CI KYC Details Change form

(For Individuals Only)

Place for
Intermediary Logo

Please fill this update / modification form in ENGLISH and in BLOCK LETTERS (Please strike off Sections that are not used).
A Name of Applicant (Mandatory as per original KYC records)
Application No. :

Title Mr. Ms. Other (Please s Aadhaar Number, if any: PAN

Name

Date of Birth d d / m m / y y y y

Please Provide the new KYC details which should be updated in your KYC records.
B. Mandatory fields for KYCs done before 1st January 2012
1. Father’s/Spouse Name

2. Current Marital status Single Married 3. Current Nationality Indian Other (Please specify)
Note “FOR OFFICE USE ONLY”: The IPV Column should be mandatorily filled for all KYCs registered before 1st January 2012. Originals Seen and Verified should
be mandatorily filled for changes to Identity and Address details.

C. Identity Details (please see guidelines overleaf)

1. New Name (As appearing in supporting identification document).
Name

2. New Status Please tick ( ü

) Resident Individual Non Resident (Passport Copy Mandatory for NRIs & Foreign Nationals)
3. PAN Please enclose a duly attested copy of your PAN Card
4. Proof of Identity submitted for PAN exempt cases Please Tick (ü
)
Aadhaar Card Passport Voter ID Driving Licence Others (Please see guideline ‘D’ overleaf)

D. Address Details (please see guidelines overleaf)

1. New Address for Correspondence

City / Town / Village Pin Code

State Country
2. Contact Details
Tel. (Off.) (ISD) (STD) Tel. (Res.) (ISD) (STD)
Mobile (ISD) (STD) Fax (ISD) (STD)
E-Mail Id.
3. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick ( ü ) against the document attached.
Passport Ration Card Registered Lease/Sale Agreement of Residence Driving License Voter Identity Card *Latest Bank A/c Statement/Passbook
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *Latest Gas Bill Others (Please specify)
*Not more than 3 Months old. Validity/Expiry date of proof of address submitted d d / m m / y y y y
4. New Permanent Address of Resident Applicant if different from above C1 OR Overseas Address (Mandatory) for Non-Resident Applicant

City / Town / Village Pin Code

State Country
5. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick (ü ) against the document attached.
Passport Ration Card Registered Lease/Sale Agreement of Residence Driving License Voter Identity Card *Latest Bank A/c Statement/Passbook
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *Latest Gas Bill Others (Please specify)
*Not more than 3 Months old. Validity/Expiry date of proof of address submitted d d / m m / y y y y

6. Any other information:

SIGNATURE OF APPLICANT DECLARATION SIGNATURE OF APPLICANT

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
Old signature as per original KYC information is found to be false or untrue or misleading or
Wherever Applicable misrepresenting, I am/we are aware that I/we may be held liable for it.

Place: Date: d d / m m / y y y y

FOR OFFICE USE ONLY IPV Done on d d / m m / y y y y

AMC/Intermediary name OR code Seal/Stamp of the intermediary should contain Seal/Stamp of the intermediary should contain
Staff Name Staff Name
(Originals Verified) Self Certified Document copies received Designation Designation
Name of the Organization Name of the Organization
(Attested) True copies of documents received
Signature Signature
Main Intermediary
Date Date
CI
INSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM

A. IMPORTANT POINTS: Card/Registered Lease or Sale Agreement of Residence/Driving License/Flat

1. Self attested copy of PAN card is mandatory for all clients in Maintenance bill/Insurance Copy.
all type of change request.
2. Utility bills like Telephone Bill (only land line), Electricity bill or Gas bill
2. Copies of all the documents submitted by the applicant should be Not more than 3 months old.
self-attested and accompanied by originals for verification. In case
3. Bank Account Statement/Passbook - Not more than 3 months old.
the original of any document is not produced for verification, then
the copies should be properly attested by entities authorized for 4. Self-declaration by High Court and Supreme Court judges, giving the
attesting the documents, as per the below mentioned list. new address in respect of their own accounts.

