Keeles keÀe ÖekeÀej - Personal Banking, NRI Banking ... Opening... · Account Opening Form for Non-Resident Indian (NRI): Individual A ... TYPE OF ACCOUNT/ Keeles keÀe ÖekeÀej

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Tatkal Non-Tatkal Walk-in

Account Opening Form for Non-Resident Indian (NRI): IndividualA{Zdmgr�^maVr`�(EZAmaAmB©)�Ho$�{bE�ImVm�ImobZo�H$m�\$m°_©:�ì`[º�JV

Application Date:D D M M Y Y YY

Branch Code:

Date of Opening Account:ImVm�ImobZo�H$s�VmarI:

D D M M Y Y Y Y

H¥$n`m�\$m°_©�ñnîQ>�Ajam|�_|�hr�âo§&�*�(ñQ>ma)�{M•�dmbo�ImZm|�H$mo�âZm�A{Zdm`©�h¡&

I/ We wish to open my/ our Non-Resident Account at your branch.

_¢/h_�AmnH$s�-------------------------------- emIm�_|�AnZm�A{Zdmgr�ImVm�ImobZm�MmhVm�hÿ±/MmhVr�hÿ±/MmhVo�h¢&

NRE Preferred Account Number:EZAmaB©�ng¨XrXm�ImVm�g¨»`m:

To open multiple accounts, please check against respective account types/ EH$�go�A{YH$�ImVo�ImobZo�Ho$�{bE�H¥$n`m�g§~§{YV�ImVm�àH$mam|�Ho$�gm_Zo�{M•�bJmE§~

NRE/ EZAmaB© NRO/ EZAmaAmo

FCNR/ E\$grEZAma USD/ `yEgS>r GBP/ Or~rnr EURO/ `yamo CAD/ grES>r AUD/ E`yS>r YEN/ òZ

FCNR/ E\$grEZAma

Fixed Deposit amount/ _r`mXr�O_m�am{e ___________________________________ Rate of Interest/ ã`mO�Ho��Xa ______________________________ %

Fixed Deposit tenor in/ _r`mXr�O_m�H$s�Ad{Y ___________________ Yrs./ df©. ___________________ Months/ _mh _____________________ Days/ {XZ

I/ We would like to subscribe to the “My Account My Number” program and would like to select the above account number/s based on the search criteria below.

Signature of 1st applicant

nhbo�AmdoXH$�Ho$�hñVmja

_¢/h_� ""_oam� AH$mC§Q>� _oam� Z§~a''� `moOZm� Ho$� {Z~§YZ� Ed§� eVm]� go� gh_V� hÿ±/h¢� Am¡a� g_PVm�hÿ±/g_PVm�hÿ±/�g_PVo�h¢�{H$�IVmm�g§»`m�H$m�Am~§Q>Z�à`mg�Ho$�AmYma�na�hmoJm�Omo�{H$�D$na�Cpëb{IV�CËnmX�_|�AZwamoY�{H$E�JE�Z§~a�H$s�CnbãYVm�Ho$�AYrZ�hmoJm&

*I have been informed that I need to maintain an average balance of` _______________________ for the account type indicated above.

____________________________________________Cash `

________________________Cheque No./ DD No./ TT Ref No. dated ____________________ on ______________________

Bank for _____________________________ (Mention Amount

and Currency) (On IndusInd Bank Ltd. A/c (Account Title))

*_wPo�gww{MV�{H$`m�J`m�h¡�{H$�D$na�{Z{X©îQ>�ImVo�Ho$�{bE�_wPo _______________________________ ` H$m�Am¡gV�eof�~ZmE�aIZm�hmoJm&

____________________________________________ZH$X

TYPE OF ACCOUNT*/ Keeles keÀe ÖekeÀej*

Initial Deposit Details/ ÖeejbefYekeÀ pecee keÀe efJeJejCe:

Fixed Deposit/ ceer³eeoer pecee:

Debit my/ our existing IndusInd Bank Ltd NRE/ NRO A/c No.

for ` _______________________________________________

Sum of DigitsOR / ³ee

(Mention sum of digits you want as account number)

Choice Criteria*: ®e³eve ceeveob[*:

String

(Select 1-10 digits of the 12 digit account number)

_____________________ ` Ho$�{bE�_oam/h_mam�_m¡OyXm�B§S>gB§S>�~¢H$�{b.EZAmaB©/EZAmaAmo�ImVm�Z§Zm_o�H$a|&

_____________________________ (am{e�Ed§�H$a|gr�H$m�CëboI�H$a|) ______________________(B§S>gB§S>�~¢H$�{b.�ImVm�(ImVm�erf©H$)�H$m

_______________ ~¢H$�H$m,�{XZm§H$ H$m�MoH$�Z§./S>r�S>r�Z§/Q>r�Q>r�g§X^©�g§.__________________________________________________

Current Account: NROEZAmaAmo

Both (NRE & NRO)Mmby�ImVm oesveesW (SveDeejF& Deewj SveDeejDees)

NREEZAmaB©

Indus SelectB§S>g�[gboŠQ�

Indus ExclusiveB§S>g�EŠgŠë`y{gd

Indus MaximaB§S>g�_¡pŠg_m

Savings Account:~MV�ImVm

NROEZAmaAmo

Both (NRE & NRO)oesveesW (SveDeejF& Deewj SveDeejDees)

Regularao½`wba

NREEZAmaB©

Product Variant (Select any one)CËnmXZ�Ho��àH$ma�([H�gr�EH��H�mo�MwZ|)

Account Type (Select any one)ImVm�àH$ma�([H�gr�EH��H�mo�MwZ|)

NRO Preferred Account Number:EZAmaAmo�ng¨XrXm�ImVm�g¨»`m:

Sum of DigitsOR / ³ee

(Mention sum of digits you want as account number)

String

(Select 1-10 digits of the 12 digit account number)

NRESveDeejF&

NROSveDeejDees

I/ We hereby agree to the terms and conditions of “My Account My Number” program and understand that the allocation of account numbers shall be done on best effort basis, subject to the availability of the requested number in the product mentioned above.

