Client Profile: Please Type " P " On The Box If " P " Required

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CLIENT PROFILE
Please type " P " on the box if " P " required
*USE BLOCK LETTERS ONLY

Open a/c with DATE:

Business Name Account Opening Requested for Registered Office Branch Office

Address Address Location City/District State Pin Code / Country Landline Number Mobile Number Fax No./Telex No. Email Home Page

Proposed Business Items


Others Air Tickets Car Rentals Tour Packages Travel Insurance Visa & Documentation Assistance Foreign Exchange Passport Riya Connect Specify

Reference (if any)


Name 1 2 Contact Number Address

LEGAL INFORMATION
PAN No Name Printed on PAN Date of Incorporation/Registration Registration no./CIN Place of Incorporation Date of Commencement of Business TAN Service TAX Registration No VAT

Type of Customer

IATA Corporate

Non-IATA Freelancer

IATA Code Premises


Rent Owned

Proprietor's/Director's/Partner's Name Contact No.

Customer Contact Persons


Domestic Counter 1 2 International Counter 1 2 Accounts 1 2

Name

Contact No.

Bank Details
** No Bank Name Bank Account Number Type Address

** "R" for Registered Office, "B" for Branch Office.

Documents Submitted

1 3 5 7

2 4 6 8

Expected International Business/Monthly Expected Domestic Business/Monthly Applied Credit TDS Exemption % and Certificate No. Exemption Period Exemption Amount Additional Information's(if any)

Agent CRS 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. Authorized Signatory Place Date Name Designation Stamp/Seal

Riya Contacts
Department Name Designation Contact No. E-mail ID

FOR OFFICE USE


Branch Name & Region Applied Credit Limit & Date of Joining Approved Credit Limit & Approved by Credit Approval Valid Up to Name

Payment Terms Services Offered


Domestic International Other Services Other Services Other Services

Period

Date of Settlement

1ST FNT 2ND FNT 1ST FNT 2ND FNT

Service Charges
Air International Air Domestic VISA Insurance Rail

Commission offered:

Remarks (if any):

Department

Name

Designation

Contact No.

E-mail ID

CRS Provided by Riya Sign Name Sales Officer Sales Manager Accounts Manager

Mirror ID

Branch Manager/Director

Customer Code CVendor Code

Verified by Date

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