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    New KYC Form - 1 RI

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    tanmoy.neogi.2019

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    New KYC Form - 1 RI

    Uploaded by

    tanmoy.neogi.2019
    18 views2 pages

    Original Title

    New-KYC-Form-_1-RI

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    18 views2 pages

    New KYC Form - 1 RI

    Uploaded by

    tanmoy.neogi.2019

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Form Type

    KRA001
    APPLICATION FORM – FOR INDIVIDUAL
    KNOW YOUR CLIENT (KYC)
    (Please fill the form in ENGLISH and in BLOCK LETTERS)
    A) IDENTITY DETAILS

    1. Name of the Applicant

    2. Father’s / Husband’s Name

    3. a. Gender Male Female Transgender 3 b. Marital status Single Married


    3. c. Date of Birth D D MM Y Y Y Y 1st Holder Signature

    5. a. PAN 5 b. Aadhaar Number, if any X X X X X X X X

    B) OCCUPATION & INCOME (PLEASE TICK)


    Private Sector Public Sector Govt. Service Business Professional Agriculturist

    Income per annum: Rs. <1 Lac 1 to 5 Lac 5 to 10 Lac 10 to 25 Lac More than 25 Lac As on OR
    Net worth is Rs. As on . (Should not be older than 1 year)
    C) ADDRESS DETAILS
    1. Residence / Correspondence Address Correspondence Address Residence Address

    City / Town / Village PIN Code


    State Country

    3. Contact Details: Tel (Off.) Tel. (Res.)


    Mobile No. Fax No.
    Email ID
    4. Permanent Address (If different from above, Mandatory for Non-Resident Applicant to specify overseas address)

    City / Town / Village PIN Code


    State Country
    D) 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 false or untrue, or misleading or misrepresenting, I am aware that I may be held liable for it I/we
    understand that as an SEBI Registered Intermediary, Axis Securities Limited is required to upload / submit my / our KYC details along with a copy of my / our Aadhaar
    Card and other documents to KRA / CERSAI. I / we herewith give our consent to the Axis Securities Limited to upload / submit my / our Aadhar Card and other
    documents along with required details to KRA / CERSAII am/we are also aware that for Aadhaar OVD based KYC, my KYC request shall be validated against Aadhaar
    details. I/We hereby consent to sharing my/our masked Aadhaar card with readable QR code or my Aadhaar XML/Digi Locker XML file, along with passcode and as
    applicable, with KRA and other Intermediaries with whom I have a business relationship for KYC purposes only.

    Signature of the Applicant


    Date: D D MM Y Y Y Y Place:
    OFFICE USE ONLY

    a. Name of the Person

    Date: D D MM Y Y Y Y
    Signature of the authorised signatory Seal / Stamp of the Branch

    2
    Account Opening Checklist – Resident Demat & Trading Account
    KRA Registration Form (dully filled & signed by the Applicant)

    + KRA Registration Form Joint Holder (for each Joint Holder in Demat Account- As applicable)
    * One Photograph of each Applicant/ Joint Holder

    Pan Card (of Applicant & All Joint Applicants(if applicable))

    Address Proof (of Applicant & All Joint Applicants (if applicable) – Anyone ) – For Communication as well as for Permanent Address
    * Aadhaar Card (First 8 digits of number must be masked)
    * Passport/ Voters Identity Card/ Driving License (Valid as on date)

    All the documents must be


    o Self-Attested by the Applicant / joint Holder
    o ‘Verified with Original’ by Axis Bank/ Axis Securities Ltd employee
    - Submitted copies must be clear & readable

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