Annexure-2
(SELF DECLARATION IN CASE OF THERE IS CHANGE OF ADDRESS ONLY IN KYC INFORMATION
INCLUDING PAN/Form 60 OF INDIVIDUAL CUSTOMER)
Name of Account Holder……………………………………….
Account/Customer ID Number…………………………………………………
(Need not to submit separately for multiple accounts, ID is must in multiple accounts)
Contact/Mobile Number:………………………………………
I submit that there is no change in KYC information except change in my address details which is
submitted hereunder:
MAILING ADDRESS ………………………………………………………………………………………
………………………………………………………………………………………………………………
CITY………………………………. PIN CODE………………………..STATE…………..
I also undertake that I have already submitted PAN No……………………. /Form 60(whichever is
not applicable to be strike off)
(Signature of accounts holders)
Enclosure: Valid Address Proof (Present Address)
# In case of joint account all account holder has to submit the declaration PAN/Form 60 is
required for KYC updation.
FOR BRANCH USE Date of acknowledgement to customer
Verified in CBS on…………………………. Signature Verified from CBS by …………. ……………………
(Sign of Official)
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CUSTOMER ACKNOWLEDGEMENT COPY
A/c No/ID No:
Declaration and documents received for Re-KYC.
ACKNOWLEDGEMNT DATE ……………………………. SIGNATURE OF BANK OFFICIAL/SEAL
