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Rekyc Form

This document is a specimen proforma for KYC updation, requiring personal and identity details from the customer, including consent for Aadhaar-based authentication. It includes sections for customer information, address details, and necessary documentation for verification. The form also contains an acknowledgment section for the branch to confirm receipt of the KYC updation request.

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vikashkumarrauda0756
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805 views1 page

Rekyc Form

This document is a specimen proforma for KYC updation, requiring personal and identity details from the customer, including consent for Aadhaar-based authentication. It includes sections for customer information, address details, and necessary documentation for verification. The form also contains an acknowledgment section for the branch to confirm receipt of the KYC updation request.

Uploaded by

vikashkumarrauda0756
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SPECIMEN PROFORMA FOR KYC UPDATION

(In case of joint account, separate form required for each joint a/c holder)

Branch Name & Sol ID________________________ DATE________________


First Name

Middle Name

Last Name
Specimen Signatures or thumb impression
Photo
Customer ID

A/C number

CKYCR ID, if
available Specimen Signatures or thumb impression
Personal information
Gender (M/F/T) PAN Number/Form 60
DOB Profession/Activity
Father’s Name Annual Income
Mother’s name Expected annual credit
Residential status Spouse’s name, if married
Identity/ Address details
OVD type OVD number
OVD Issue date OVD Expiry date
Mention address as
per OVD, if OVD
submitted District___________________________State__________________________PIN________________
Communication
address If different
from OVD District___________________________State__________________________PIN________________
Attach Documentary proof for OVD, Tax-ID (PAN/ Form 60), Documentary proof orSelf Declaration in respect of current address, nature of
business and financial status (whichever applicable).
I hereby state that I have no objection in authenticating myself with Aadhaar based authentication system and I give my
consent to provide my Aadhaar Number for Aadhaar based Know Your Customer. (optional) YES ☐ NO ☐
Reference no. of e-KYC Authentication, if carried out ___________________
I/We hereby provide my consent to share my personal details/KYC documents with CKYCR portal for any purpose as
per extant guidelines of Bank/ RBI/ CERSAI etc. I give my consent to download my KYC Records from the Central KYC
Registry (CKYCR), only for the purpose of verification of my identity and address from the database of CKYCR Registry.
I understand that my KYC Record includes my KYC Records /Personal information such as my name, address, date
of birth, PAN number etc.
Signature of the Customer _________________
Contact Number__________________________ Email ID___________________________________
For Office Use Only
Name of Authorized Officer
Signature with GBPA No./ PF No. Stamp/ seal
-----------------------------------------------------------Acknowledgement------------------------------------------------------------------------------
Sh./Ms. ________________ Dated: ____________
Customer ID_____________
Request for KYC Updation in your Customer-ID: _________________
We hereby acknowledge receipt of your request for KYC updation. KYC updation in your account for change in current address
details; provided on declaration basis, shall be subject to verification of declared address by the branch.
(Signature of branch official with seal)

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