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Individual FATCA Form

The document is a FATCA-CRS Declaration form requiring individuals to provide personal and tax residency information for compliance with tax regulations. It includes sections for tax identification numbers and a certification confirming the accuracy of the provided information. Additionally, it outlines the responsibilities of account holders to report any changes in their information promptly.

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MANOJKUMAR PS
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8 views1 page

Individual FATCA Form

The document is a FATCA-CRS Declaration form requiring individuals to provide personal and tax residency information for compliance with tax regulations. It includes sections for tax identification numbers and a certification confirming the accuracy of the provided information. Additionally, it outlines the responsibilities of account holders to report any changes in their information promptly.

Uploaded by

MANOJKUMAR PS
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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FATCA-CRS Declaration

Please seek appropriate advice from your professional tax professional on your tax residency and related
FATCA & CRS guidance

Name

Place of Birth

Country of Birth

Nationality

Constitute Individual HUF NRI Foreign National

Corporate Others (Pl. Specify)

Are you a tax resident of any country other than India - Yes No

If Yes, please indicate all countries in which you are resident for tax purposes and the associated Tax ID Numbers below.

Country # Tax Identification Number% Identification Type


S.No. (TIN or other, please specify)

1.
2.
3.

# To also include USA, where the individual is a citizen / green card holder of the USA
% In case Tax Identification Number is not available, kindly provide its functional equivalent $

CERTIFICATION
I / We have understood the information requirements of this Form (read along with the FATCA & CRS Instructions) and
hereby confirm that the information provided by me/us on this Form is true, correct and complete. I / We also confirm
that I / We have read and understood the FATCA & CRS Terms and Conditions below and hereby accept the same.

FATCA & CRS - TERMS & CONDITIONS


Details under FATCA & CRS : The Central Board of Direct Taxes has notified Rules 114F to 114H, as part of the Income-
tax Rules, 1962, which Rules require Indian financial institutions such as the Bank to seek additional personal, tax and
beneficial owner information and certain certifications and documentation from all our account holders. In relevant
cases, information will have to be reported to tax authorities / appointed agencies. Towards compliance, we may also
be required to provide information to any institutions such as withholding agents for the purpose of ensuring appropriate
withholding from the account of any proceeds in relation thereto.
Should there be any change in any information provided by you, please ensure you advise us promptly, i.e. within 30
days.
It is important that you respond to our request, even if you believe you have already supplied any previously requested
information.

Date :
6
Place :
Signature
(11)

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