VËH mb J¡a-VËH mb dmH -BZ

emIm�H moS

AmdoXZ�H s�VmarI

(Omo�ImVm�Z¨~a�Amn�MmhVo�h¢�CZ�A¨H mo�H m�OmoS�gy{MV�H ao§)

pñQ—¨ J

pñQ—¨ J

A§H mo�H m�OmoS

A§H mo�H m�OmoS

(Omo�ImVm�Z¨~a�Amn�MmhVo�h¢�CZ�A¨H mo�H m�OmoS�gy{MV�H ao§)(12�A§H$m|�Ho$�ImVm�Z§~a�_|�go�1-10�A§H$�MwZ|)

(12�A§H$m|�Ho$�ImVm�Z§~a�_|�go�1-10�A§H$�MwZ|)

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APPLICANT/S DETAILS/ AmdoXH/H$m|�H$m/Ho$�{ddaU

Name*: Mr/Mrs/Ms/Dr/OthersZm_*:�lr/lr_Vr/gwlr/S>m°./AÝ`

Country of Residence*:{Zdmg�H$m�Xoe*:

Nationality*:amîQ´>r`Vm*:

Passport No*:nmgnmoQ>©�Z§.*: D D M M Y Y Y YD D M M Y Y Y YOmar�H�aZo�H$s�VmarI*:

Date of Issue*: Date of Expiry*:g_mßV�hmoZo�H$s�VmarI*:

[dXoe�_o§�[Zdmg�Ho��gmb*:

STATE:amÁ`:PIN/ ZIP*:{nZ/�{µOn*:

COUNTRY*:Xoe*:

Overseas Address*:{dXoe�H$m�nVm�*:

Tel. No. Resi.:Q>obr.�Z§.�{Zdmg:

Country Code amï´>r`�H$moS> Area Code joÌr`�H$moS> Number Z§~a

Off.:H$m`m©b`.:


Fax:\¡$Šg:


Mobile No.*:_mo~mBb�Z§.*:

Country Code amï´>r`�H$moS> Number Z§~a

Renew principal and remit interest by pay order_ybYZ�H$m�ZdrH$aU�H$a|�Am¡a�ã`mO�H$s�am{e�H$mo�no�AmS>©a�Ho$�O[aE�ào{fV�H$a|

Remit proceeds by pay order to the mailing addressAmJ_�am{e�H$mo�no�AmS>©a�Ho$�Ûmam�nÌmMma�Ho$�nVo�na�ào{fV�H$a|Credit proceeds to existing account no. __________________AmJ_�am{e�H$mo�{dÚ_mZ�ImVm�g§.�___________________|�O_m�H$a|Other _____________________________________________

Reinvest with principal amount_ybYZ�am{e�Ho$�gmW�nwZ{Z©doeOther _____________________________________________________ AÝ` AÝ`

DEPOSIT MATURITY INSTRUCTIONS O_m�n[anŠdVm�AZwXoeã`mO�^wJVmZ�AZwXoe�(_r`mXr�O_mAm|�Ho$�{bE�A{Zdm`©)

Renew along with interest for the same periodCgr�Ad{Y�Ho$�{bE�ã`mO�g{hV�ZdrH$aU�H$a|

Credit my/ our account no. _____________________________ with you (quarterly)

Issue pay order/ DD in_______________________ and mail to me/us at the mailing address (quarterly)

[mention currency]

AmnHo$�̀ hm§�_m¡OyX�_oao/�h_mao�ImVm�g§.�______________________________|�O_m�H$a|�({V_mhr�AmYma�na)

_______________________ _|�no�AmS>©a/�S>rS>r�Omar�H$a|�Am¡a�Cgo�_wPo/�h_|�nÌmMma�Ho$�nVo�na�S>mH$�go�̂ oO�X|�({V_mhr�AmYma�na)

[H$a|gr�H$m�CëboI�H$a|]

Note - Interest on FCNR deposits is compounded half-yearly./�{Q>ßnUr�-�E\$grEZAma�{S>nm°{OQ>�na�ã`mO�N�_mhr�_|�Omo‹Sr�OmVr�h¡&

Cust ID (For Existing Customer)/ J«mhH$�AmB©S>r�(_m¡OyXm�J«mhH$�Ho$�{bE):

F I R S T T NN NM MM MI D D L E EE E L A AA A S



Type of Visa/ Labour Card/ Work Permit*: __________________________________ {d‹Om/�bo~a�H�mS©/�dH©��na_rQ�Ho��àH$ma��(Visitor & Business Visas are not allowed/ AmJ§VwH��Am¡a�ì`mnma�{d‹Om�H�r�AZw_{V�Zht�h¡)

Place of Issue*:Omar�H�aZo�H�m�ñWmZ*:

D D M M Y Y Y YDate of becoming Non-Resident Indian*:

A{Zdmgr�hmoZo�H$s�VmarI*:

1 1For NR accounts, PAN is mandatory, in the absence of which Form 60 is to be provided./ EZAma�ImVo�Ho$�{bE�n¡Z�A{Zdm`©�h¡&�n¡Z�Z�hmoZo�na�\$°m_©�60�àñVwV�{H$`m�OmE&

