KYC Non-Individual FORM

 

[A] IDENTITY DETAILS

1 ) Name of the applicant

2) Date of incorporation

Place of incorporation

3) Date of commencement of business

4) Pan Number

Registration No. (e.g. CIN)

6) Status (please select any one)

[B] ADDRESS DETAILS

1) Address for correspondence

City/town/village

Pin Code

State

Country

2) Contact Details
Tel. (Off.)

Tel. (Res.)

Mobile Number

Fax Number

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

5) Specify the proof of address submitted for Registered Address

[C] OTHER DETAILS

1) Gross Annual Income Details (please specify)
Income Range per annum

3) Net-worth as on (date)
(Net worth should not be older than 1 year)
3) Name, PAN, residential address and photographs of Promoters/Partners/Karta/Trustees and whole time directors
Name of the Promoters/Partners/Karta/Trustees and whole time directors

Pan Number of the directors

residential address of the directors

Upload Photos

4) DIN/UID of Promoters/Partners/Karta and whole time directors

5) Please tick, if applicable, for any of your authorized signatories/Promoters/Partners/Karta/Trustees/whole time directors
Politically Exposed Person (PEP)
Related to a Politically Exposed Person (PEP)
6) Any other information

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.