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KYC ApplForm P

This document contains a Know Your Client (KYC) application form for individuals and non-individuals. The individual KYC form collects details such as name, gender, date of birth, address, identity and address proofs. It requires the applicant's signature and photograph. The non-individual KYC form seeks details of the applicant organization such as name, date of incorporation, PAN, address and proofs. It also requires photographs, PAN and addresses of promoters, partners, trustees and directors. Both forms require the applicant's declaration that the information provided is true and any changes will be informed immediately.

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Shoaib Mirza
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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178 views

KYC ApplForm P

This document contains a Know Your Client (KYC) application form for individuals and non-individuals. The individual KYC form collects details such as name, gender, date of birth, address, identity and address proofs. It requires the applicant's signature and photograph. The non-individual KYC form seeks details of the applicant organization such as name, date of incorporation, PAN, address and proofs. It also requires photographs, PAN and addresses of promoters, partners, trustees and directors. Both forms require the applicant's declaration that the information provided is true and any changes will be informed immediately.

Uploaded by

Shoaib Mirza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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KNOW YOUR CLIENT (KYC) APPLICATION FORM

For Individuals
Please fill this form in ENGLISH and in BLOCK LETTERS.
A. IDENTITY DETAILS
1. Name of the Applicant: ________________________________________________________________

PHOTOGRAPH
Please affix your
recent passport
size photograph
and sign across it

2. Fathers/ Spouse Name: _______________________________________________________________


3. a. Gender: Male/ Female

b. Marital status: Single/ Married

4. a. Nationality: ___________________________

c. Date of birth: ____________(dd/mm/yyyy)

b. Status: Resident Individual/ Non Resident/ Foreign National

5. a. PAN: ____________________ b. Aadhaar Number, if any: ______________________________________________


6. Specify the proof of Identity submitted: _______________________________________________________________
B. ADDRESS DETAILS
1. Residence Address: ________________________________________________________________________________
________ City/town/village: ___________ Pin Code: __________ State: ______________ Country: _________________
2. Contact Details: Tel. (Off.) _______ Tel. (Res.) ________ Mobile No.: _________ Fax: _________ Email id: __________
3. Specify the proof of address submitted for residence address:_______________________________________
4. Permanent Address (if different from above or overseas address, mandatory for Non-Resident Applicant): ____________
________ City/town/village: ___________ Pin Code: _________ State: ______________ Country: __________________
DECLARATION
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to
inform you of any changes therein, immediately. 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.
__________________
Signature of the Applicant

Date: ___________ (dd/mm/yyyy)


FOR OFFICE USE ONLY

Originals verified and Self-Attested Document copies received


(..)
Name & Signature of the Authorised Signatory
Date .

Seal/Stamp of the intermediary

KNOW YOUR CLIENT (KYC) APPLICATION FORM


For Non-Individuals
Please fill this form in ENGLISH and in BLOCK LETTERS.
A. IDENTITY DETAILS
1. Name of the Applicant: ________________________________________________________________

PHOTOGRAPH
Please affix the
recent passport
size photographs
and sign across it

2. Date of incorporation: _______________(dd/mm/yyyy) & Place of incorporation: ________________


3. Date of commencement of business: ______________________________________________________ (dd/mm/yyyy)
4. a. PAN: _______________________________ b. Registration No. (e.g. CIN): _________________________________
5. Status (please tick any one):
Private Limited Co./Public Ltd. Co./Body Corporate/Partnership/Trust/Charities/NGOs/FI/ FII/HUF/AOP/ Bank/Government
Body/Non-Government Organization/Defense Establishment/BOI/Society/LLP/ Others (please specify) _______________
B. ADDRESS DETAILS
1. Address for correspondence: ________________________________________________________________________
_________ City/town/village: _____________ Pin Code: _________ State: ______________ Country: _______________
2. Contact Details: Tel. (Off.) _______ Tel. (Res.) _______ Mobile No.: ________ Fax: ___________ Email id: __________
3. Specify the proof of address submitted for correspondence address: ______________________________________
4. Registered Address (if different from above): ____________________________________________________________
_________ City/town/village: _____________ Pin Code: _________ State: _____________ Country: ________________
C. OTHER DETAILS
1. Name, PAN, residential address and photographs of Promoters/Partners/Karta/Trustees and whole time directors:
_________________________________________________________________________________________________
2. a) DIN of whole time directors: _______________________________________________________________________
b) Aadhaar number of Promoters/Partners/Karta:______________________________________________
DECLARATION
I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we
undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or
untrue or misleading or misrepresenting, I am/we are aware that I/we may be held liable for it.
_____________________________________
Name & Signature of the Authorised Signatory

Date: ___________ (dd/mm/yyyy)


FOR OFFICE USE ONLY

Originals verified and Self-Attested Document copies received


(..)
Name & Signature of the Authorised Signatory
Date .

Seal/Stamp of the intermediary

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