_m±�H$m�{ddmhnyd©�Zm_*:

E-mail ID*:B©-_ob�AmB©S>r*:Indian Address:^maVr`�nVm:

CITY/ TOWN/ PROVINCE:Landmark:eha/�ZJa/�amÁ`:

D D M M Y Y Y YDate of Birth*:OÝ_�{V{W*:

1PAN No. :1n¡Z�Z§. :_{hbm

Female nwéf�MaleGender*:

qbJ*:

City of Birth*:OÝ_�eha*:

Country of Birth*:OÝ_�Xoe*:

b¢S>_mH©$:

Mobile No.:_mo~mBb�Z§.:

Preferred Address for Communication: Overseas Indian (please Tick)nÌmMma�Ho$�{bE�dar`�nVm: {dXoe�H$m ^maVr`�(H¥$n`m�{ZemZ�bJmE§)

Country Code amï´>r`�H$moS> Number Z§~a

Fax:\¡$Šg:



COUNTRY*:Xoe*:



Off.:H$m`m©b`.:


CITY/ TOWN/ PROVINCE:Landmark:eha/�ZJa/�amÁ`:b¢S>_mH©$:

Visa No.*:{dµOm�H«$_m§H$*: {dµOm�OmarH$aU�{XZm§H$*:

Visa Issuance Date*: Visa Expiry Date*:D D M M Y Y Y Y D D M M Y Y Y Y{dµOm�g_m{á�{V{W*:

Third GenderAÝ`�qbJ

CKYC ID:

Marital Status*: Married / Single / Others /

Residential Status*: Non Resident Indian Person of Indian Origin( PIO) Foreign National

grHo dm`gr�AmBS© r:

{ddm{hV A{ddm{hV AÝ`d¡dm{hH$�pñW{V*:

^maVr`�_yb�H m�ì`{ŠV�(�nrAmB©Amo�)A{Zdmgr�^maVrÀdmgr`�pñW{V: {dXoer�ZmJ{aH

Fax:\¡$Šg:

Mobile No.:_mo~mBb�Z§.:

E-mail ID*:B©-_ob�AmB©S>r*:

Overseas Address*:{dXoe�H$m�nVm*:

Indian Address:^maVr`�nVm:

RELATIONSHIP DETAILS/ g§~§Y�{ddaUIndus Smart Sweep Instructions/�B§S>g�ñ_mQ>©�ñdrn�AZwXoe

H¥$n`m�_oao�/h_mao�~MV�ImVo�Ho$�{bE�"B§S>g�ñ_mQ>©�ñdrn'�g{H«$`�H$a|�{OgHo$�A§VJ©V�_oao/�h_mao�ImVo� _|� `� 1,00,000/-� (ao½`wba�ImVo� Ho$� {bE),�AWdm� `� 2,00,000/-� (B§S>g�_¡pŠg_m�ImVo�Ho$�{bE),�`�3,00,000�(B§S>g�[gboŠQ�ImVo�Ho$�{bE),�`�5,00,000�(B§S>g�EŠgŠë`y{gd�ImVo�Ho$�{bE),�go�A{YH$�am{e�hmoZo�na�Cgo�`�25,000/-�Ho$�JwUOm|�_|�_r`mXr�O_mam{e�Ho$�ê$n�_|�~wH$�{H$`m�Om�gHo$&

H¥$n`m�_r`mXr�O_m�H$mo �1�df© 2�df©��H$s�Ad{Y�Ho$�{bE�~wH$�H$a|

_oao/�h_mao�~MV/�Mmby�ImVm�g§. ________________________ _|�n`m©ßV�eof�am{e�Z�hmoZo�na,�H¥$n`m�_oao/�h_mao�~MV/�Mmby�ImVm�g§.�________________________ �go�{Z{Y`m§�A§V[aV�H$aHo$�AWdm�_oao/�h_mao�_r`mXr�O_m�ImVm�g§.�___________________��H$s�̀ y{ZQ>m|�H$mo�Vmo‹S>H$a�MoH$m|�H$m�emoYZ�H$a|&

Mode of Operation*/ n[aMmbZ�{d{Y*Single/ EH$b 1 1Either or Survivor / XmoZmo§�_|�go�H$moB©�EH$�`m�CÎmaOrdr 2 2Any one or Survivor / H$moB©�EH$�AWdm�CÎmaOrdr All Jointly / g^r�g§`wŠV�ê$n�go

Others (please specify)/ AÝ`�(H¥$n`m�CëboI�H$a|)� ______________________________

1 1Applicable only in case of 2 applicants/ Ho$db�2�AmdoXH$�dmbo�_m_bo�_|�bmJy�2 2Applicable only in case there are more than 2 applicants/ Ho$db�2�go�A{YH$�AmdoXH$�dmbo�_m_bm|�_|�bmJy

Name*: Mr/Mrs/Ms/Dr/OthersZm_*:�lr/lr_Vr/gwlr/S>m°./AÝ`

Place of Issue:Omar�H�aZo�H�m�ñWmZ:

stRelationship with 1 Applicant:nhbo�AmdoXH$�go�[aíVm:

Passport No:nmgnmoQ>©�Z§.:

Date of Issue:

Omar�H�aZo�H$s �VmarI:

Date of Expiry:

g_mßV�hmoZo�H$s�VmarI:D D M M Y Y Y YD D M M Y Y Y Y

Country of Residence*:{Zdmg�H$m�Xoe*:

