Version Oct’24

Classification - Internal

Extended Declaration For Non-Individual Entities (For Account opening and ReKYC)

Date: DD / MM / YYYY Place: AOF Number

{All Questions from 1 to 5 are mandatory}
1. Name of the entity: _
2. a) Customer ID (Applicable for existing customer): ______________
3. a) Country of incorporation: b) Place/City of incorporation:
c) Date of Commencement of Business DD / MM / YYYY

4. a) Is the entity a tax resident of any country/ies outside India Yes No

(If Yes, please fill Annexure 1)

b) Is the entity incorporated or organized in the United States (including a Trust, if the trustee is a U.S. citizen or resident)
Yes No (If Yes, please fill Annexure 1)
5. Questions relevant for entity FATCA and CRS classification
(Please consult your professional tax advisor for further guidance on tax residency and FATCA& CRS classification)
a. Is the entity a Governmental entity, an International Organization, a Central Bank, or an entity wholly owned by
one or more of the above mentioned entity types Yes No
(If yes, please sign the declaration on Page 2; If No, go to next question)

b. Is the entity a Financial Institution1 (FI) OR a Direct Reporting NFE Yes No

(If Yes, please fill Annexure 1; If No, please go to next question)

c. Is the entity a publicly traded corporation/ a related entity of a publicly traded corporation

i. Publicly traded corporation Yes No

(If Yes, please specify any one stock exchange upon which the stock is regularly traded)
Name of the stock exchange __

ii. Related entity of a publicly traded corporation Yes No

If Yes, please provide below details:

Name of the listed company, the stock of which is regularly traded _ _

Name of the stock exchange __
Nature of relation:
Subsidiary of the listed company Controlled by a listed company or under common control

(If answer to Q.5(c)(i) or Q.5(c)(ii) above is Yes, please sign the declaration on Page 2; If No, go to next
question)

d. Does the entity have any ultimate beneficial owners (incl. controlling persons) who are tax residents (incl. U.S.
citizens/green card holders) of countries other than India Yes No
(If yes, please fill Annexure 1)

Note: If the entity is not listed in any of the stock exchange, then please fill Annexure 2 (beneficial ownership
declaration) mandatorily.
1
Including a Foreign Financial Institution

1
 Version Oct’24

Classification - Internal

FATCA-CRS terms & conditions

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 or 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. Please note that you may receive more than one request for information if you have multiple relationships with HDFC
Bank or its group entities. Therefore, it is important that you respond to our request, even if you believe you have already
supplied any previously requested information.

If you have any questions about your tax residency, please contact your tax advisor. If you are a US citizen or resident or
green card holder, please include United States in the foreign country information field along with your US Tax
Identification Number.

Certification
Under penalty of perjury, I/we certify that:

• I/We understand that HDFC Bank is relying on this information for the purpose of determining the status of the account
holder named above in compliance with FATCA/CRS. HDFC Bank is not able to offer any tax advice on FATCA or
CRS or its impact on the account holder. I/we shall seek advice from professional tax advisor for any tax questions.

• I/We agree to submit a new form within 30 days if any information or certification on this form becomes incorrect.

• I/We agree that as may be required by domestic regulators/tax authorities, HDFC Bank may also be required to report,
reportable details to CBDT or other authorities/agencies or close or suspend my account, as appropriate.

• I/We have understood the information requirements of this Form (read along with the FATCA/CRS Instructions and
definitions in Part C to this Form) and hereby confirm that the information provided by me/us on this Form including
the taxpayer identification number is true, correct, and complete. I/We also confirm that I/We have read and understood
the FATCA Terms and Conditions below and hereby accept the same.

Name: _

Designation: _

Signature:

Date: / _/ Place: _ _

For Bank use only: Sourcing Branch Name: Branch Code: Signature verified and form

approved by BDA / BM employee Code : _ _ Employee Name: _

Signature & Date: _ _