Know Your Client (KYC)
Application Form (For Non-Individuals Only)
Please fill in ENGLISH and in BLOCK LETTERS with black ink
N Application No. :
"Please note that the KYC Application Form and overleaf instructions should be printed on the same page (back to back). If printed separately then both the pages should be attached and signed by the applicant."
A. Identity Details (please see guidelines overleaf)
2. Date of Incorporation d d / m m / y y y y
Place of Incorporation
4. Status Pleas e tick (ü)
FI FII HUF AOP Bank Government Body Non-Government Organisation
Defence Establishment Body of Individuals Society LLP Others
Private Ltd. Co. Public Ltd. Co. Body Corporate Partnership Trust / Charities / NGOs
(Please specify)
5. Permanent Account Number (PAN) (MANDATORY) Please enclose a duly attested copy of your PAN Card
3. Registration No. (e.g. CIN)
Date of commencement of business d d / m m / y y y y
Place: Date:
NAME & SIGNATURE(S)
OF AUTHORISED
PERSON(S)
I/We hereby declare that the details furnished above are true and
correct to the best of my/our knowledge and belief and I/we undertake
to inform you of any changes therein, immediately. In case any of the
above information is found to be false or untrue or misleading or
misrepresenting, I am/we are aware that I/we may be held liable for it.
DECLARATION
B. Address Details (please see guidelines overleaf)
2. Contact Details
Tel. (Off.) (ISD) (STD) Tel. (Res.)
Mobile (ISD) (STD) Fax
E-Mail Id.
(ISD) (STD)
(ISD) (STD)
FOR OFFICE USE ONLY
1. Name o f Applicant (Please write complete n ame a s p er C ertificate o f Incorporation / R egistration; l eaving one box b lank b etween 2 words. P lease do not abbreviate the N ame).
3. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick ( ) against the document attached.
Latest Bank Account Statement Registered Lease / Sale Agreement of Office Premises
Any other proof of address document (as listed overleaf).
ü
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *
*Not more than 3 Months old.
(Please specify)
Validity/Expiry date of proof of address submitted
d d / m m / y y y y
5. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick ( ) against the document attached.
Latest Bank Account Statement Registered Lease / Sale Agreement of Office Premises
Any other proof of address document (as listed overleaf).
ü
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *
*Not more than 3 Months old.
(Please specify)
Validity/Expiry date of proof of address submitted
d d / m m / y y y y
C. New Other Details (please see guidelines overleaf)
3.
(Please use the Annexure to fill in the details)
Name, PAN, DIN/UID, residential address and photographs of Promoters/Partners/Karta/Trustees/whole time directors
5. Any other information:
1. Gross Annual Income Details Please tick (ü): Below 1 Lac 1-5 Lac 5-10 Lac 10-25 Lac 25 Lacs-1 Crore > 1 Crore
4. Is the entity involved/providing any of the following services YES NO
- For Foreign Exchange / Money Changer Services YES NO – Gaming / Gambling / Lottery Services (e.g. casinos, betting syndicates) YES NO
- Money Lending / Pawning YES NO
2. Net-worth in `. ( * N e t w o r t h s h o u l d n o t b e o l d e r t h a n 1 y e a r ) as on (date) d d / m m / y y y y
Please affix
the recent passport
size photograph of
Authorised Signatory
and sign across it
PHOTOGRAPH
Seal/Stamp of the intermediary should contain
Staff Name
Designation
Name of the Organization
Signature
Date
4. Registered Address (If different from above)
City / Town / Village Postal Code
State Country
1. Address for Correspondence
City / Town / Village Postal Code
State Country
(Attested) True copies of documents received
(Originals Verified) Self Certified Document copies received
AMC/Intermediary name OR code
A. IMPORTANT POINTS: Residence/Driving License/Flat Maintenance bill/Insurance Copy.
1. 2. Utility bills like Telephone Bill (only land line), Electricity bill or Gas bill - Not more than
2. Copies of all the documents submitted by the applicant should be self-attested and 3 months old.
accompanied by originals for verification. In case the original of any document is not 3. Bank Account Statement/Passbook - Not more than 3 months old.
produced for verification, then the copies should be properly attested by entities 4. Self-declaration by High Court and Supreme Court judges, giving the new address in
authorized for attesting the documents, as per the below mentioned list. respect of their own accounts.
3. If any proof of identity or address is in a foreign language, then translation into English 5. Proof of address issued by any of the following: Bank Managers of Scheduled
is required. Commercial Banks/Scheduled Co-Operative Bank/Multinationa Foreign
4. Name & address of the applicant mentioned on the KYC form, should match with the Banks/Gazetted Officer/Notary public/Elected representatives to the Legislative
documentary proof submitted. Assembly/Parliament/Documents issued by any Govt. or Statutory Authority.
5. If correspondence & permanent address are different, then proofs for both have to be 6. Identity card/document with address, issued by any of the following: Central/State
submitted. Government and its Departments, Statutory/Regulatory Authorities, Public Sector
6. Sole proprietor must make the application in his individual name & capacity. Undertakings, Scheduled Commercial Banks, Public Financial Institutions,Colleges
7. For non-residents and foreign nationals,(allowed to trade subject to RBI and FEMA affiliated to Universities and Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council
guidelines), copy of passport/PIOCard/OCICard and overseas address proof is etc.,to their Members.
mandatory. 7. For FII/sub account, Power of Attorney given by FII/sub-account to the Custodians
8. For foreign entities, CIN is optional; and in the absence of DIN no. for the directors, (which are duly notarized and/or apostiled or consularised) that gives the registered
their passport copy should be given. address should be taken.