Nationality*:amîQ´>r`Vm*:[dXoe�_o§�[Zdmg�Ho��gmb:

Cust ID (For Existing Customer) / J«mhH$�AmB©S>r�(_m¡OyXm�J«mhH$�Ho$�{bE):



F I R S T T NN NM MM MI D D L E EE E L A AA A S_m±�H$m�{ddmhnyd©�Zm_*:

D D M M Y Y Y YDate of Birth*:OÝ_�{V{W*:

1PAN No. :n¡Z�Z§.:_{hbm

Female nwéf�MaleGender*:

qbJ*:

City of Birth*:OÝ_�eha*:

Country of Birth*:OÝ_�Xoe*:

Fax:\¡$Šg:

Mobile No.*:_mo~mBb�Z§.*:

Country Code amï´>r`�H$moS> Number Z§~aCountry Code amï´>r`�H$moS> Area Code joÌr`�H$moS> Number Z§~a

Country Code amï´>r`�H$moS> Area Code joÌr`�H$moS> Number Z§~a Country Code amï´>r`�H$moS> Number Z§~a

`

` ``

` .

2,00,000


COUNTRY*:Xoe*:



Off.:H$m`m©b`.:




COUNTRY*:Xoe*:



Off.:H$m`m©b`.:



D D M M Y Y Y YDate of becoming Non-Resident Indian:A{Zdmgr�hmoZo�H$s�VmarI*:

Type of Visa/ Labour Card/ Work Permit: _________________________ {d‹Om/�bo~a�H�mS©/�dH©��na_rQ�Ho��àH$ma��

(Visitor & Business Visas are not allowed/ AmJ§VwH��Am¡a�ì`mnma�{d‹Om�H�r�AZw_{V�Zht�h¡)Visa No.: Visa Issuance Date: Visa Expiry Date:D D M M Y Y Y Y D D M M Y Y Y Y{dµOm�OmarH$aU�{XZm§H$: {dµOm�g_m{á�{V{W:��{dµOm�H«$_m§H$:

Third GenderAÝ`�qbJ

1 1For NR accounts, PAN is mandatory, in the absence of which Form 60 is to be provided./ EZAma�ImVo�Ho$�{bE�n¡Z�A{Zdm`©�h¡&�n¡Z�Z�hmoZo�na�\$°m_©�60�àñVwV�{H$`m�OmE&

Residential Status*: Non Resident Indian Person of Indian Origin( PIO) Resident Indian Foreign National

Marital Status* / Married / {ddm{hV Single / A{ddm{hV Others /AÝ`d¡dm{hH$�pñW{V*:

CKYC ID:grHo dm`gr�AmBS© r:

Admgr`�pñW{V: A{Zdmgr�^maVr` ^maVr`�_yb�H m�ì`{ŠV�(�nrAmB©Amo�) {Zdmgr�^maVr` {dXoer�ZmJ{aH

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Documents Submitted/ àñVwV�{H$E�JE�XñVmdoOND2 APPLICANT / Xygam�AmdoXH$ST1 APPLICANT / nhbm�AmdoXH$

Duly completed Account Opening form/s / {d{YdV�âm�J`m/âo�JE�ImVm�ImobZo�H$m/Ho$�\$m_© Duly completed Account Opening form/s / {d{YdV�âm�J`m/âo�JE�ImVm�ImobZo�H$m/Ho$�\$m_©

One Recent Photograph/ EH$�ZdrZV_�\$moQ>moJ«m\$

Copy of Visa/ Resident Permit/ drOm/�{Zdmg�na{_Q>�H$s�à{V�Copy of Visa/ Resident Permit/ drOm/�{Zdmg�na{_Q>�H$s�à{V

Copy of CDC & Employment contract, in case of Mariners_¡[aZg©�Ho$�_m_bo�_|,�grS>rgr�Ed§�{Z`moOZ�H$m°ÝQ´>¡ŠQ>�H$s�à{V

Copy of CDC & Employment contract, in case of Mariners_¡[aZg©�Ho$�_m_bo�_|,�grS>rgr�Ed§�{Z`moOZ�H$m°ÝQ´>¡ŠQ>�H$s�à{V

PAN Card copy/ Form 60/ n¡Z�H$mS>©�à{V/�\$m°_©�60

Direct Banking (Accounts with Joint mode of operations not eligible) / S>mBaoŠQ>�~¢qH$J�(g§`wŠV�n[aMmbZ�{d{Y�dmbo�ImVo�nmÌ�Zht�h¢)

Net Banking/ ZoQ>�~¢qH$J Phone Banking/ \$moZ�~¢qH$J

NRE/ NRO Regular NRE/ NRO Maxima NRE/ NRO Select NRE/ NRO ExclusiveEZAmaB©/�EZAmaAmo�ao½`wba EZAmaB©/�EZAmaAmo�_¡pŠg_m EZAmaB©/�EZAmaAmo�[gboŠQ EZAmaB©/�EZAmaAmo�EŠgŠë`y{gd

NRO(For Domestic Useonly) - Tick any one




EZAmaAmo�(Ho�db�KaobyBñVo_mb�Ho��{bE)�-�

H�moB©�EH��MwZob







Regular / ao½`wba

Gold Chip / JmoëS>�[Mn

Platinum Chip/ßb¡[QZ_�[Mn

NA/ bmJy�Zhr¨ NA/ bmJy�Zhr¨ NA/ bmJy�Zhr¨ NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

NA/ bmJy�Zhr¨

If you have applied for an IndusInd Bank Debit Card, please mention your name as you want it to be embossed on your card:

`{X�AmnZo�B¨S gB¨S�~¢H��S>o{~Q>�H$mS>©�Ho��{bE�AmdoXZ�{H�`m�h¡�Vmo�H$mS>©�na�Ab¨H¥�V�H�aZo�dmbo�Zm_�H�m�CëboI�H�a|&First Applicant/ nhbm�AmdoXH$ Second Applicant/ Xygam�AmdoXH$

For charges & fees, please refer to our Schedule of Charges. Terms and Conditions apply. Debit Card will not be issued in case the appropriate checkbox is not ticked. SMS Alerts to International Mobile numbers available only in select countries. In case appropriate checkbox is not ticked under SMS Alerts, the alerts will be sent on the Mobile No. corresponding to the Preferred Address for Communication opted.

