Customer Information Updation Form For KYC: Please Select A State

Customer Information Updation Form for KYC
Customer ID :
Please affix your
latest Passport
Name of Account Holder :
Size Photograph
with signature
PAN Number : across the
photograph
There is no Change in my Address
I wish to change my address / Contact Details as below
Flat / Door No. Building Name
Road Landmark
City PIN
State Please select a state Country
Tel (Off) Tel (Res)
Mobile No E Mail ID
Name Specimen of Latest Signature
I hereby submit photo copy of the following documents (self attested) for the proof of –
For Identity Proof :

For Address Proof :
For Signature Proof :
I do hereby solemnly declare that the information provided above with respect to my account is up to date and correct.
Signature of Account holder

Date
Note:
1) Please provide self attested address proof even when there is no change of address.
2) List of acceptable identity, Signature and address proof documents (in photocopy) as per the enclosed sheet
should be submitted to the nearest IDBI Bank branch.
3) If you wish to make a change in any of your contact details please fill appropriate boxes given above.
4) In absence of valid address proof, the address proof of a close relative with whom account holder is residing may
be provided along with a declaration from the close relative, and the close relative's id and address proof. The
declaration should state that account holder is a close relative and resides at the address mentioned above.
For Branch Use only For RPU Use only

Sourcing Br. Name ID Proof updated on
SOL Add. Proof updated on
Documents and signature verified Photograph updated on
SOM / ASOM Signature updated on
BH Signature of RPU Official
Customer Profile Format (Individuals)
1. Cust ID :
2. Account No. :
3. Name :
Resident
4. Residential status :
Non Resident
Service Retired Self employed Housewife
5. Occupation :
Other please specify
If in service
6. :
Name of Organisation
Trading
Manufacturing
If self employed – nature of
Services
7. business :
Agriculture
Since specify Year
Real Estate
CA
Doctor
Lawyer
8. If self employed professional :
Stock Broker
Consultant
9 Annual Income :
Expected transactions in
10 :
accounts
Salary
Business
11 Source of Income :
Agriculture
Owned
12 Residence : Leased
13 CUSTOMERS SIGNATURE :
For Bank's use
14 Level : Level 1 Level 2 Level 3
Basis of Level categorization

15 (Please refer to Annexure III :
of Master Circular)
SIGNATURE OF BRANCH
16 :
HEAD / SOM
Customer Profile Format (Non - Individuals)
1. Cust ID :
2. Account No. :
3. Account Title :
4.
Name and Address(es) of
: 1.
proprietor / partners / directors 2.
3.
5. Purpose of opening account :
Trading / Manufacturing / Services
6. Nature of Business : If Trading / Service please specify the nature of business
___________________________________________________
Reg. No. _________ IEC No. ___________

7. Date of Incorporation :
Any other
Proprietorship / Partnership / Pvt. Ltd. Company /

8. Type of organisation :
Public Limited / Society / Association / Club
9 Registered Address :
10 Annual Turnover : Rs.
Expected transactions in the
11 :
account
Names and addresses of 1.
12 clients. Please attach a :
2.
separate sheet if required
3.
I certify and declare that the information furnished herein are correct to the best of my knowledge
13 CUSTOMERS SIGNATURE :
For Bank's use
14 Level : Level 1 Level 2 Level 3

Basis of Level Categorization
15 (Please refer to Annexure III :
of Master Circular)
SIGNATURE OF BRANCH
16 :
HEAD / SOM
Table A (Acceptable KYC Documents)
Mailing
Identity Signature
Document Acceptable as Proof for Address
(I) (S) (A)
Introduction Yes Yes No
Signature in presence of Branch Head (Subject to production of

No Yes No
documents supporting Identity and Address)
Passport Yes Yes Yes
PAN Card Yes Yes No
Driving License (laminated/ non laminated) Yes No Yes
Election ID/ Voters' ID Card Yes No Yes
Identity card with applicants photograph issued by Central / State

Government Department, Statutory/ Regulatory Authorities,
Public Sector Undertakings, Scheduled Commercial Banks and Yes Yes Yes
Public Financial Institutions. Acceptable only for Low Risk
Customers(refer Appendix II of Master Circular on KYC and AML)
Letter from a recognized public authority at the level of a

Gazetted Officer like District Magistrate, Divisional
Commissioner, BDO, Tehsildar, Judicial Magistrate etc. Yes No Yes
Acceptable only for Low Risk Customers( refer Appendix II of
Master Circular on KYC and AML)
NREGA job card Yes No Yes
Aadhar letters / Card Issued by the Unique Identification

Authority of India(UIDAI) / e-Aadhar (refer Para 2.43.26 of Master Yes No Yes
Circular on KYC and AML)
Self-signed cheque. No Yes No

Customer Information Updation Form For KYC: Please Select A State

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Customer Information Updation Form For KYC: Please Select A State

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Customer Information Updation Form for KYC

There is no Change in my Address

I wish to change my address / Contact Details as below

Flat / Door No. Building Name

State Please select a state Country

Tel (Off) Tel (Res)

Name Specimen of Latest Signature

For Identity Proof :

Signature of Account holder

For Branch Use only For RPU Use only

For Bank's use

14 Level : Level 1 Level 2 Level 3

Basis of Level categorization

Trading / Manufacturing / Services

6. Nature of Business : If Trading / Service please specify the nature of business

Reg. No. _________ IEC No. ___________

Proprietorship / Partnership / Pvt. Ltd. Company /

For Bank's use

14 Level : Level 1 Level 2 Level 3

(I) (S) (A)

Introduction Yes Yes No

Signature in presence of Branch Head (Subject to production of

Passport Yes Yes Yes

PAN Card Yes Yes No

Driving License (laminated/ non laminated) Yes No Yes

Election ID/ Voters' ID Card Yes No Yes

Identity card with applicants photograph issued by Central / State

Letter from a recognized public authority at the level of a

NREGA job card Yes No Yes

Aadhar letters / Card Issued by the Unique Identification

Self-signed cheque. No Yes No

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Reg. No. _ IEC No. ___