File Name: KYC-Form_new_16.09.10.pdf
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Name of the Group-Entity Group-Entity’s logo KNOW YOUR CUSTOMER (KYC) FORM STRICTLY CONFIDENTIALS.No. Particulars Details 1 Full Name of the Customer _______________________________________________ 2 Legal Status Individual Company Partnership Others ___________________________________ 3 Permanent Address _______________________________________________ _______________________________________________ _______________________________________________ 4 Business/Trading Address _______________________________________________ _______________________________________________ _______________________________________________ 5 ID No./CR No./Registration No. _________________________________ Purpose and Nature of Transaction to be 6 undertaken _______________________________________________ 7 In case of Individual (i) Nationality _________________________________ (ii) Occupation or Profession _______________________________________________(iii) Name of Establishment or Employer _______________________________________________(iv) Location of activity _______________________________________________ (v) Is the Individual a Politically Important YES NO Person (PEP)? 8 In case of Others (i) City & Country of Incorporation _______________________________________________ 9 Date of Birth / Incorporation _________________________________ 10 What is the principal business/activity of the Customer? _______________________________________________ KYC Form Page 1 Name of the Group-Entity Group-Entity’s logo11 Is the Customer acting on behalf of YES NO another Person ? If Yes,(i) Name of Beneficial Owner _______________________________________________(ii) ID No./CR No./Registration No. _________________________________(iii) Domicile Country _________________________________(iv) If Beneficial Owner is an Individual, thena) Nationality _________________________________b) Is the Individual a Politically Important YES NO Person (PEP)? Independent12 Regulatory Status Regulator Non-Independent Regulator Unregulated13 Name of Regulator (if any) _______________________________________________14 Name of Stock Exchange(if Listed) _______________________________________________ _______________________________________________ If a Holding company, name of any other15 subsidiaries/branches/associated companies _______________________________________________16 If not, Group Company (if any) _______________________________________________ _______________________________________________ If business activities are conducted in more17 than one country, please indicate names of all _______________________________________________ countries _______________________________________________18 Bank Details _______________________________________________19 Contact Details of Customer(i) Contact Person _______________________________________________(ii) Tel & Fax _______________________________________________(iii) E-mail/website _______________________________________________(iv) Contact details of Compliance Officer (if any) _______________________________________________ _______________________________________________KYC Form Page 2 Name of the Group-Entity Group-Entity’s logo 20 Copies* of Customer Identification Documents Please submit the documents and tick( a) against the documents attached (i) Individual:- ID Card/Passport/Driving License(DL) Proof of Domicile Country** (ii) Company:- Company Registration (CR) List & Passport copies of Authorised Signatories List of Major Shareholders List & Proof of Domicile Country** of Directors Major Shareholders:-Shareholders who, directly or indirectly, owns or controls more than5% of the shares or voting rights (iii) Partnership:- Certificate of Registration Partnership Deed List & Passport copies of Authorised Signatories List & Proof of Domicile Country** of Partners (iv) Trust:- Certificate of Registration Trust Deed List & Passport copies of Settlor,Trustees,Protector List & Passport copies of Authorised Signatories List of Major Beneficiaries Major Beneficiaries:-Beneficiary who is to receive atleast 25% of the funds of the Trust (v) Any other Legal Person:- Registration Document List & Passport copies of Authorised Signatories List of the Individuals/Entities who ultimately owns, or exercises effective control over such personDeclarationI/We hereby confirm that the above information provided to you is true and correct to the best of our knowledge. I/Weacknowledge that if the information provided is found to be false or misleading then the business relationship may beannulled anytime at your discretion. I/We hereby agree to provide any additional information/documentation that may berequired
Date:- __________________ _________________________ Signature of Authorised Signatory*Certified copies of documents clearly signed, stamped and dated by any of the following:- (1) A representative of an embassy, consulate or high commission of the country; or (2) A lawyer or attorney; or (3) A notary public or commissioner of oaths; or (4) A chartered or certified accountant
The date of signatory should not be older than 3 months
Copies of certified copies is not acceptable
**Any document to show the residential address like utility bill, tenancy agreement,etc
KYC Form Page 3
Any other Legal Person:-Registration Document List & Passport copies of Authorised Signatories Company:-Company Registration (CR) List & Passport copies of Authorised Signatories Partnership:-Certificate of Registration Partnership Deed List of Major Shareholders List & Proof of Domicile Country** of Directors
10 Things to Know About Your Customers How old is your customer? Gen X, Gen Y, Gen Z? ... Why do they buy your product or service? How does it serve them? ... How did they find your business? ... What do they like about your company? ... What do they expect from your brand? ... What do they think of your competition? ... Where does your customer like to buy? ... How does your customer like to buy? ... More items...
Steps to check KYC status