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Annexure-I: Cust Id A/C Number

This document is a specimen proforma for Know Your Customer (KYC) updation. It contains fields for collecting the customer's personal details like name, gender, date of birth, address, ID proofs, occupation, income and consent for Aadhaar authentication. The customer is given the option to change their old debit card or update their contact details like mobile number and email ID. Bank officials need to verify the submitted identity and address documents before processing the KYC updation request.

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JEC MCA
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6K views

Annexure-I: Cust Id A/C Number

This document is a specimen proforma for Know Your Customer (KYC) updation. It contains fields for collecting the customer's personal details like name, gender, date of birth, address, ID proofs, occupation, income and consent for Aadhaar authentication. The customer is given the option to change their old debit card or update their contact details like mobile number and email ID. Bank officials need to verify the submitted identity and address documents before processing the KYC updation request.

Uploaded by

JEC MCA
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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Annexure-I

BO:_____________________ D. No.________

SPECIMEN PROFORMA FOR KYC UPDATION


(In case of joint account, separate form required for each joint a/c holder)

CUST ID

A/C Number

Photo

(Specimen signature / thumb impression of the applicant)

Name #: ……………………………………. Gender (M/F) # ……………..DOB #…………….…….


Father / Husband Name #…………………………………. Mother Name…………………………..
Address #……………………………………………………………………………………………….…
…………………………………………………………………………………PIN………………………
Correspondence Address (if different from above) ……………………………………………………….
…………………………………………………………………………………PIN………………………
Do you wish to use address on Aadhar as Correspondence Address: Y/N
# Details as per Aadhar, if submitted
PAN No. / Form 60

Aadhar No.
Any other ID/Address Proof
(Passport/DL/Voter ID/MGNREGA)

Mobile No

E mail ID

Do you wish to change your old (19-digit) Debit Card & get a new card: Y/N
Profession/Occupation: ………………………Total Annual Income: ……………………………...
Total Annual Turnover (in case of business): ………………………...
Issue Y/N
Address Proof * ………………………. ID Proof * …………………… Internet Banking
* Attach Documentary proof for ID, Permanent Address, Correspondence Address, DOB Mobile Banking
If Aadhar & PAN submitted, no separate proof of address and ID is required
If PAN is not submitted, Form-60 is to be submitted mandatorily

I hereby state that I have no objection in authenticating myself with Aadhaar based authentication system
and I consent to provide my Aadhaar Number for Aadhaar based Know Your Customer. I agree that Bank may use
above Mobile Number for sending SMS Alerts & any other required information.

Date: Signature of the A/C holder

For Office Use Only

Name of Authorized Officer Signature with GBPA

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