Know Your Customer (KYC) Application Form | Individual

Important Instructions:

A. Fields marked with ‘*’ are mandatory fields.

B. Tick ‘’ wherever applicable.

C. Please fill the form in English and BLOCK letters.

D. Please fill the date in DD-MM-YY format.

E. For particular section update, please tick () in the box

section number and strike off the sections not

required to be updated.

F. Please read section wise detailed guide

G. List of State/U.T code as per Indian Motor Vehicle Act, 1988 is available at the end.

H. List of two character ISO 3166 country codes is available at the end.

I. KYC number of applicant is mandatory for update application.

J. The ‘OTP based E-KYC’ check box is to be checked for accounts opened using

OTP based E-KYC in non-face to face mode

Normal

Maiden Name

Father / Spouse Name*

Mother Name

Date of Birth*

Gender*

FORM 60 furnished

T- Transgender

2. PROOF OF IDENTITY AND ADDRESS* (Please refer instruction B at the end)

Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the following OVDs)

Line 1*

Line 2

Line 3

District*

3. CURRENT ADDRESS DETAILS (Please refer instruction B at the end)

I. Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the following OVDs)

II

III

IV

Address

Line 1*

Line 2

Line 3

District*

Passport Expiry Date

No need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customer

No need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customer

No need to attach. Aadhaar card. If submitted, Aadhaar Number to be masked by the customer

D

D

M

M

-

Y

Y

Y

-

Y

Y

Y

Y

Signature /Thumb Impression

Tel. (Off)

Email ID*

-

Tel. (Res)

-

Mobile*

-

5. Remarks (If any)

6. Applicant Declaration

▪ I hereby declare that the details furnished above are true and correct to the best of my knowledge/belief and I

undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false

▪ I hereby declare that I am not making this application for the purpose contravention of any Act, Rules, Regulations or

guidelines.

Date:

Y

Y

7. Attestation / For Office Use only

Documents Received Certified Copies

E-KYC data received from UIDAI

Video Based KYC

Data received from Offline verification Digital KYC Process

Emp. Designation

Emp. Branch

Date:

D

D

-

M

-

Y

Y

Instruction / Check list / Guidelines for filling individual KYC Application Form

AM

BM