Page 1 of 3 M-284759

609807/284759/1-3/RESTS/05-24
Your Base Branch : NEYVELI3 TOWNSHIP BRANCH, PB
NO 18, UNIT 5/5, MAIN BAZAR, NEYVELI TOWNSHIP,
607803
MR.K SIVAPRAKASAM & SELVI S
171/17,GOLDEN JUBILEE FLATS,PADIKUPPAM ROAD,
ANNA NAGAR WEST, CHENNAI -600040 : Visit www.icicibank.com
CHENNAI
TAMIL NADU - INDIA - 600040 Å Dial your Bank 7305667777

NEVER SHARE your Card number, CVV, PIN, OTP, Internet Banking User ID, Password or URN with anyone, even if the caller claims
to be a bank employee. Sharing these details can lead to unauthorised access to your account.

STATEMENT SUMMARY for Customer ID : 70751592 as on December 31, 2017

ACCOUNT DETAILS - INR

ACCOUNT TYPE A/C. BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) NOMINATION
Savings A/c 039501000298 2,98,020.78 0.00 2,98,020.78 Registered

TOTAL 2,98,020.78 0.00 2,98,020.78

FIXED DEPOSITS - INR

DEPOSIT NO. OPEN DATE DEP. AMT. # ROI% PERIOD MAT. AMT. ^ MAT. DATE BALANCE * NOMINATION
039513000456 28-01-2017 4,68,828.00 7 390 Days 5,04,889.00 22-02-2018 4,74,068.00 Not Registered
039514005963 25-01-2017 5,74,706.00 7 390 Days 6,18,909.00 19-02-2018 5,81,422.00 Not Registered
039513002900 14-10-2017 6,43,025.00 6.75 390 Days 6,90,719.00 08-11-2018 6,43,025.00 Not Registered
TOTAL 16,98,515.00

# Deposit amount shown is as on 01-01-2018 ^ Maturity value is subject to change due to payment of Tax Deducted at Source (TDS) wherever applicable * includes accrued interest if any

Statement of Transactions in Savings Account 039501000298 in INR for the period October 01, 2017 - December 31, 2017

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

01-10-2017 B/F 2,56,501.57
05-10-2017 DEBIT CARD MPS/OOTY VEGETA/20171005071528/0 195.00 2,56,306.57
06-10-2017 MOBILE BANKING MMT/Ref727920351511/9110200485657 30,000.00 2,26,306.57
06-10-2017 NET BANKING BIL/001307354101/LL Bill Sept 17/BSNLPOST_JICI57 1,238.00 2,25,068.57
07-10-2017 DEBIT CARD VPS/NEW SARAVAN/20171007130053/0 1,526.00 2,23,542.57
09-10-2017 DEBIT CARD MPS/SRI SAI TEX/20171008132809/0 3,325.00 2,20,217.57
09-10-2017 DEBIT CARD VPS/OOTY VEGETA/20171009172658/0 420.00 2,19,797.57
11-10-2017 OTHER ATMS NFS/CASH WDL/11-10-17 5,000.00 2,14,797.57
11-10-2017 DEBIT CARD VPS/AMAZON SELL/20171011085133/0 399.00 2,14,398.57
11-10-2017 MOBILE BANKING MMT/Ref728414662597/9110200485657 40,000.00 1,74,398.57
11-10-2017 DEBIT CARD VPS/NEW SARAVAN/20171011220243/0 1,728.00 1,72,670.57
16-10-2017 DEBIT CARD IPS/GRT JEWELLE/20171015160916/0 550.00 1,72,120.57
16-10-2017 DEBIT CARD IPS/GRT JEWELLE/20171015170754/0 13,798.00 1,58,322.57
16-10-2017 OTHER ATMS NFS/CASH WDL/15-10-17 5,000.00 1,53,322.57
17-10-2017 MOBILE BANKING MMT/Ref729010441620/9110200485657 33,700.00 1,19,622.57
17-10-2017 NET BANKING BIL/001314477411/Payment I-17-18/CMWSSB_JICI5743 622.90 1,18,999.67
18-10-2017 DEBIT CARD MPS/OOTY VEGETA/20171018115410/0 446.00 1,18,553.67
18-10-2017 DEBIT CARD VPS/K N BROTHER/20171018115933/0 1,217.00 1,17,336.67
18-10-2017 TATA PROJECTS LIMITED 1,35,000.00 2,52,336.67
20-10-2017 OTHER ATMS NFS/CASH WDL/20-10-17 10,000.00 2,42,336.67
20-10-2017 OTHER ATMS NFS/CASH WDL/20-10-17 10,000.00 2,32,336.67
21-10-2017 CHEQUE 563424 CASH PAID:SELF 80,000.00 1,52,336.67
CHQ,563424
23-10-2017 OTHER ATMS NFS/CASH WDL/22-10-17 5,000.00 1,47,336.67
23-10-2017 NET BANKING IIN/I-Debit/CCAVENUE /20171022212635 1,062.00 1,46,274.67
23-10-2017 ICICI ATM ATM/CASH WDL/23-10-17/0 800.00 1,45,474.67
24-10-2017 OTHER ATMS NFS/CASH WDL/24-10-17 8,000.00 1,37,474.67
27-10-2017 by tata projects 6,420.00 1,43,894.67
30-10-2017 NET BANKING IIN/I-Debit/PayTM /20171029180336 99.00 1,43,795.67
31-10-2017 OTHER ATMS NFS/CASH WDL/31-10-17 8,000.00 1,35,795.67
Total: 1,41,420.00 2,62,125.90 1,35,795.67
 Page 2 of 3 M-284759

