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    Bob Kyc

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    lightinghappiness575
    This document is a self-declaration form for individuals to update their Know Your Customer (KYC) information with a bank. It collects personal details like name, date of birth, address, occupation, income sources, and a declaration that the information provided is accurate. The form also requests consent to receive communication through SMS/email and to update the customer's records.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Bob Kyc

    Uploaded by

    lightinghappiness575
    46 views1 page
    This document is a self-declaration form for individuals to update their Know Your Customer (KYC) information with a bank. It collects personal details like name, date of birth, address, occupation, income sources, and a declaration that the information provided is accurate. The form also requests consent to receive communication through SMS/email and to update the customer's records.

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    Bob kyc

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    This document is a self-declaration form for individuals to update their Know Your Customer (KYC) information with a bank. It collects personal details like name, date of birth, address, occupation, income sources, and a declaration that the information provided is accurate. The form also requests consent to receive communication through SMS/email and to update the customer's records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    46 views1 page

    Bob Kyc

    Uploaded by

    lightinghappiness575
    This document is a self-declaration form for individuals to update their Know Your Customer (KYC) information with a bank. It collects personal details like name, date of birth, address, occupation, income sources, and a declaration that the information provided is accurate. The form also requests consent to receive communication through SMS/email and to update the customer's records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Self-Declaration Form for Individuals

    (In case of no change in KYC information including PAN/Form60)

    PERSONAL
    Customer ID Account No.

    Customer Name PR EF IX F I R S T N A M E M I D D L E N A M E L A S T N A M E
    Father/Mother Name PR EF IX F I R S T N A M E M I D D L E N A M E L A S T N A M E

    Date of Birth* D D M M Y Y Y Y Gender* M - Male F - Female T - Transgender


    PAN Number Form 60. “CKYC Number, if available”

    Source of Business Investment


    Income Salary Agriculture Pension Student Housewife Others (Please Specify)
    Income Income

    Gross
    Annual Occupation Code : ______________________ (Refer Table A overleaf)
    Income
    Customer Type Code :_________________ (Refer Table B overleaf)
    Widow/
    Marital Married Unmarried
    Status Widower Divorcee Others (Please Specify)

    City of Birth

    Employment Self-
    Status Salaried Retired employed Housewife Others (Please Specify)
    Unemployed

    (If Applicable)
    Company _____________ ___________
    /Firm Name
    (Please leave space between two words)
    PERMANENT ADDRESS
    Flat No/
    Bldg Name
    Road Name
    Landmark
    City PIN Code
    State Country
    Tel. (R) S T D - N U M B E R Tel. (0) S T D - N U M B E R Extension
    Number

    Email ID*
    Mobile Number +91 N U M B E R

    MAILING/CURRENT ADDRESS (If different from permanent Address)


    Flat No/
    Bldg Name
    Road Name
    Landmark
    City PIN Code
    State Country
    Note: - For Minor below 10 years, separate self-declaration form for both “Minor” as well as “Guardian” is mandatorily required.
    In case of Joint Account, all account holder has to submit the declaration separately. PAN/Form60 is required for KYC purpose.
    DECLARATION
    I declare that the information provided above with respect to my account is up to date and correct.
    I declare that I am tax resident of India and not resident of any other country. OR
    I declare that I am tax resident of
     I hereby consent to update above information in Bank’s Record. I further declare that the details furnished above are true and
    correct to the best of my knowledge and belief and I undertake to inform Bank of any changes therein, immediately. In case any
    of the information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
     I hereby consent to receiving information from CKYC Registry through SMS/Email on the above registered number/email address.
    Affix Recent Photo
    I have also attached my
    recent photograph alongside
    Place Signature of Account Holder
    Date

    FOR OFFICE USE ONLY Signature/Customer ID Verified/Address Change Verified


    *Branch to carry out CKYC and obtain Branch ALPHA
    detailed Form 60 additionally if Form 60
    is selected
    Signature of Verifying Official SOL ID
    RISK CATEGORY H M L
    Specimen Sign No.

    CUSTOMER ACKNOWLEDGEMENT COPY


    Reference Number Acknowledgement date D D M M Y Y Y Y Signature of Bank Official

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