Customer Updation Form For BAR CODE

KYC - Resident Indian/ HUF

All fields are mandatory
The Branch Head Axis Bank Ltd. CKYC ID

Branch Sol ID Date D D M M Y Y Y Y

Same as OVD

I wish to change my name as per OVD No change in my KYC details

OVD Name Same as OVD

Please provide KYC documents (Attach photocopies of the following documents and produce the original copies of these documents for verification)
*Identity Proof Document Type *ID No. Issuing Authority Place of Issue

Gender M F T

(To be ticked only when

Occupation is Salaried)

(To be ticked only when

Occupation is Self Employed)

*Date of Birth/Date of Incorporation D D M M Y Y Y Y Nationality : Indian

Constitution code Resident Individual HUF

____________________________________________
(Only Alphabetical character allowed)

Is the Customer having link with any Politically Exposed Persons

*COMMUNICATION ADDRESS (Please leave space between two words)

*Address Proof Document Type *Incase of Aadhaar mention last four digits only Issuing Authority Place of Issue

Address

Landmark City

Pin code State Country

Residence Type Owned Rented/Leased Ancestral/Parental Company Provided

*PERMANENT ADDRESS (Please leave space between two words) Same as communication address

Address

Landmark City

Pin code State Country

Residence Type Owned Rented/Leased Ancestral/Parental Company Provided

*Mobile Number Telephone (R) (O):

EMAIL ID

*Permanent Account Number (PAN) Or form 60 (overleaf) Aadhaar Card No.

*Mandatory fields
I wish to update below contact information in
Individual Segment Non-Individual Segment
Please select below if you wish to update in selective accounts only.
All Linked Accounts Also update at Cust ID level for CA
All Relationships Savings & FD Loan A/cs
Current A/cs Credit Cards Only in A/c no

Additional Details

Maiden Name (If any*) Prefix First Name Middle Name Last Name

Father Name*

Mother Name*

Spouse Name*

Passport Expiry Date D D M M Y Y Y Y Required if Passport provided as Identity/Address Proof

AFFIX
Driving License Expiry Date D D M M Y Y Y Y Required if Driving License provided as Identity/Address Proof RECENT
PHOTO
&
Cross sign across photo

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 Additional Declarations (Tick as Applicable)
Form 60
Form for declaration to be filed by an individual or a person (not being a company or firm) who does not have a permanent account number and who
enters into any transaction specified in rule 114B Date of Birth

If applied for PAN and it is not yet generated enter date of application and acknowledgement number

If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per a Agricultural income (`)
section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is held b Other than Agricultural income (`)
Verification
I, __________________________________________________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I
do not have a Permanent Account Number and my/ our estimated total income (including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in
accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction is held will be less than maximum amount not chargeable to tax. Verified today,
the _____________________________________ day of___________________________20____
Date ________________________, Place ________________________ Signature _______________________________
FATCA- CRS DECLARATION Please tick the applicable tax resident declaration (Any one)*
I am a tax resident of India and not resident of any other country OR I am a tax resident of the country/ies mentioned in the table below:
Please indicate the country/ies in which the entity is a resident for tax purposes and the associated Tax ID Number below:
City of Birth* Country of Birth* Address Type for Tax Purpose*- Residential Business Registered Office

Tax Identification Identification Type Address For Tax Purpose*

Country#
Number% (TIN or Other, please specify)% Communication Address Permanant Address Please note the address below

Landmark
Pin State___________________ Country _________________
# To also include USA, where the individual is a citizen/ green card holder of USA % incase Tax Identification Number is not available, kindly provide functional equivalent$ FATCA
- CRS Certification. I have understood the information requirements of this Form (read along with the FATCA/CRS Instructions and Terms & Conditions) and hereby Confirm that
information provided by me/us on this Form is true, correct, and complete and hereby accept the same.

Signature ______________________________

HUF Declaration & Mandate

We, the undersigned, for ourselves and ______________________________________________________________________________as Manager/Karta and Ejaman of the family, also guardian of

*____________________________________________________________ request you to take notice that we are members of Hindu Undivided Family/firm.