MR.K SIVAPRAKASAM & SELVI S

Statement of Transactions in Savings Account 039501000298 in INR for the period October 01, 2017 - December 31, 2017

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

31-10-2017 NEFT-710310432538-TATA PROJECTS LIMITED606-Sivapr 99,298.00 2,35,093.67
kasam K SAL OCT 2017-00210310004606-HDFC0004989
01-11-2017 NET BANKING BIL/001323563390/Air/NSP 5,000.00 2,30,093.67
01-11-2017 OTHER ATMS NFS/CASH WDL/01-11-17 5,000.00 2,25,093.67
01-11-2017 NET BANKING BIL/001323936292/PGMIB-/7305628406_ 1,407.00 2,23,686.67
01-11-2017 DEBIT CARD VPS/K N BROTHER/20171101201357/0 671.00 2,23,015.67
02-11-2017 OTHER ATMS NFS/CASH WDL/02-11-17 2,000.00 2,21,015.67
06-11-2017 OTHER ATMS NFS/CASH WDL/06-11-17 6,000.00 2,15,015.67
07-11-2017 MOBILE BANKING MMT/Ref731121551652/9110200485657 30,000.00 1,85,015.67
09-11-2017 NET BANKING BIL/001330038510/Eb Bill Oct 17/091620241011T17 1,100.00 1,83,915.67
09-11-2017 BY TATA 9,280.00 1,93,195.67
09-11-2017 DEBIT CARD MPS/COURTALLAM /20171109215728/0 1,280.00 1,91,915.67
10-11-2017 NET BANKING BIL/001330976183/Tax Sept 17/401902683 1,865.00 1,90,050.67
10-11-2017 NET BANKING BIL/001330980526/LL Bill for Oct/BSNLPOST_JICI58 1,216.00 1,88,834.67
13-11-2017 DEBIT CARD MPS/OOTY VEGETA/20171112111735/0 275.00 1,88,559.67
13-11-2017 DEBIT CARD MPS/HI PROTEINS/20171112112817/0 238.00 1,88,321.67
13-11-2017 DEBIT CARD MPS/OOTY VEGETA/20171112184120/0 286.00 1,88,035.67
13-11-2017 TRFR FROM:TATA PROJECTS LTD 1,40,000.00 3,28,035.67
13-11-2017 MOBILE BANKING MMT/Ref731714548263/9110200485657 74,400.00 2,53,635.67
13-11-2017 NET BANKING BIL/001332713072/paid for kktrav/NSP 25,000.00 2,28,635.67
14-11-2017 OTHER ATMS NFS/CASH WDL/14-11-17 10,000.00 2,18,635.67
15-11-2017 DEBIT CARD IPS/FOOD FINGER/20171115202851/0 1,010.00 2,17,625.67
17-11-2017 NET BANKING BIL/001335493835/Premium 2017/3485207 9,668.00 2,07,957.67
18-11-2017 OTHER ATMS NFS/CASH WDL/18-11-17 8,000.00 1,99,957.67
18-11-2017 OTHER ATMS NFS/CASH WDL/18-11-17 1,800.00 1,98,157.67
20-11-2017 IPAY NO 529477 25,000.00 2,23,157.67
21-11-2017 BY TATA PROJECTS LIMITED 7,150.00 2,30,307.67
22-11-2017 NET BANKING IIN/I-Debit/CCAVENUE /20171122072627 1,062.00 2,29,245.67
22-11-2017 OTHER ATMS NFS/CASH WDL/22-11-17 3,000.00 2,26,245.67