3. If any proof of identity or address is in a foreign language, then 5. Proof of address issued by any of the following: Bank Managers of
translation into English is required. Scheduled Commercial Banks/Scheduled Co-Operative
Bank/Multinational Foreign Banks/Gazetted Officer/Notary
4. Name & address of the applicant mentioned on the KYC form, should
public/Elected representatives to the Legislative
match with the documentary proof submitted.
Assembly/Parliament/Documents issued by any Govt. or Statutory
5. If correspondence & permanent address are different, then proofs for Authority.
both have to be submitted.
6. Identity card/document with address, issued by any of the following:
6. Sole proprietor must make the application in his individual name & Central/State Government and its Departments,
capacity. Statutory/Regulatory Authorities, Public Sector Undertakings,
Scheduled Commercial Banks, Public Financial Institutions, Colleges
7. For non-residents and foreign nationals,(allowed to trade subject to
affiliated to Universities and Professional Bodies such as ICAI,
RBI and FEMA guidelines), copy of passport/PIOCard/OCICard and
ICWAI, ICSI, Bar Council etc.,to their Members.
overseas address proof is mandatory.
7. For FII/sub account, Power of Attorney given by FII/sub-account to
8. For foreign entities, CIN is optional; and in the absence of DIN no. for
the Custodians (which are duly notarized and/or apostiled or
the directors, their passport copy should be given.
consularised) that gives the registered address should be taken.
9. In case of Merchant Navy NRI’s, Mariner’s declaration or certified
8. The proof of address in the name of the spouse may be accepted.
copy of CDC (Continuous Discharge Certificate) is to be submitted.
D. Exemptions/clarifications to PAN
10. For opening an account with Depository participant or Mutual Fund,
(*Sufficient documentary evidence in support of such claims
for a minor, photocopy of the School Leaving Certificate/Mark sheet
to be collected.)
issued by Higher Secondary Board/Passport of Minor/Birth
Certificate must be provided. 1. In case of transactions undertaken on behalf of Central Government
and/or State Government and by officials appointed by Courts e.g.
11. Politically Exposed Persons (PEP) are defined as individuals who are
Official liquidator, Court receiver etc.
or have been entrusted with prominent public functions in a foreign
country, e.g., Heads of States or of Governments, senior 2. Investors residing in the state of Sikkim.
politicians, senior Government/judicial/military officers, senior
3. UN entities/multilateral agencies exempt from paying taxes/filing tax
executives of state owned corporations, important political party
returns in India.
officials, etc.
4. SIP of Mutual Funds upto Rs 50,000/- p.a.
B. Proof of Identity( POI): List of documents admissible as Proof
of Identity: 5. In case of institutional clients, namely, FIIs, Mfs, VCFs, FVCIs,
1. PAN card with photograph. This is a mandatory requirement for all Scheduled Commercial Banks, Multilateral and Bilateral
applicants except those who are specifically exempt from obtaining Development Financial Institutions, State Industrial Development
PAN (listed in Section D). Corporations, Insurance Companies registered with IRDA and Public
Financial Institution as defined under section 4A of the Companies
2. Aadhaar Number / Passport / Voter ID card / Driving license.
Act, 1956, Custodians shall verify the PAN card details with the
3. Identity card/ document with applicant’s Photo, issued by any of the original PAN card and provide duly certified copies of such verified
following: Central/State Government and its Departments, PAN details to the intermediary.
Statutory/Regulatory Authorities, Public Sector Undertakings,
E. List of people authorized to attest the documents:
Scheduled Commercial Banks, Public Financial Institutions, Colleges
1. Notary Public, Gazetted Officer, Manager of a Scheduled
affiliated to Universities, Professional Bodies such as ICAI, ICWAI,
Commercial/Co-operative Bank or Multinational Foreign Banks
ICSI, Bar Council etc., to their Members; and Credit cards/Debit cards
(Name, Designation & Seal should be affixed on the copy).
issued by Banks.
2. In case of NRIs, authorized officials of overseas branches of
C. Proof of Address (POA): List of documents admissible as Proof
Scheduled Commercial Banks registered in India, Notary Public,
of Address: (*Documents having an expiry date should be
Court Magistrate, Judge, Indian Embassy/Consulate General in the
valid on the date of submission.)
country where the client resides are permitted to attest the
1. Aadhaar Number / Passport / Voters Identity Card/Ration
documents.

Please Submit the KYC Documents on A4 Size Paper Only.