DORMANT ACCOUNT ACTIVATION FORM

(Only for Resident Individual customers)

Please fill the form in Black Ink and in CAPITAL LETTERS.

Date
ALL fields marked ”*” are mandatory.
D D M M Y Y Y Y

*Account Number

Reason for not transacting / Dormancy:

PRIMARY APPLICANT DETAILS

*Customer ID

Customer Name

I/We hereby request you to activate my/our account, basis the following documents

Aadhaar No. X X X X X X X X PAN*

(enter only last 4 digits of Aadhaar number)

Voter ID Expiry Date D D M M Y Y Y Y

Driving License Expiry Date D D M M Y Y Y Y

Passport Expiry Date D D M M Y Y Y Y

NREGA National Population Register

I wish to change my permanent address

PERMANENT ADDRESS
Aadhaar Passport Driving License Voter ID NREGA NPR
Line 1
Line 2
Landmark
(If any)

City State Pin Code

I wish to change my mailing address

COMMUNICATION / MAILING ADDRESS
Same as avobe This is my Residence Place of work
Line 1
Line 2
Landmark
(If any)

City State Pin Code

TELL US WHAT YOU DO FOR A LIVING

1) Occupation (Select Anyone)
1a) Salaried (Select Anyone) Public Private Government
Corporate Name
1b) Self Employed Doctor CA Architect Lawyer Consultant Entertainment
Professional Others
Alternate Medical Practitioner Beautician

1c) Self Employed Business Sole Proprietorship Partnership/Company No. of years in business < = 5 yrs > 5 yrs
1d) Any other Occupation Homemaker Retired Farmer Politician Student Minor
2) Source of Income Salary Business Professional Fees Investments Agriculture Family Wealth
3) Gross Annual Income (INR)

FATCA DETAILS
Place of Birth Country of Birth Country of Tax Residence

For Tax Residents of countries in addition to India, please complete below:

Country of Tax Residence Foreign Tax Identification Number TIN Issuing Country
 SECOND/JOINT APPLICANT DETAILS

*Customer ID

Customer Name

Aadhaar No. X X X X X X X X PAN*

(enter only last 4 digits of Aadhaar number)

Voter ID Expiry Date D D M M Y Y Y Y

Driving License Expiry Date D D M M Y Y Y Y

Passport Expiry Date D D M M Y Y Y Y

NREGA National Population Register

I wish to change my permanent address

PERMANENT ADDRESS
Aadhaar Passport Driving License Voter ID NREGA NPR
Line 1
Line 2
Landmark
(If any)

City State Pin Code

I wish to change my mailing address

COMMUNICATION / MAILING ADDRESS
Same as avobe This is my Residence Place of work
Line 1
Line 2
Landmark
(If any)

City State Pin Code

TELL US WHAT YOU DO FOR A LIVING

1) Occupation (Select Anyone)
1a) Salaried (Select Anyone) Public Private Government
Corporate Name
1b) Self Employed Doctor CA Architect Lawyer Consultant Entertainment
Professional Others
Alternate Medical Practitioner Beautician

1c) Self Employed Business Sole Proprietorship Partnership/Company No. of years in business < = 5 yrs > 5 yrs
1d) Any other Occupation Homemaker Retired Farmer Politician Student Minor
2) Source of Income Salary Business Professional Fees Investments Agriculture Family Wealth
3) Gross Annual Income (INR)

FATCA DETAILS
Place of Birth Country of Birth Country of Tax Residence

For Tax Residents of countries in addition to India, please complete below:

Country of Tax Residence Foreign Tax Identification Number TIN Issuing Country
 DECLARATION & SIGNATURE(S)

1. I/We, the undersigned, have read, understood and agree to absolutely and unconditionally abide by and be bound by the Terms and
Conditions displayed on website www.idfcfirstbank.com as revised from time to time by IDFC FIRST Bank Limited. In relation to all of my/ our
accounts, for present and future, maintained/opened/to be maintained/ to be opened with IDFC FIRST Bank Limited.
2. I certify that I have declared my status as per applicable FATCA / CRS rules in India as notified by Government of India / Central board of
Direct Taxes (CBDT) / Reserve Bank of India ( RBI ) in this regard.
3. I certify that the information stated in this form and supporting documentary evidence provide by me is to the best of my knowledge and belief
true, correct and complete and that I have not withheld any material information / document that may affect the assessment/ categorization
of the account at a US Reportable account/ Other Reportable account or otherwise.
4. I understand, acknowledge and authorize that as per the provision of Income Tax Act, Rules made thereunder and the guidelines issued by
the Government/ RBI in the matter, depending upon the residential status and/ or other criteria stipulated therein, the Bank may have to report
the details in respect of my account(s) as per the prescribed format to the Central Board of Direct Taxes ( CBDT ) or other Government
Agencies to comply with the obligations as per the Inter-Governmental Agreements ( IGA ) in respect of Foreign Accounts Tax Compliance
Act ( FATCA ) and Common Reporting Standards ( CRS ) and / or any other similar arrangements.
5. I undertake the responsibility to declare, disclose and recertify within 30 days any changes that may take place in the information provided in
this form and signed by me as well as in the documentary evidence provided by me or if any certification become incorrect.
6. I also agree that our failure to disclose any material fact known to me now or in future, may invalidate my application and IDFC FIRST Bank
would be within its right to put restrictions in the operations of my account or take appropriate action permissible under the Indian regulations
for the purpose or take any other action as may deemed appropriate if the deficiency is not updated/ rectified by me within the stipulated period.
7. I agree to Furnish any particulars / information that is called upon me by IDFC FIRST Bank on account of any change in law either in India or
abroad in the subject matter herein.
8. In the event there is any tax demand {including interest (if any)} raised due to nondisclosure / inaccurate disclosure of information /
documents on my / our part, I undertake to pay the demand forthwide and provide the bank with all information/ documents that may be
necessary for any proceeding before GOI/RBI/ Income Tax Authorities.
9. I/We state, declare, confirm and agree that the Bank has duly explained to me/us that submission of a copy of my / our Proof of Possession
of Aadhaar Number ( OVD ) containing Aadhaar number, as an Officially Valid Document ( OVD ) is not mandatory and I/We have the option
to submit any one of the documents as per the list of Officially Valid Documents (updated by the RBI from time to time).
10. I/We further state, declare and confirm that I am/ We are providing my/ our Proof of Possession of Aadhaar number ( OVD ) as an officially
valid document voluntarily in accordance with extant rules and regulations; I/ We authorize IDFC FIRST Bank to redact/blacken out the
Aadhaar number through appropriate means on my / our behalf “.
11. I hereby authorise IDFC FIRST Bank and its vendors to access my Aadhaar number and fetch my details. I understand that IDFC FIRST Bank
and its vendors will not be storing or sharing the same in any manner.

I/We hereby give my/ our consent to download my/ our KYC Records from the Central KYC Registry ( CKYCR ), only for the purpose of verification
of my/ our identify and address from the database of CKYCR Registry. I/We understand that my / our KYC Record includes my / our KYC Record
includes my/ our KYC Records / Personal information such as my name, address, date of birth, PAN number etc.

First / Only Holder Second Holder (If Any)

Signature Signature

Individuals: All holders to sign.

Name Name

FOR BANK USE ONLY

Service Request No.

Employee ID

Name of the
Branch Official
Signature of the Branch Official
I have seen and verified the original

The customer has signed in my presence