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KYC APPLICATION FORM

A. IDENTITY DETAILS

Name of the Member *

Father’s/ Spouse Name *

Email *

Gender *

Marital status

Date of birth *

Mobile No *

Tel.(Off.)

Tel.(Res.)

Fax

Nationality *

PAN

Aadhaar *

B. ADDRESS DETAILS

Residence Address *

City/town/village *

Pin Code *

State *

Country *

Tick if you Are residing at the permanent address ?

Permanent Address:

City/town/village

Pin Code

State

Country

C. Documents

Photo *

Adhar *

( 1. Photo format should be in JPEG, JPG or WEBP. )

( 2. Other Document Should be in PDF format)

( 3. Size must be less then 1.5 MB)

E. 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.