ORIENTAL BANK OF COMMERCE (OF- 148D)

DORMANT ACCOUNT ACTIVATION / REKYC FORM FOR NON RESIDENT CUSTOMER

The Manager, Date D D M M Y Y Y Y

B/o ………………………….. SOLID Customer ID:

I/We are maintaining the Account Number with your branch which is presently in dormant status.

I/We am/are submitting form for the purpose of Re-KYC/Activation of Dormant Status.
APPLICANT DETAILS AND ADDRESS
Applicant Name PR EF IX F I R S T
(As mentioned in
Passport) M I D D L E L A S T

PR EF IX F I R S T Paste latest color photograph

Maiden Name
(Attach proof) and sign it across, keeping the
M I D D L E L A S T face clear (to be attested by
branch official under seal of
PR EF IX F I R S T
Father's/Spouse the bank)
Name
M I D D L E L A S T

PR EF IX F I R S T
Mother's Maiden
Name
M I D D L E L A S T

Correspondence/L
ocal Address District City

State Country PIN/ZIP

Mobile Landline

Email ID

Permanent or
Same as above Y N Address type Residential & business Residential Business Registered Unspecified
Indian Address

(Please fill, if
not same as above District City
add.)
State Country PIN/ZIP

Marital
Category GN SC ST OBC Oth Disabled Y N Caste Religion M UM Oth
status

Gender M F T Date of Birth D D M M Y Y Y Y *Minor Y N Place/City of Birth

# Senior citizen, minor provide proof of DOB * If Minor, please fill up minor declaration section also
Xth or or Form
Education Illiterate Non -Matric Grad. Proff. PAN No.
XIIth 60
Person of Indian US person (if US
Residential Status Resident Individual Non Resident Foreign National Nationality
Origin citizen/resident)

Country of* Birth Citizenship Residence for Tax Purpose

* If any of the above mentioned country/countries is not India and/or if US Person status is "YES" then please provide TIN (Tax Payer Identification Number) or Functional Equivalent in table mentioned below:

TAX RESIDENCY DETAILS UNDER FATCA/CRS GUIDELINES(Self certification as per Foreign Account Tax Compliance Act/Common Reporting Standard)
S No. Tax Payer Identification Number (TIN/Functional Equivalent**) Issuing Country Type of Identification
1

3
**In case TIN is not available please provide the Functional Equivalent - Social Security Number, National Insurance Number, Citizen/Personal Identification Code/Number, Resident Registration number etc.

PERSONAL INFORMATION
Occupation Business Services Others Un-categorized (includes un-employed)

If Salaried, employed with Private Sector Public Sector Govt Sector

If others, Professional Retired Farmer Housewife Student Self Employed

Annual Income (INR) <2 Lakh 2 to <5 Lakh 5 to <10 Lakh 10 to <20 Lakh 20 to <50 Lakh > 50 Lakh

Expected Annual Turnover (In Lakh INR for non salaried person) Domestic Foreign
IDENTITY AND ADDRESS DOCUMENTS
Identity & Add. Proof PAN Card UID (AADHAAR) Passport Driving License Voter ID Card NREGA Job Card Others**
**Other ID/Address Proof Details________________________________________________________________________________________________
Visa/Work Permit Details (Not required for PIO/OCI status &
1st ID No (Identity Proof)
NRIs with seafarer work profile and on ship)

Passport Details Passport No Date of Issue D D M M Y Y Y Y Expiry Date D D M M Y Y Y Y

Visa/Work Permit Number*** Date of Issue D D M M Y Y Y Y Expiry Date D D M M Y Y Y Y

***(Not required for PIO/OCI status & NRIs with seafarer work profile and on ship)
1) I hereby declare that the information furnished above is true and correct to the best of my knowledge and nothing has been concealed therein. In case any of the above information is found to be false or
untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
2) My personal KYC details may be shared with Central KYC registry. I hereby consent to receiving information from central KYC registry through SMS/Email on the above registered number/email address. I
hereby give my consent to scan my fingertips and use my Aadhaar number for conducting online verification of my Identity, Address, etc. by using e-KYC Service of UIDAI for the purpose of opening account
with you. Further, I authorize you to retrieve my email ID and Mobile/ Phone number using e-KYC Service. In the event of change in my address or other personal information, I will intimate to the Bank
immediately of such a change. I agree and undertake to inform the bank in writing of any change in residential status. I undertake to operate and use the account / deposit as well as the said banking facilities
strictly in accordance with the provisions of Foreign Exchange Management Act as laid down by the Reserve Bank of India from time to time.
3) I hereby give my consent to Bank to obtain my Aadhaar Number, Demographic Details and Fingerprint/Iris for authentication with UIDAI. Bank has informed me that my identity information would be used
for Aadhaar seeding & e-KYC and that my biometrics will not be stored/shared and will be submitted to CDIR only for the purpose of authentication.
4) I also declare that I have read and fully understand the FATCA/CRS declaration provided with this form and I give my consent for the same.

KYC Registry
1st Witness Name & Address

1st Witness Signature

2nd Witness Name & Address

Applicant's sign/thumb impression

2nd Witness Signature (Male-LTI/Female-RTI)

FOR OFFICE USE ONLY

I,________________________(name of the authorised officer) Confirm
that the request to activate the account having Cust
ID____________________ has been received from account holder(s) Signature of Authorised Official/Hall In Charge/Branch
Incumbents along with PA Signature of CASA Back Office Authorised Person along with
along with KYC documents which has been verified with original No.______________________ PA No.___________________________________

FORM NO. 60 (Please see the third proviso to Rule 114-B)

1. Applicant Name F I R S T M I D D L E S U R N A M E

2. Father's Name F I R S T M I D D L E S U R N A M E

3. Flat/Room No 4. Floor No 5. Name of Premises

6. Block Name. No. 7. Road/Strt Lane 8. Area/Locality

9. Town/City 10. District 11. State

12. PIN 13. Tel No. 14. Mobile

15. Date of birth/

D D M M Y Y Y Y 16. Txn Amount 17. Txn Date D D M M Y Y Y Y
incorporation

18. If joint transaction, No. of people 19. Mode of Transaction Cash Cheque Card Draft Online Transfer Others

20. AADHAAR No provided by UIDAI (if available)

21. If applied for PAN but not generated yet, fill details: D D M M Y Y Y Y
Application Date Acknowledgement No.
22. If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per section 64 of Income Tax Act 1961) for the financial year in which the above

transaction is held (In Rs.) Agriculture Income Other Income

23. Details of documents being produced in support of identity in field 1 (Refer instructions ) Name & address of issuing authority

Doc Code Doc ID

24. Details of documents being produced in support of address in field 4-13 (Refer instructions ) Name & address of issuing authority

Doc Code Doc ID

I______________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare
that I do not have a Permanent account number and my/our estimated total income(including income of spouse, minor child etc. as per
section 64 of Income tax Act 1961) computed in accordance with the provisions of Income-tax Act 1961 for the financial year.
Signature of the declarant
Note: 1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this form is true, correct and complete in all respects. Any person making false statement in the declaration shall be liable
to prosecution under section 277 of Income Tax Act, 1961 and on conviction be punishable:- (i) In a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall not be less than six
months but which may extend to seven years and with fine; (ii) In any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two years and with fine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is applied for and
column 21 is duly filled.