“Account Opening Form (For Indviduals Ony) Know Your Gliont(KYC) Pease fil in ENGUSH and in LOCK LETTERS ‘ae Appa Osea sing ercon en ane | siento ae) ater ane Spouse ane 2ende Cae Cemsk CT tareperdor Maal sas Cisige Cared ores Comeatank finn fo 4. sun etek) Tee nial estas i! Pa Cony Windy fe & Foi aa Pee a ean Oe Sm ee i cata yl Cand ade nar, we 6. Pot fy sted for PN exempt ar Pe Tk wep nto is Clr re] a IRAE (esa camer rotedtyPecetogeermert——__Epraetpottioey steed 00 y |B. Addies Deals (ease so guidelines veges) 1. Ads or Comspendee ‘ante fie wat Cat et iw | ‘a 2. conic Dea fen] 0 |) fees 0 | 0) ‘wale | ($0) | (STD) (ra) (80) | (STO) el ‘atuiDmitaetoebebgraC Se Spans Come aenidees Cin Tetiesienmnts meres eoeteing oC Se (Soul Ospeben art I Onn 2. as oe oid by plat Meas sbi ANYONE lh oon al dooms 8 (op he doa atch Cuan (lubiaceony Choeeree ene Clog ese hams caret) henley cP ne Sere ek {Die ere iy rinse at” lobes. eto an ec Wy dwt pet of isms 7 |= FLV) LILY ‘romana has of Res phen fr on abort eee fw oie Sire cs wy Ca taii cet Talo ‘a | (ae Adres ype [Reset /Bsrs eset Russ [epson ofc ‘et a tsb oid by Ap, Pes sit ANYONE oth flv ald estas 8 (apn homer ich Gimme (lubassany Ciowpe kere Clowg tensa Ciunms Goel) Corben Cf nea tet ae Sehr {tae rn) Chesney a” Clots pos ey. ‘shot mom Pan Bente ot Wry date of proof of adereas bested |6 4 J ime fy yy 6. ny thr nn a ay eet ae altar ane ore murmnti nat on FOR LOFFICE USE ONLY rv Donerson floes ‘chores net ec noe Det et Care ima = a he cos ne i wes in rig a 4, secu 3 Vor. 4 gyINSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM | impontan poms: 1, Selarecopy of ANcastsmandaeryeralen. 2 Copies ofa the docs submited bythe appa souk be seated ad accomparied by agin for veatn. nase the egal of any doce ot produce for vertexion the the copies shoul be popelyateed by ents authorzed for estingthe documents asper the bebe mentioned. 1 ary poo af idem rads sna foreign guage then atonal i eques, 4 Name wadtessofte appllantmentnedontte KYCfom sous match ith thedoanentyprotsubrited 5 eanegondene pemarendcs ardent then proctor ott have tobe submited 6 Soleporetormastmae te aplation nhs iva name & cape For nonresidents and forign naa allowedt tate sujet to Foland FEMA guidelines, copy of apertPIOCa OCs ns vescaatesprofismandan. 1. {8 Fafareg ents CINisopiona and inthe absence of DIN nn for ‘hedrecorshepasoat copy sou begin. In ase of Merchant Navy Nl Mares dedaation orcad ‘copy of CC (Coninuous Dichare Crate) ta besubite, 10.frperng an acrunt wth Depestoy paricpant or Mutual Fun, foramioc photocapyofthe School eaing Cent Man sest sued by Higher Secondary BaorPasipor of Minar Conca musto paises "Plc Exposed Persons (PP) are dfn as neve bo re rhe beenentused ith prominent pbcfunctos ina frig county, 69, Hate of Stes of of Goverment, senor polis, senor Govermemjudilktany ofces senor ecb of sate ouned coparatons impoantpoical pany afeak et Proof of Kentity Pom: Us of documents admissible as Proof of Identity: 1, PAN cad with photograph Tiss a manda requement for a applans xcept thae who ae speccaly exempt a caiing FaNiedinseconD}, 2. Unique Mefton Nonbe (WD) Aad Paso Voter ardiDivrglcense 3, erty card documet wth apa Phota,suedbyanyofhe ‘owing: CentlStte Goverment and. Depriment, StamtoyRepibzoy Autonies Puble Secor Underabnes Schesuled Commercial Banks Pu Fnancllsituns Cleges fate to Unestes Profesional Bodies such 3, KAA Test Barcauncete, tthe Members and Crd aD cad sued Barc, . Proof of Address (PON): List of documents admissibleasProot of Address: ‘Documents having an expiry date should be valid onthe date of submission) 1. Pagers deny CaRatonCariReisteed ease or Sole Ageament of Resdnceriing Leesa aitnance besos Cops, 2, Ushi bisBeTelephone ono lee bilo Gas Netmoethon3 months 4 Sankcount StatemenuPesbook- Natt han 3manbs ok 4, Setclaratin by hghCourandSupeme Cou spe ging te ew assim espe er own accu. 5. Prof of ates ised by ayo te fallovng Bonk Manages of Scheied Conmercal BankScheduks —Co-perve BankNMabinatoraForignBarksGazeted —OfcerNetay publoteted —rresentaives tothe Legbtve PezenbhyPalamertDacaret ues by any Govt or Son aon, 6, Wenty cardlscament with aes, suedby ay ofthe flowing CentalSiie Government and IS eparments, StaunyRegdstay Autortes Pale Sear Underabgs, Sched Conmrc dans at Finencal tits Cllges fled to Unites and Poeional Seles sch o¢ KA WALICS ar Counce tothe Menbes. 