S>o{~Q>/�[MnS>o{~Q>�H$mS>©

[dŠbnEZAmaB©�-�

H�moB©�EH��MwZobEZAmaB©�-�




à^mam|�Ed§�ewëH$m|�Ho$�{bE,�H¥$n`m�h_mar�à^ma�AZwgyMr�XoI|&�{Z~§YZ�Ed§�eV]�bmJy�hm|Jr&�̀ {X�Cn`wŠV�{dH�ën�Zht�MwZm�OmVm�h¡�Vmo�S>o{~Q>�H$mS>©�Omar�Zht�{H�`m�OmEJm&�A§VaamîQ´>r`�_mo~mBb�Z§~am|�na�EgE_Eg�AbQ>©�H$s�gw{dYm�Ho$db�MwqZXm�Xoem|�_|�hr�CnbãY�h¡&�̀ {X�Eg�E_�Eg�EbQ>©�Ho$�ZrMo�ghr�Mm¡admZo�na�ghr�H$m�{ZemZ�Z�bJm`m�J`m�hmoJm�Vmo�EbQ²>©g�g§Xoe/~mVMrV�Ho$�{bE�{XE�JE�ng§X�{H$E�nVo�_|�_m¡OyX�_mo~mBb�Z§.�na�̂ oOo�OmE§Jo.

E-Statement/ B©-ñQ>oQ>_|Q>

OCCUPATION*:ì`dgm`*:

EDU QUALIFICATIONS*:e¡j{UH$�`mo½`VmE§*:

Retiredgodm{Zd¥Îm

House-wifeJ¥{hUr

StudentNmÌ

Others:AÝ`�:

Please Specify

H¥$n`m�CëboI�H$a|

IF SELF EMPLOYEDPROFESSIONALS*:

DoctorSm°ŠQa

EngineerB§Or{Zà

CA-CSgrE-grEg

Others:AÝ`�:

Please Specify / H¥$n`m�CëboI�H$a|`[X�ñd-{Z`mo{OVì`mdgm{`H�*:

LawyerdH�sb

ArchitectAm[H©�QoŠQ

IT ConsultantAmB©Qr�gbmhH�ma

DoctorSm°ŠQa

EngineerB§Or{Zà

CA-CSgrE-grEg

Others:AÝ`�:

Please Specify / H¥$n`m�CëboI�H$a|

LawyerdH�sb

ArchitectAm[H©�QoŠQ

IT ConsultantAmB©Qr�gbmhH�ma

Retiredgodm{Zd¥Îm

House-wifeJ¥{hUr

StudentNmÌ

Others:AÝ`�:

Please Specify

H¥$n`m�CëboI�H$a|

PAN Card copy/ Form 60/ n¡Z�H$mS>©�à{V/�\$m°_©�60

CUSTOMER PROFILE FORM KYC CHECK LIST/ J«mhH$�àmo\$mBb�\$m°_©-�Ho$dmB©gr�Om±M�gyMrST1 APPLICANT*/ nhbm�AmdoXH$* ND 2 APPLICANT*/ Xygam�AmdoXH$*

SalarieddoVZ^moJr

Self-Employedñd-{Z`mo{OV

Self-Employed Professionalsñd-{Z`mo{OV�ì`mdgm{`H

SalarieddoVZ^moJr

Self-Employedñd-{Z`mo{OV

Self-Employed Professionalsñd-{Z`mo{OV�ì`mdgm{`H

Signature Chip/ {g¾Ma�[Mn

Others(Please mention Card Type)

AÝ`(H$¥ n`m�H$mS>�© H$o �àH$ma�~VmE)§

For NRE/FCNR (B) accounts, where Second Applicant is a Resident Close Relative (as defined in section 2 (77) of the Companies Act 2013)/ For NRO accounts, where Second Applicant is a Resident Indian / EZAmaB©/E\$grEZAma�(~r)�ImVm|�Ho$�{bò,�{OZ_|�Xÿgam�AmdoXH$�EH$�{Zdmgr�H$ar~r�[aíVoXma�h¡�(O¡gm�{H$�H§$nZr�A{Y{Z`_�2013�H$s�Ymam�2�(77)�_|�n[a^m{fV�h¡)/EZAmaAmo�ImVm|�Ho$�{bò,�{OZ_|�Xÿgam�AmdoXH$�EH$�{Zdmgr�̂ maVr`�h¡

I hereby declare that the Second Applicant is a Resident Close Relative (as defined in section 2 (77) of the Companies Act 2013) /� �_¢�KmofUmH$aVm/H$aVr�h±ÿ±ÿ�{H$�Xÿgam�AmdoXH$�EH$�{Zdmgr�H$ar~r�[aíVoXma�h¡�(O¡gm�{H$�H§$nZr�A{Y{Z`_�2013�H$s�Ymam�2�(77)�_|�n[a^m{fV� )h¡

For NRO accounts / EZAmaAmo ImVm| Ho$ {bò

I hereby declare that the Second Applicant is a Resident Indian / h¡�_¢�KmofUm�H$aVm/H$aVr�h±ÿ�{H$�Xÿgam�AmdoXH$�EH$�{Zdmgr�^maVr`�Relationship between the First and Second Applicants / nhbo Am¡a Xygao AmdoXH Ho ~rM _| g§~§Y _________________________________In case the joint applicant for an NRE/FCNR (B) accounts is a Resident Close Relative (as defined in section 2 (77) of the Companies Act 2013)/ the joint applicant for an NRO account is a Resident Indian, the Mode Of Operation will be:/EZAmaB©/E\$grEZAma�(~r)�ImVm|�Ho$�{bò,�{OZ_|�Xÿgam�AmdoXH$�EH$�{Zdmgr�H$ar~r�[aíVoXma�h¡�(O¡gm�{H$�H§$nZr�A{Y{Z`_�2013�H$s�Ymam�2�(77)�_|�n[a^m{fV�h¡)/EZAmaAmo�ImVm|�Ho$�{bò,�{OZ_|�Xÿgam�AmdoXH$�EH$�{Zdmgr�̂ maVr`�h¡,�n[aMmbZ�{d{Y�hmoJm

Former Or Survivor /

Please Note: Resident applicant cannot operate the account or deposit any proceeds in his/her name into the account. Only the NR applicant will be the authorized signatory permitted to operate the account /H¥ n`m�ZmoQ�H ao§�:{Zdmgr�AmdoXH��ImVm�n{aM{bV�Zht�Ha�gH Vm�`m�Bg�ImVo�_o§�AnZo�Zm_�_o§�Am`�O_m�Zht�H a�gH Vm�/�gH Vr�&�Ho db�A{Zdmgr�^maVr`�AmdoXH��ImVo�_|�àm{YH¥ V�hñVjaH Vm©�hmoJm

For NRE/FCNR (B) accounts /�EZAmaB©/E\$grEZAma�(~r) ��ImVm|�Ho$�{bò

Note: UID(Aadhar Card) / Voter Identity Card can be accepted for Indian address proof only./ {Q>ßnUr:� �̀y AmB�© S>r�(AmYma�H$mS>)© �/�_VXmVm�nhMmZ�nÌ�H$o db�^maVr`�nVm�à_mU�H$o �{bE�hr�ñdrH$ma�{H$E�OmEJ§ �o &�

Overseas Mobile No./ {dXoer�_mo~mBb�Z§~aIndian Mobile No./^maVr`�_mo~mBb�Z§~a

One Recent Photograph/ EH$�ZdrZV_�\$moQ>moJ«m\$

& &

SMS Alert/ EgE_Eg�AbQ>©(Tick any one /([H�gr�EH��H�mo�MwZ|)

nhbm AWdm CËVaOrdr

Address proof document/ nVo�Ho��à_mU H m XñVmdOo �( Tick any one/[H�gr�EH��H�mo�MwZ|): �

Passport / nmgnmoQ>©� Driving Licence / S´mB{d¨J bmB©g|g

UID (Aadhar Card) / `�y AmB�© S>r�(AmYma�H$mS>)© Voter Identity Card / _VXmVm�nhMmZ�nÌ

Address proof document No. (If available) / nV�o H�o �à_mU�H m�H�§« �(`{X�CnbãY�hm)o _________ Address proof document Expiry date (If available)/ nVo�Ho��à_mU�H r�g_mßVr�H r�VmarI�(`{X�CnbãY�hmo)________________

Others / ________________ AÝ`

Address proof document/ nVo�Ho��à_mU H m XñVmdOo �( Tick any one/[H�gr�EH��H�mo�MwZ|): �

Passport / nmgnmoQ>©� Driving Licence / S´mB{d¨J bmB©g|g

UID (Aadhar Card) / `�y AmB�© S>r�(AmYma�H$mS>)© Voter Identity Card / _VXmVm�nhMmZ�nÌ

Address proof document No. (If available) / nV�o H�o �à_mU�H m�H�§« �(`{X�CnbãY�hm)o _________ Address proof document Expiry date (If available)/ nVo�Ho��à_mU�H r�g_mßVr�H r�VmarI�(`{X�CnbãY�hmo)________________

Others / ________________ AÝ`

Page 5

MONTHLY INCOME*:

_m{gH$�Am`*:

LINE OF BUSINESS / INDUSTRY (In case of salaried persons that of the employer)*:

H$mamo~ma/CÚmoJ�H$m�àH$ma(doVZ^moJr�ì`pŠV`m|�Ho$�_m_bo�_|�{Z`moŠVm�H$m�H$mamo~ma/CÚmoJ)*:

ARE YOU A POLITICALLY EXPOSED PERSON (PEP)?*

Š`m�Amn�amOZr{VH$�{Oå_oXmardmbo�ì`pŠV�(nrB©nr)�h¢?*

` 10,001 to ` 25,000`�10,001�g�o `�25,000` 50,001 to ` 1,00,000`�50,001�g�o `�1,00,000

Upto ` 10,000 `10,000�VH$` 25,001 to ` 50,000 `�25,001�g�o `�50,000��Above ` 1,00,000`�1,00,000�g�o A{YH$

Yes / hm± No / Zht Yes / hm± No / Zht

` 10,001 to ` 25,000`�10,001�go�`�25,000` 50,001 to ` 1,00,000`�50,001�go�`�1,00,000

Upto ` 10,000 `10,000�VH$` 25,001 to ` 50,000 `�25,001�go�`�50,000��Above ` 1,00,000`�1,00,000�go�A{YH$

Mfg {d{Z_m©U

Real Estate [a`b�BñQ>oQ>

Trader ì`mnmar

Bullion~w{b`Z

Stock ñQ>m°H$

Broker ~«moH$a

Agri H¥${f

Others:AÝ`


Mfg {d{Z_m©U

Real Estate [a`b�BñQ>oQ>

Trader ì`mnmar

Bullion~w{b`Z

Stock ñQ>m°H$

Broker ~«moH$a

Agri H¥${f

Others:AÝ`


NATURE OF ORGANISATION (In case of salaried persons that of the employer)*:g§JR>Z�H$m�ñdê$n�(doVZ^moJrì`pŠV`m|�Ho$�_m_bo�_|�{Z`moŠVmHo$�g§JR>Z�H$m�ñdê$n)*:

Proprietary ñdm{_Ëd

Partnership ^mJrXmar

Unlisted Co.J¡a-gyMr~Õ�H§$nZr

Listed Co.gyMr~Õ�H§$nZr

MNCs E_EZgrEg

PSU/ Govt Sector nrEg`y/�gaH$mar�joÌ

Others:AÝ`


Proprietary ñdm{_Ëd

Partnership ^mJrXmar

Unlisted Co.J¡a-gyMr~Õ�H§$nZr

Listed Co.gyMr~Õ�H§$nZr

MNCs E_EZgrEg

PSU/ Govt Sector nrEg`y/�gaH$mar�joÌ

Others:AÝ`


DECLARATIONS/ KmofUmE§(Of the declarations that follow, sign one or more if applicable) / (ZrMo�Xr�JB©�KmofUmAm|�_|�go�bmJy�hmoZo�na�EH$�AWdm�A{YH$�KmofUmAm|�na�hñVmja�H$a|)

Person of Indian Origin (PIO) Declaration ^maVr`�_yb�Ho$�ì`pŠV�(nrAmB©Amo)�KmofUm

Loan Amt./ F$U�am{eCar LoanH$ma�F$UHome LoanAmdmg�F$UConsumer LoanCn^moŠVm�F$UOthersAÝ`

àñVm{dV�ImVo�_|�g§ì`dhmam|�Ho$�{ddaUDetails of Existing Loans with Other BanksAÝ`�~¢H$m|�go�{bE�JE�{dÚ_mZ�F$Um|�Ho$�{ddaU

Expected value of Transactions in a month*EH$�_mh�_|�{H$E�OmZo�dmbo�g§ì`dhmam|�H$m�AZw_m{ZV�_yë`*

No. of Transactions in a month*EH$�_mh�_|�{H$E�OmZo�dmbo�g§ì`dhmam|�H$s�g§»`m*

Value of Cash Transactions in a month*EH$�_mh�_|�{H$E�OmZo�dmbo�ZH$X�g§ì`dhmam|�H$m�_yë`*

No. of Cash Transactions in a month*EH$�_mh�_|�{H$E�OmZo�dmbo�ZH$X�g§ì`dhmam|�H$s�g§»`m*

EMI/ B©E_AmB©`_________________`

`_________________`

`_________________`

`_________________`

`_________________`

`_________________`

`_________________`

`_________________`

`

`

I ________________________________________ (2nd account holder) hereby declare that I am a Person of Indian Origin (and I am not a citizen of Pakistan or Bangladesh) and I satisfy one of the below mentioned conditions:

I ________________________________________ (1st account holder) hereby declare that I am a Person of Indian Origin (and I am not a citizen of Pakistan or Bangladesh) and I satisfy one of the below mentioned conditions:

_¢�_____________________ (nhbm�ImVm�YmaH$)�EVXÛmam�KmofUm�H$aVm�hÿ±/H$aVr�hÿ±/H$aVo�h¢�H$s�_¢�^maVr`�_yb�H$m/H$s/Ho$�ì`pŠV�hÿ±/h¢�Am¡a�nm{H$ñVmZ�AWdm�~m§JbmXoe�H$m/H$s�ZmJ[aH$�Zht�hÿ±/h¢�Am¡a�_¢�{ZåZ{b{IV�eVm]�_|�go�EH$�eV©�nyar�H$aVm�hÿ±/H$aVr�hÿ±/H$aVo�h¢&�

_¢�_____________________ (Xygam�ImVm�YmaH$)�EVXÛmam�KmofUm�H$aVm�hÿ±/H$aVr�hÿ±/H$aVo�h¢�H$s�_¢�^maVr`�_yb�H$m/H$s/Ho$�ì`pŠV�hÿ±/h¢�Am¡a�nm{H$ñVmZ�AWdm�~m§JbmXoe�H$m/H$s�ZmJ[aH$�Zht�hÿ±/h¢�Am¡a�_¢�{ZåZ{b{IV�eVm]�_|�go�EH$�eV©�nyar�H$aVm�hÿ±/H$aVr�hÿ±/H$aVo�h¢&�

SOURCE OF FUNDS*:{Z{Y`m|�Ho$�òmoV*:

Salary doVZ

Business Investment {Zdoe

GiftCnhma

Professional Feeì`mdgm{`H$�ewëH$

Others:AÝ`�:

Please Specify / H¥$n`m�CëboI�H$a|H$mamo~ma

Others:AÝ`�:


Salary doVZ

Business H$mamo~ma

Investment {Zdoe

GiftCnhma

Professional Fee ì`mdgm{`H$�ewëH$

J«mhH$�Ûmam�BñVo_mb�{H$E�OmgH$Zo�dmbo�Ano{jV�CËnmX*:

Drafts POs Cross-Border Remittances

Forward Contracts

S´>mâQ> nrAmo'g gr_m�nma�go�àofU

dm`Xm�g§{dXmTraveler’s Cheque`mÌr�MoH$

Drafts POs Cross-Border Remittances

Forward Contracts

S´>mâQ> nrAmo'g gr_m�nma�go�àofU

dm`Xm�g§{dXmTraveler’s Cheque`mÌr�MoH$

DECLARATION AS PER FATCA-CRS*

Yes / hm±

No / ZhtŠ`m�Amn�^maV�Ho$�Abmdm�{H$gr�AÝ`�Xoe�Ho$�H$aXmVm�{Zdmgr�h¢?