23-11-2017 DEBIT CARD MPS/AMAZON SELL/20171123081855/0 330.00 2,25,915.67
27-11-2017 MOBILE BANKING MMT/Ref732910127007/9110200485657 25,000.00 2,00,915.67
27-11-2017 ICICI ATM ATM/CASH WDL/27-11-17/0 5,000.00 1,95,915.67
28-11-2017 DEBIT CARD IPS/SANTHOSH SU/20171128104421/0 3,800.00 1,92,115.67
30-11-2017 NEFT-711304088149-TATA PROJECTS LIMITED606-Sivapr 99,298.00 2,91,413.67
kasam K SAL NOV 2017-00210310004606-HDFC0004989
02-12-2017 DEBIT CARD VPS/K N BROTHER/20171202174952/0 1,159.00 2,90,254.67
02-12-2017 OTHER ATMS NFS/CASH WDL/02-12-17 5,000.00 2,85,254.67
04-12-2017 OTHER ATMS NFS/CASH WDL/03-12-17 4,000.00 2,81,254.67
04-12-2017 OTHER ATMS NFS/CASH WDL/03-12-17 4,000.00 2,77,254.67
04-12-2017 DEBIT CARD MPS/OOTY VEGETA/20171204214754/0 503.00 2,76,751.67
06-12-2017 MOBILE BANKING MMT/Ref734014310186/9110200485657 20,000.00 2,56,751.67
07-12-2017 TATA PROJECTS LIMITED 1,45,000.00 4,01,751.67
07-12-2017 MOBILE BANKING MMT/Ref734120995418/9110200485657 1,01,800.00 2,99,951.67
07-12-2017 MOBILE BANKING MMT/Ref734120995418/9110200485657 1,01,800.00 4,01,751.67
07-12-2017 MOBILE BANKING MMT/Ref734120008963/9110200485657 50,000.00 3,51,751.67
08-12-2017 MOBILE BANKING MMT/Ref734210602546/9110200485657 51,300.00 3,00,451.67
08-12-2017 NET BANKING BIL/001349343128/ChgRs10 GSTRs1.80 IRCTC/10000107 1,131.80 2,99,319.87
11-12-2017 DEBIT CARD MPS/OOTY VEGETA/20171210094032/0 344.00 2,98,975.87
11-12-2017 CMS TRANSACTION CMS/000389663109/ICICIPRULIFEINS__19028413 1,20,000.00 1,78,975.87
13-12-2017 DEBIT CARD MPS/HOTEL JUNIO/20171213224216/0 2,591.00 1,76,384.87
15-12-2017 DEBIT CARD MPS/MEDPLUS MAI/20171215113756/0 277.50 1,76,107.37
15-12-2017 OTHER ATMS NFS/CASH WDL/15-12-17 4,000.00 1,72,107.37
20-12-2017 DEBIT CARD VPS/APOLLO PHAR/20171220083346/0 201.00 1,71,906.37
21-12-2017 NET BANKING IIN/I-Debit/CCAVENUE /20171221080304 1,062.00 1,70,844.37
21-12-2017 OTHER ATMS NFS/CASH WDL/21-12-17 10,000.00 1,60,844.37
21-12-2017 APBS/OPERATION DEPARTMENT/AIR1007666 177.39 1,61,021.76
21-12-2017 APBS/OPERATION DEPARTMENT/AIR1007191 266.31 1,61,288.07
27-12-2017 MOBILE BANKING MMT/Ref736117166275/9110200485657 30,000.00 1,31,288.07
Total: 6,27,269.70 6,31,777.30 1,31,288.07
 Page 3 of 3 M-284759