2, For sub acount, Power of Atemey gen by sub-account to the Cusedars (whch ae duly notarized andor apes or conse that gives terested adtess shouldbe ale, Te profofadtes inthe namecftespousemaybe acted, xemprionscaritcationsto PAN (Sufficient documentary evidence in support of such aims tobe collected) 1, Incase ofransactonsunderalen on behalf Cental Goverment dor State Government andy ofl spoilt Courts Oficallqudst, Coutreceneet, 2, storsresdingin testator, 3, UNenttesntistealagecs exempt tompayngtaesfing tax retunsinin 4, sPor wal Funds ups 0000+ pa 5. case of insttional dens, nary, Ni, VCR FUCK, Scheduled Conmerial Banks Mutbtesl and Sloteal DeveprentFrancid Inttuton, Sut Indust Delopnent Copoatns Insuance Companies registered ith ROA ad Fue Financ stato defied under secon 48 athe Companies ‘Ac, 1956, Castodans shal very the PAN card deta withthe ‘gal PAN car and prove ul ceri copes of such eid Pv detaletteintemasian. LUstof people authorized tates the documents: 1, Notay Puke, Gaetied Ofiet Manager of 2 Scheduled ConmercaVCoeperatte Bank or Mubiatenal Frign Barks (ame Deighton eaehouldbe aiedon becom, 2. In ce of NR, autoed ofc of eves branches of Schedles Commercial Banks rested in India, Noiay Pub our Magsvate, ue, Idan EmbasConute Gener the county whee te dent resides ae perited % atest the oeurens he Ste RY Bom nM Se Poe OoEATCA-CRS Declaration & Supplementary KYC Information (Deciaration Form for individuals) 1. PAN No: - 2. Trading Account No: - 3, Name: 4, Gross Annual Income: [<1 Lac []< 1-5 Lac] <5-10 Lac [1< 10-25 Lac [> 25 Lac oR Net Worth in INR Net worth As On. 5. Occupation CTprivate Sertor Service [7] Public SecrorL] Government Servicel] Business Lorrotessione! Retired [EE] housewite [2] student []settemptoyed []Not categorized. 6. Politically Exposed Person (PEP){_] Yes ]Related to PEP Not Applicable 7. Are you a US Person [] Yes [1] No 8, Country of Birth: [] India [U.S Other 9. Citizenship: C1 india Clu.s other 10. Place (City/Town) of Birth (if other than India) : 11. Primary Source of Wealth (choose any one from following) Ciselary Coausiness E]cit LJ Ancestral “operty CG Rental Income [J Prize Money [1] Royalty [Others 12. Whether Tax Resident in any country other than India:[] Yes] No 13, If for any of the above fields, the country mentioned by you is not India or if your US person status is "Yes’ or you are an NAl or Foreign National, then please provide following details: Country of Tax Identification No. | Type of No. Please specify FE Residence for Tax _| (TIN) or functional Type/ Name (Not Purpose (other than_| equivalent (FE) of TIN applicable if TIN India) / TIN issuing provided) country 0 ow Ore OW oOFfe 14. Address in the foreign country of which you are a tax resident (Other than India): City/Town Village. State Pin Code, Country,15, If you satisfy the criteria as mentioned in point 7 above but do not have TIN / FE, please fill the following details: Country No. other than TIN/ Type of No. Name FE Tvs Dy Resident no. ] Work permit no. Cdependent visa LI student visa D1 Seafarer status [1 Going to the country of residence for first time* {_ Under penalty of perjury, I certify that: 1The applicant is (i) an applicant taxable as @ US person under the laws of the United States of America (US.1 or any state oF politcal subdivision thereof or therein, including the District of Columbia or any other states of the U.S. {i) an estate the income of which is subject to U.S. federal income tax regardless of the source thereof. (This clause is applicable only ifthe account holder is identified as a US person) or 2. The applicant is taxable as a tax resident under the laws of country outside India. (This clause is applicable only ifthe account holder is a tax resident outside of India) {il) | hereby declare that the details furnished above are true, correct and complete to the best of my knowledge and belief including my/our taxpayer identification number. In case of any change in the above siven status on a future date, | undertake to inform |= Sec the same within 30 days. {il) | agree that if | am a U.S. Person oF tax resident of a reportable foreign jurisdiction (other than U.S.) requiring reporting under FATCAICRS or any other laws, my account details, as required under Inter Governmental Agreement (IGA)/ Multilateral Competent Authority Agreement (MCA) signed by Indian Government, would be reported by |-Sec to the relevant tax authority, {IVI [hereby confirm thet details 8s provided by me above can be shared by I-Sec with the concerned Asset ‘Management Companies (AMCs) or such other product providers, to whom FATCAICRS norms are applicable, in whose schemes! products I may invesVransact in future through lSec. Following clause applicable only if any of th since not resident for tax purpose outside | No’ in point no.1: iia parameters is outside India and TIN/ FE is not available (OR Country of Birth is US and US person is mentioned as | hereby confirm that | am not a US Person ora resident for tax purpose in any country other than India, though my Country of Birth suggests my relation with US or one or more parameters suggest my relation with the country outside india. | am providing / already provided copy of my PAN card to Sec and now providing a cortficate of relinquishment of US citizenship (loss of nationality} OR reasons for not having such a certificate despite relinquishing US citizenship OR for not obtaining US citizenship at birth (only if born in US) Please specify reason Please select any one of the below option- | am signing this document as, 1 First Holder [J] Bank Joint Holder] DP Co Holder [] MF Joint Holder Name: Signature: Date: