‘CUSTOMER INFORMATION SHEET (CIF Creain/Amondment) ; sani (ust be accompania wt Terms and Conon) >= ACCOUNT OPENING FORM FOR INDIVIDUAL (PART -1) & (case of Joint Ales Parti(CF Shes) and Terms & Conditions tobe taken foreach customer (For once Use Only) Sranchnleme [rence Coe EEE Feld mate steric] are mandy Piste pin BLOCK Iter ony and ue Black nk or Signals cusomerio: [ CLE opleaton Typ New vocae recountno: CT COLETTI) exer; QO rrr rr rt (Mandatory for KY update Request) ‘ame ‘Account Typet [Z]Normat [2]smat []etinor [7] ‘Personal Details [ 1 c TT TTT 2Maiden Name LOGCELLEEEL ECCEEELI 3Date of ith ‘Gender vaio L]Fomate Ltrs conaer sMartal status [P]varied [JUnmered [C]singe [E]oworces EJuving aver [E-] Defect 6 Name of Lratner Elioiner — Efspouser COTE rrr rrr rrr rrr rrr rr irri aaa eRe) [Link] of Dependents [[] .uiterate[]ves []no ves, tdentitcaton Marks: [Link] of Guardian: [TTT TTTTTTTTTTTTTTTTCLIIICL a sons flexes forme ced of] sate *2.0ccupation Type: Service []state Govt, [Jeena Govt. [L]Public Sector Undertaking [Joefence L-JPvtSector Business [Jindustiatst E]rrade Sect. [T]senSect []Migrant Labour [F]Gontractor Efrann snop [Jimporvexport customer []other Settemployea [Jeweller /Bulion Trader owe — E]iedcalrt. Lert [Clearcwareatontnarce [_Jenparcmacyocn consaan Lretres FAuouranatist [House wite [T]student []share & stock Broker [TJAgrcuttre [Dlrottical societ worker [E-Jomer Professional X Not Caegtzed Please Spety | [> 18. Organisations ame COT LT TITITITI — cesianstion protein CI TITITITILL ee | | 16 Religion: Gtinas Eitsin [Jenisian C]sixn a | [Link] i cenerat Lose = Esc 6 sr ePerson windieasity: Yes] No LE] ives, [J i Visutyimpaied i. oterenty aed 19.64 Quaifeaton: — Juptosth cass passes] passed —— [Joraudat(en) []Post Gratuate(Gon) [Jatorate TEiites crauatePost radiate [] Eng GraduatPost Gradiato [law GraduatiPost Graduate Demcwamencra [Elcomputer DegreeiDiplomainica oter Professional Degree/Diploma 20Ptease Tek he Appleabio box’ [T]Potticaly Exposed Peron PEP) [elated to Pottcay Exoeed Person []None TH cH I (Potenly Expnnd Peron are nal who aro have been entsted wh prone pubte ureters in fren county 24, Hed of SatelGoverments Serie Potcas/Serir Goverment! Juialtary Ofee, Senor Executhes cf Siateanned Corporatio, Inport Plc! Pay Ones ete) 21. county Code of Residence nina oat in any her county oon oubie nat Live) notte, plese th FATCA deta for Anno naw CLO (HPAN te ot xbmite, submit Farm 60 - Arenal) opin oI WTS DOG ET HSE WoT SST mobo. [TT] CLI TT] \miof(TTTTTTITIITITII1iIiTiIiitili soso EEEETTPTTt TPT) — wes COREE CEEeeeereeoGive satay” Issued by eeue Dato" Expiry Dato of apleatie) [arassrorr COLETTI 1 a [ ] Je-voreRs IDENTITY CARO { Looorwincucence ==ETTTTTTTItTrrry £ 1 1 1 [lp ret opcsaen of Axhaar boone Ces — Pare Ie-NREGA Joo Cano L JF-LETTER ISSUED BY NATIONAL POPULATION REGISTER CONTAINING DETAILS OF NAME AND ADDRESS. I Smal Accounts: Only Self Atsted Photograph D. Address detaia —[_[eurent Cases area [Ciesiseniat Business ecioniat [Jousress []Reastered orice _[T]Unspecied a 1 a 1 | a TOTEEII reer es COLE Jeoty name LEE TITEL Jearespandence [_Jtocal “__ Same ws Current / Permanent Adarass ‘adcress ype []Reeidental/Business []Residental [TJeusiness [T]Registeroa once []Unspeciies ade COT TTITCLCIITTEIIIIrT rT rrrirtrrrretriittrrircrr) COLORECT ee eC) cityrvilage* I District” I sete CEE Ce eawnty name CE] FI the Proof of Address (OVD) provided doos not contain current address lease provide any ofthe documents below: lusty 2 (ot more thar 2 months ld) [oppo Fero — [JProperty or Municipal tax receipt [Eister ot sttmre of scamosten leued by empoer J ued by Site Cental ovement departments, suhtoy or wafalry bodes Puc Sar Undoing, Scheaies ciara, Franc pnd eld compre Sd res anes een ih ch enpe bi eznalon [Foor cecaton or Ancar i trtany ried fr enucabon prose and cuentas i erent om addres avataie Cantal eis Desesh Repos Atencio face umber ng 00 abana ety seedy th UA a anda) Document Number [- ] owe COE {Customer shall submit OVD with current address within « period of three months ef submitting deemed OVD ‘G. DECLARATION CUM UNDERTAKING CUM SELF-CERTIFICATION ‘1 ave read the copy of Terms and Conditions of the Account Opening given ta me. The Terms ans Candtions have been explained to me / us ‘and having understood, | accept the same, 2 hereby deciae that | have submilad Aadhaar Card Issued by UIDAL voluntary for dentfcation and / or Adéress proof towards the Compliance of KYC Norms under the PMLA 2002 8. hereby consent thatthe Bank may verify te eame with the UIDAL and authorise the UIDAI expressely to elease the deny and address through bio-metie/ OTP authentication tothe bank, [Jee [L]No (€ KY aeration an Aachear seednais mandatary tr avg OBT ent) Praia ‘Signature Thumb Impression of the Please paste Recent Passport Applicant Pisace sign in ‘Size Photograph Here, lace Ink only (a not staple ) eel ] GEER EET Ti For Office Use [Documents Received LAsencertticd EEtrue copies [Z]notary [C]Video Based KY [CJEKYC data received from VION TSelf= Contitcaton & documents received as pat of account opening process have beeh verfed and found corect 4. Centied that copy of Terms and Conditions signed by Customer obtained 1. Contes that te implications and conditions torte operation ofthe account have been explained tothe depositor (Oniy in case of titrate ppicant) Depositor [T]titerate Doeina = see CET TTT TT] Risk categoy” [J igh [T]meaium = [tow Details of Ono oF Two Identification Marks, if any Such as a Mole or Scar (Mandatory fr literate Applica.) Inperson verfcaton cared cut an Signature /LTI ofthe appcntvrfiod by Poritad to open CIF] Oficial Name: JsRno EET pomsionaton = bate LL No Signature