MR.K SIVAPRAKASAM & SELVI S

Statement of Transactions in Savings Account 039501000298 in INR for the period October 01, 2017 - December 31, 2017

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

28-12-2017 SAL/BY TATA 23,340.00 1,54,628.07
29-12-2017 NEFT-712286480554-TATA PROJECTS LIMITED606-Sivapr 1,48,086.00 3,02,714.07
kasam K SAL DEC 2017-00210310004606-HDFC0004989
29-12-2017 DEBIT CARD VPS/K N BROTHER/20171229163631/0 442.00 3,02,272.07
29-12-2017 OTHER ATMS NFS/CASH WDL/29-12-17 2,000.00 3,00,272.07
30-12-2017 039501000298:Int.Pd:30-09-2017 to 29-12-2017 1,795.00 3,02,067.07
30-12-2017 APBS/OPERATION DEPARTMENT/AIR8002106767 1.71 3,02,068.78
30-12-2017 DEBIT CARD VPS/DSK BENELLI/20171230125408/0 4,048.00 2,98,020.78
TOTAL Total: 1,73,222.71 6,490.00 2,98,020.78

Summary of TDS/Interest on Fixed Deposits during the period October 01, 2017 - December 31, 2017

DATE OF
ACCOUNT INTEREST PAID/ TAX DEDUCTED
PAYMENT/
NUMBER CREDITED (INR) (INR)
CREDIT
Opening Balance(Cumulative) 0.00 0.00

039513002900 16-10-2017 24,283.00 2,429.00

Closing Balance(Cumulative) 24,283.00 2,429.00

REWARD POINTS SUMMARY

SAVINGS ACCOUNT LINKED PAYBACK Points earned for the month of November, 2017
POINTS BALANCE*
NUMBER NUMBER
My Savings REWARD DEBIT CARD
039501000298 9401150757714109 0 99 10012
To get current reward points balance and for other queries, visit www.icicibank.com or call ICICI Bank Customer Care.
* As on December 20, 2017, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the point balance.

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFS CODE NAME OF NOMINEE*
Savings 039501000298 600229028 ICIC0000395 -
* Nominee name is displayed only on specific consent of customer.
•Update Aadhaar for your account easily! Simply SMS Aadhaar <space>12 digit Aadhaar No. <space> last 6 digits of Account No. to 9215676766.

For ICICI Bank Limited 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 above Rs 2 Lakh) NEFT- National Electronic Fund Transfer
Authorised Signatory

• 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.
• As per PMJJY, debit of Rs.289 is towards insurance premium collected on behalf of ICICI
Prudential & Rs.41 is towards administration charges by ICICI bank (including GST). For details
refer Terms and Conditions at www.icicibank.com

www.icicibank.com
Corporate Office: ICICI Bank Ltd., ICICI Bank Towers, Bandra-Kurla complex, Mumbai - 400051, India. Category of service: Banking & Financial Services.
Registered Office: ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, Gujarat. Pin – 390 007. Registration No. MIV/ST/Bank & Finc/4.
CIN : L65190GJ1994PLC021012
This is an authenticated intimation/statement.
Customers are requested to immediately notify the Bank of any discrepancy in the statement
ROG_ SR128812020_DB_AS_SSen_26052019