KYC Form PDF
KYC Form PDF
Notes:
1. Your contact details mentioned below will be updated in our records.
2. Signatures of all the account holders are mandatory.
3. Enclose self-attested photocopies of ID proof, Non-Resident status proof (Only for NRI) and Address proof for all account holders.
4. Passport size photographs of all holders to be pasted.
5. * marked points are mandatory.
6. ** marked points are mandatory if the customer is a NRI.
7. The address on this form should be same as in supporting documents.
8. If there are more than 2 signatories, use photocopies of this form.
9. The submitted data is valid for all accounts held by you
Account Number:
Customer ID:
*Name:
There is no change to my current overseas address I wish to update my current overseas address as below
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Tel (Office):
Tel (Res):
*Mobile Number:
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Tel (Office):
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Tel (Res):
*Mobile Number:
Current Overseas Address Permanent Address (Default is current overseas address if no box is ticked)
I/We acknowledge and confirm that I/we have read and understood the terms and conditions governing my/our accounts held with ICICI Bank
Limited., India (ICICI Bank) as available on http://www.icicibank.com/nri-banking/RHStemp/termNcondition.html and further agree and confirm that
I/we shall be bound by such terms and conditions governing my/our accounts with ICICI Bank.
I/We declare, confirm and agree to inform ICICI Bank regarding any change in my/our Overseas / Permanent Address and to provide new address
to the bank within two weeks of such a change.
*Customer Profile:
A) Occupation
a. If Salaried, employed with
Proprietorship Partnership Pvt. Ltd. Public Ltd.
Public Sector Government Multinational Others (Please specify)
B) Education
Under Graduate Graduate Post Graduate Professional (Please specify)
D) Source of funds
Salary Business Income Agriculture Investment
Inheritance Rent Pension
Funds of family members Other (Please specify)
FOR ICICI BANK USE ONLY (PRIMARY APPLICANT KYC CERTIFICATION) (Applicable for face to face cases):
I have met Mr./Ms./Dr. ______________________________________________________________in person and hereby confirm that the identity details
filled in the Customer Identification Updation Form which has been filled in my presence, and I have verified the same with the original documents.
I have understood the documents and certify that the documents convey compliance with Bank's KYC guidelines.
Employee Number: ______________________________________
At present working at:________________________________________________________ (Mention city and country)
as (Designation):_________________________________________
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2. JOINT HOLDER 1 / GUARDIAN DETAILS (In case of Joint account):
*Fathers name:
*Gender: M F T
*Photo Identity Proof Document No. (Passport No. mandatory in case of a NRI):
*Place of Issue:
** Type of Visa/ Labour card/ Work permit: _________________________________ (Please provide proof)* (Visitor & Business visas are not allowed)
#Politically Exposed Person (PEP) Individuals who are or have been entrusted with prominent public functions in a foreign country. Examples
include but are not limited to Heads of State or of Governments, Senior politicians, Senior government/judicial/military officers, Important political
party official. The term PEP also includes the families (close family members such as spouse, children, parents and siblings and may also include
other blood relatives and relatives by marriage) and close associates (include close business colleagues and personal advisors/consultants to the
PEP as well as persons who obviously benefit significantly from being close to such a person) of the PEPs.
Contact Details:
*E-mail ID:
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Tel (Office):
Tel (Res):
*Mobile Number:
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Permanent Address (Proof Mandatory if different than Current Overseas Address):
If the address is same as the Communication address then please tick here
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
City:____________________________ PIN Code:________________________ State:__________________________ Country:_________________________
Tel (Office):
Tel (Res):
*Mobile Number:
I/We acknowledge and confirm that I/we have read and understood the terms and conditions governing my/our accounts held with ICICI Bank
Limited, India (ICICI Bank) as available on http://www.icicibank.com/nri-banking/RHStemp/termNcondition.html and further agree and confirm that
I/we shall be bound by such terms and conditions governing my/our accounts with ICICI Bank.
I/We declare, confirm and agree to inform ICICI Bank regarding any change in my/our Overseas / Permanent Address and to provide new address
to the bank within two weeks of such a change.
*Customer Profile:
A) Occupation
a. If Salaried, employed with
c. If Others
House Wife Retired Student
B) Education
D) Source of funds
FOR ICICI BANK USE ONLY (PRIMARY APPLICANT KYC CERTIFICATION) (Applicable for face to face cases):
I have met Mr./Ms./Dr. _______________________________________________________in person and hereby confirm that the identity details filled in
the Customer Identification Updation Form which has been filled in my presence, and I have verified the same with the original documents. I have
understood the documents and certify that the documents convey compliance with Bank's KYC guidelines.
Employee Number: ______________________________________
At present working at:________________________________________________________ (Mention city and country)
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as (Designation):_________________________________________
Identity Proof:
Address Proof:
Business Salaried
(Manufacturing, Trading, 41241 41242 (Proprietorship, Partnership, 41341 41342
Services, Retailing, Agriculture, Pvt.Ltd., Public Ltd.,
Real Estate) Public Sector, Government,
Professional Multinational, Wage Salary
(Doctor, CA/CS, Lawyer, earners, Others
Architect, Consultant, Engineer)
Housewife, Retired, Student
Please activate my account basis this form in case the same is dormant
Photograph of Photograph of
First Holder Signature of Second Holder Signature of
First Holder Second Holder
Name:......................................................................... Name:.........................................................................
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Mentioned below are acceptable list of documents :
Valid Indian passport with photo and signature No Yes Yes Yes Yes Yes
In case of NRIs : Valid Visa/ Work Permit/ Resident Card Yes No No No Yes No
Utility Bills : (Electricity, Land line, Piped Gas, Water Connection) No No No No Yes No
not older than 2 months
Driving License bearing the photo & the expiry date No No Yes Yes Yes No
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