Rakesh PDF
Rakesh PDF
A. Identity details
Photograph
RAKESH PATEL
1. Name (Same as ID Proof) Please affix your
recent passport size
1a. Maiden Name (If any) photograph and
2. Father's/Spouse's Name NAGAJI PAYEL sign across it
2a. Mother's Name HEER PATEL
Signed by: Rakesh Patel
eSigned using Aadhaar (digio.in)
F1
Date: 2024-03-16 16:07:34 IST
3a. Gender * Male Female Transgender 3b. Marital Status Single * Married Other 3c. DOB 2000-01-20
4a. Citizenship * Indian Other ___________________(ISO 3166 Country Code )
4b. Residential Status * Resident Individual Non Resident Indian Person of Indian Origin Foreign National
Tick if applicable Residence for tax purposes in jurisdiction(s) outside India
ISO 3166 Country Code of Jurisdiction of residence Place of birth_____________________________________
Tax Identification Number or Equivalent ISO3166 Country Code of Birth
C. DECLARATION
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and
I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be Signed by: Rakesh Patel
false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. eSigned using Aadhaar
(digio.in)
Date: F2
I hereby consent to receiving information from Central KYC Registry through SMS/email on the above registered Client Signature
2024-03-16 16:07:34 IST
number/email address.
Date :
4. Address in the jurisdiction details where applicant is resident outside India for tax purpose (if applicable)
Address
D. Details of related person (In case of additional related persons, please fill below details)
Addition of Related Person Deletion of Related Person
KYC Number of Related Person (if available)
Related Person Type Guardian of Minor Assignee Authorized Representative
Name
(If KYC number & name are provided, below details are optional)
Proof Of Identity Of Related Person
Identity Proof Submitted Number
Expiry Date :
Others (any document notified by the Central Govt.) Identification No
Simplified Measures Account-Document Type Code Identification No
Unless the constituent notifies the bank immediately of any discrepancy found by him/her in this statement of Account, it will be taken that
he/she has found the account correct.
The closing balance as shown/displayed includes not only the credit balance and / or overdraft limit, but also funds which are under clearing. It
excludes the amount marked as lien, if any. Hence the closing balance displayed may not be the effective available balance. For any further
clarifications, please contact the Branch.
We would like to reiterate that, as a policy, Axis Bank does not ask you to part with/disclose/revalidate of your iConnect passord,login id and
debit card number through emails OR phone call Further,we would like to reiterate that Axis Bank shall not be liable for any losses arising
from you sharing/disclosing of your login id, password and debit card number to anyone. Please co-operate by forwarding all such
suspicious/spam emails, if received by you, to [email protected]
With effect from 1st August 2016, the replacement charges for Debit card and ATM card applicable on Current accounts have been revised. To
know more about the applicable charges,please visit www.axisbank.com Signed by: Rakesh Patel
eSigned using Aadhaar (digio.in)
Deposit Insurance and Credit Guarantee Corporation (DICGC) insurance cover is applicable in all Banks' deposits, Date:such as savings,
2024-03-16 current,
16:07:34 IST
fixed, recurring etc* up to maximum amount of Rs 5 Lakh including principal & interest both* (* for exceptions and details please refer
www.dicgc.org.in )
In compliance with regulatory guidelines, the non-CTS cheque books attached to the accounts would be destroyed in banks core banking
System. Thus, Non CTS cheques will not be valid for CASH, Clearing and Transfer transactions
REGISTERED OFFICE - AXIS BANK LTD,TRISHUL,Opp. Samartheswar Temple, Near Law Garden, Ellisbridge, Ahmedabad .
380006.This is a system generated output and requires no signature.
BRANCH ADDRESS - AXIS BANK LTD, DUNGARPUR [RJ], OPPOSITE NEW BUS STAND, SAGWADA ROAD, , 314001,
DUNGARPUR, RAJASTHAN, INDIA, TEL:02964-230300/3130023 FAX:234600
Legends :
ICONN-Transaction trough Internet Banking
VMT-ICON-Visa Money Transfer through Internet Banking
AUTOSWEEP-Transfer to linked fixed deposit
REV SWEEP-Interest on Linked fixed Deposit
SWEEP TRF-Transfer from Linked Fixed Deposit / Account
VMT-Visa Money Transfer through ATM
CWDR-Cash Withdrawal through ATM
PUR-POS purchase
TIP/ SCG-Surcharge on usage of debit card at pumps/railway ticket purchase or hotel tips
RATE.DIFF-Difference in rates on usage of card internationally
CLG-Cheque Clearing Transaction
EDC-Credit transaction through EDC Machine
SETU -Seamless electronic fund transfer through AXIS Bank
Int.pd-Interest paid to customer
Int.Coll-Interest collected from the customer