891593221/
UPI/403190913456/Payment from
31-01-2024 Ph/paytmqr1amx5yc7/Paytm Payments 12.00 51,965.75
/IBL6d903f5759c64974be9fed3d59bd8978
UPI/439803575900/payment on
01-02-2024 CRED/cred.club@axisb/Axis Bank 3,983.00 47,982.75
Ltd./ACD781b6a274b1648929be6d3e777cd83a4/
UPI/403275303666/Payment from Ph/paytm-
01-02-2024 33345433@/Paytm Payments 9.00 47,973.75
/PYTM4020123995603185665/
 Page 4 of 4

MR.PALTHURU CHAND

DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/403277645472/UPI/ksakthiamma@oks/ICICI
01-02-2024 Bank/ICId9b46e13a35b433195fc8bdcf5c05a56/ 12,600.00 35,373.75
UPI/403215939291/Payment from
01-02-2024 Ph/paytmqr1amx5yc7/Paytm Payments 48.00 35,325.75
/IBL14bdd9493360464998f53340eced4c93
UPI/439808664253/Payment from
01-02-2024 Ph/chandjk113@ibl/HDFC BANK 32,000.00 3,325.75
LTD/IBLdb3c3f68ab3b47fb80ed07a042d63951/
UPI/403279406789/Payment from
01-02-2024 Ph/crajendran6911@/Kotak Mahindra 70.00 3,255.75
/IBL68110fb64f5f400ab2ea0bcf3b75da57
UPI/403290424911/Payment from Ph/gpay-
01-02-2024 1116937258/Axis Bank 30.00 3,225.75
Ltd./IBL2aabda7a4c84447c804d666fa8ee8fc8/
TOTAL 4,75,739.00 4,72,865.65 3,225.75

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFSC CODE NAME OF NOMINEE
Savings 142801532959 515229003 ICIC0003551 -

Nominee name is displayed only on specific consent of customer.

Sincerely,

Team ICICI Bank.

This is a system-generated statement. Hence, it does not require any signature.

Legends for transactions in your account statement

VAT/MAT/NFS - Cash Withdrawal at other bank's ATM INF - Internet funds transfer in Linked accounts
EBA - Transaction at ICICIDirect BIL - Internet bill payment or Funds transfer to third party
VPS/IPS - Debit card transaction TOP - Mobile Recharge
RTGS - Real Time Gross Settlement (Instant Transfer of Rs 2 Lakh and up to Rs 10 Lakh) NEFT - National Electronic Fund Transfer (Up to Rs 10 Lakh)
• **Mode is available only for transaction done after August 6, 2013.

• As per prevailing guidelines of the Income tax Act, 1961 if a valid PAN is not provided by the
Customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher.
•As per guidelines issued by CBDT on May 13, 2011, Form 16A (TDS Certificates) will be generated
through the Income tax website for which the PAN of the customer needs to be necessarily updated
in Bank's record.
•In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
•In case your PAN is not updated in our record, please visit the nearest branch and provide a copy
of the PAN card along with the original PAN card for verification.
•The address of the customer in Form 16A will be the last updated address in the data base of the
Income tax department.

REGD ADDRESS: “LANDMARK”, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA www.icicibank.com
This is an authenticated intimation/statement. Category of service: Banking & Financial Services.
Customers are requested to immediately notify the Bank of any discrepancy in the statement Registration No. MIV/ST/Bank & Finc/4.
MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1 PAN Based STC No. AAACI1195HSST001.