9. In case of Merchant Navy NRI’s, Mariner’s declaration or certified copy of CDC 8. The proof of address in the name of the spouse may be accepted.
(Continuous Discharge Certificate) is to be submitted. D. Exemptions/clarifications to PAN
10. For opening an account with Depository participant or Mutual Fund, for amin or, (*Sufficient documentary evidence in support of such claims to be collected.)
photocopy of the School Leaving Certificate/Mark sheet issued by Higher Secondary 1. In case of transactions undertaken on behalf of Central Government and/or State
Board/Passport of Minor/Birth Certificate must be provided. Governmentand by officials appointed by Courts e.g. Official liquidator, Court receiver etc.
11. Politically Exposed Persons (PEP) are defined as individuals who are or have been 2. Investors residing in the state of Sikkim.
entrusted with prominent public functions in a foreign country, e.g., Heads of 3. UN entities/multilateral agencies exempt from paying taxes/filing tax returns in India.
States or of Governments, senior politicians, senior Government/judicial/military officers,
senior executives of state owned corporations, important political party 4. SIP of Mutual Funds upto Rs 50,000/- p.a.
officials, etc. 5. In case of institutional clients, namely, FIIs, Mfs, VCFs, FVCIs, Scheduled Commercial
Banks, Multilateral and Bilateral Development Financial Institutions, State Industrial
B. Proof of Identity( POI): List of documents admissible as Proof of Identity: Development Corporations, Insurance Companies registered with IRDA and Public
1. PAN card with photograph. This is a mandatory requirement for all Financial Institution as defined under section 4A of the Companies Act, 1956,
applicants except those who are specifically exempt from obtaining PAN (listed in Section D). Custodians shall verify the PAN card details with the original PAN card and provide
2. Unique Identification Number (UID) (Aadhaar)/Passport/Voter ID card/Driving license. duly certified copies of such verified PAN details to the intermediary.
3. Identity card/ document with applicant’s Photo, issued by any of the following: E. List of people authorized to attest the documents:
Central/State Government and its Departments, Statutory/Regulatory Authorities, 1. Notary Public, Gazetted Officer, Manager of a Scheduled Commercial/Co-operative
Public Sector Undertakings, Scheduled Commercial Banks, Public Financial Bank or Multinational Foreign Banks (Name, Designation & Seal should be affixed on
Institutions, Colleges affiliated to Universities, Professional Bodies such as ICAI, the copy).
ICWAI, ICSI, Bar Council etc., to their Members; and Credit cards/Debit cards issued by
Banks. 2. In case of NRIs, authorized officials of overseas branches of Scheduled Commercial
Banks registered in India, Notary Public, Court Magistrate, Judge, Indian
C. Proof of Address (POA): List of documents admissible as Proof of Address: Embassy/Consulate General in the country where the client resides are permitted to
(*Documents having an expiry date should be valid on the date of submission.) attest the documents.
1. Passport/Voters Identity Card/Ration Card/Registered Lease or Sale Agreement of
Self attested copy of PAN card is mandatory for all clients.
INSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM
F. Incase of Non-Individuals, additional documents tobe obtained from non-individuals, over & above the POI & POA, as mentioned below:
Types of entity
Corporate
Partnership firm
Trust
HUF
Unincorporated
Association or a body of individuals
Banks/Institutional Investors
Foreign Institutional
Investors (FII)
Army/Government Bodies
Registered Society
Documentary requirements
Copy of the balance sheets for the last 2 financial years (to be submitted every year)
Copy of latest share holding pattern including list of all those holding control, either directly or indirectly, in the company in terms of SEBI
takeover Regulations, duly certified by the company secretary/Whole time director/MD(to be submitted every year)
Photograph, POI, POA, PAN and DIN numbers of whole time directors/two directors in charge of day to day operations
Photograph, POI, POA, PAN of individual promoters holding control – either directly or indirectly
Copies of the Memorandum and Articles of Association and certificate of incorporation
Copy of the Board Resolution for investment in securities market
Authorised signatories list with specimen signatures
Copy of the balance sheets for the last 2 financial years (to be submitted every year)
Certificate of registration (for registered partnership firms only)
Copy of partnership deed
Authorised signatories list with specimen signatures
Photograph, POI, POA, PAN of Partners
Copy of the balance sheets for the last 2 financial years (to be submitted every year)
Certificate of registration (for registered trust only).Copy of Trust deed
List of trustees certified by managing trustees/CA
Photograph, POI, POA, PAN of Trustees
PAN of HUF
Deed of declaration of HUF/List of coparceners
Bank pass-book/bank statement in the name of HUF
Photograph, POI, POA, PAN of Karta
Proof of Existence/Constitution document
Resolution of the managing body & Power of Attorney granted to transact business on its behalf
Authorized signatories list with specimen signatures
Copy of the constitution/registration or annual report/balance sheet for the last 2 financial years
Authorized signatories list with specimen signatures
Copy of SEBI registration certificate
Authorized signatories list with specimen signatures
Self-certification on letterhead
Authorized signatories list with specimen signatures
Copy of Registration Certificate under Societies Registration Act
List of Managing Committee members
Committee resolution for persons authorised to act as authorised signatories with specimen signatures
True copy of Society Rules and Bye Laws certified by the Chairman/Secretary
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Please Submit the KYC Documents on A4 Size Paper Only.