The joint family/firm is carrying business under the name and style of M/s. _______________________________________________________, which is our joint family trade
(Applicable for Current Account only)
The Hindu Undivided Family is engaged in_______________________________________________ activity/occupation not in the nature of the business or trade.

We, the undersigned, hereby authorize (Karta/Manager)____________________________________ to operate upon the Bank account severally, jointly and all transactions entered into
and obligations incurred or to be hereafter incurred by them will be binding on all of us. Any acts done/to be done to comply with Bank's rules which are in force or as amended from
time to time in the matter of maintaining and conduct of such accounts will be binding on us.
Please treat this as a mandate from us to:
Collect/ Credit Cheques/ remittances/ Warrants/ Refund orders/ ECS/ RTGS/ NEFT/ instruments issued in favour of ______________________________________, being the karta in the
account in the HUF A/c No________________________________of ______________________________ HUF
We hereby undertake to indemnify the Bank in case of any loss/claims/damages/penalty/charges etc suffered by the Bank, on account of our aforesaid instruction/mandate.
Place:_____________________________ Date:_____________________________ Name :________________________________________________ Signature :_____________________________
Place:_____________________________ Date:_____________________________ Name :________________________________________________ Signature :_____________________________
Place:_____________________________ Date:_____________________________ Name :________________________________________________ Signature :_____________________________
Place:_____________________________ Date:_____________________________ Name :________________________________________________ Signature :_____________________________
*Here state the name of the children of each of the family members stating their parentage and state also the name of guardians by whom they are represented.

Terms & Conditions

In case of Joint A/c., separate form is required.
• I hereby state that I have no objection in authenticating myself with Aadhaar based authentication system and consent to providing my Aadhaar number, Biometric and/or One
Time Pin (OTP) data(and/or any similar authentication mechanism ) for Aadhaar based authentication for the purposes of Re-KYC for updating my details with Axis Bank.
• I understand that the Biometric Information and/or OTP and/or any other authentication mechanism, I may provide for authentication shall be used only for identity through
the Aadhaar Authentication system and for obtaining e-KYC from UIDAI for that specific transaction and for no other purposes.
• I understand that Axis Bank shall ensure security and confidentiality of my personal identity data provided for the purpose of Aadhaar based authentication.I hereb physically
present and provided my Biometric Information for authenticating myself and for receiving e-KYC details from UIDAI for the purpose of Re-KYC for updating my accounts with
Axis Bank.
• All information provided by me of any nature (including personal & sensitive information) can be shared with agencies/service providers who have an agreement business
purpose and on need to know basis.
• Axis Bank shall always strive to comply with the rules and regulations as applicable from time to time on this context in accordance with the bank's Privacy policy my consent
to the sharing of the data, the products/services available to me, pursuant to the consent provided earlier, shall no longer be available to me, and initiate closure of such
products/ services.
• All the terms and conditions, processes and alternatives have been explained to me in local language as well.

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 DECLARATION
• I hereby declare that the details furnished above are true and correct to the best of my/our 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/We am/are aware that I/we may be held liable for it.
• My personal / KYC details may be shared with Central KYC Registry
• I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered
number/email address

Signature of
Date D D M M Y Y Y Y Place: ______________________________________ Primary Applicant

For Branch Office & Office Use Only

Request Received Date D D M M Y Y Y Y Request Accepted By

Signature
Forwarded To CPU Date D D M M Y Y Y Y Employee Number

Certified that this Form is complete in all respect & all relevant documents are obtained & verified with Mode of operation and
signatures of the A/c. The request may please be processed. For AXIS BANK LTD.
Signature
Designation OH BH S.S No

Documents Received Certified Copies E-KYC data received from UIDAI Data received from Offline verificaion Digital KYC Process Equivalent e-document
Video based KYC

KYC VERIFICATION CARRIED OUT BY

Identity Verification Done Date D D M M Y Y Y Y
Emp. Name :______________________________________________________

Emp. Code :______________________________________________________

Emp. Designation :_________________________________________________

Emp. Branch:______________________________________________________ S.S No Employee Signature

Acknowledgement To Customer

Customer Name Prefix First Name Middle Name Last Name

Date of Request Received D D M M Y Y Y Y Request Option No.

Name of Branch Official

Signature
Employee Number of Branch Official