`{X�hm±,�Vmo�H¥$n`m�{ZåZ{b{IV�OmZH$mar�X|&�H¥$n`m�CZ�Xoem|�H$s�OmZH$mar�X|,�{OZHo$�Amn�H$aXmVm�{Zdmgr�h¢�Am¡a�ZrMo�g§~Õ�Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�(H$a�nhMmZ�g§»`m)�~Vm`|

�\�Q H m-grAmaEgH$�o AZwgma�KmofUm*

`{X�hm±,�Vmo�H¥$n`m�{ZåZ{b{IV�OmZH$mar�X|&�H¥$n`m�CZ�Xoem|�H$s�OmZH$mar�X|,�{OZHo$�Amn�H$aXmVm�{Zdmgr�h¢�Am¡a�ZrMo�g§~Õ�Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�(H$a�nhMmZ�g§»`m)�~Vm`|

Country Identification Type(TIN or Others, please specify)

Xoe Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�(Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�CnbãY�Z�hmoZo�na,�H¥$n`m�BgHo$�g_Vwë`�H$m`©H$mar�OmZH$mar�X|)

nhMmZ�H$m�àH$ma�(Q>rAmBEZ�`m�AÝ`,�H¥$n`m�ñnï>�H$a|)

Country Identification Type(TIN or Others, please specify)

Xoe Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�(Q>¡Šg�AmBS>|{Q>{\$Ho$eZ�Z§~a�CnbãY�Z�hmoZo�na,�H¥$n`m�BgHo$�g_Vwë`�H$m`©H$mar�OmZH$mar�X|)

nhMmZ�H$m�àH$ma�(Q>rAmBEZ�`m�AÝ`,�H¥$n`m�ñnï>�H$a|)

Yes / hm±

No/ ZhtŠ`m�Amn�^maV�Ho$�Abmdm�{H$gr�AÝ`�Xoe�Ho$�H$aXmVm�{Zdmgr�h¢?

&

If YES, please provide the following information. Please indicate all the countries in which you are a resident for tax purposes and the associated Tax Identification Number below

If YES, please provide the following information. Please indicate all the countries in which you are a resident for tax purposes and the associated Tax Identification Number below

Page 6

g§ajH$�H$m�Zm_: ________________________________________________

_________________________________________________________

nyam�nVm: ____________________________________________________

_________________________________________________________

eha:_________________________ Xoe: _________________________

_¢ � EVX ²Ûmam� Km ofUm� H$aVm /� H$aVr � {H$� Ad`ñH$,� Om o � _ oam/� _ oar �� h ± ÿ � h ± ÿ_________________________ h¡,�H$s�OÝ_�{V{W�___________ h¡�Am¡a�_¢�{XZm§H$�___________Ho$�Ý`m`mb`�AmXoe�Ûmam�{Z`wŠV�CgH$m/�CgH$s�Z¡g{J©H$�Ed§�{d{Y_mÝ`�g§ajH$�hÿ±�(à{V�g§b½Z)&_¢�Cn`w©ŠV�Ad`ñH$�go�g§~§{YV�g^r�^mdr�g§ì`dhmam|�Ho$�{bE�V~�VH$�Ad`ñH$�H$m�à{V{YËd�H$é±Jm/� H$é±Jr� O~� VH$� {H$� CŠV�A`dñH$,� d`ñH$� Zht� hmo� OmVm&� _¢� Bg� ~mV� H$s� ^r� nw{ï>�H$aVm/H$aVr� �{H$�Aënd`ñH$�ImVm|�_|�O_m�H$s�J`r�am{e�H$m�BñVo_mb�Aënd`ñH$�Ho$�bm^�Ho$�h±ÿ{bò�{H$`m�OmòJm&�_¢�CŠV�Ad`ñH$�Ho$�ImVo�_|�_oao�Ûmam�{H$E�JE�{H$gr�^r�AmhaU/�g§ì`dhma�Ho$�g§~§Y�_|�Ad`ñH$�Ho$�{H$gr�̂ r�Xmdo�Ho$�{déÕ�~¢H$�H$mo�nyU©V:�j{Vny[aV�aIy±Jm/�aIy±Jr&

Minor Declaration (Leave blank if not applicable)

Ad`ñH$�g§~§Yr�KmofUm�(bmJy�Z�hmoZo�na�[aŠV�ahZo�X|)

Signature of the applicant/ AmdoXH$�Ho$�hñVmja

Mariners International Declaration (Leave blank if not applicable) _¡[aZa�A§VaamîQ´>r`�KmofUm�(bmJy�Z�hmoZo�na�[aŠV�ahZo�X|)

Signature of the applicant/ AmdoXH$�Ho$�hñVmja

I hereby declare and confirm that I am a Non-Resident Indian and I am presently on contract with (mention name of the shipping company)

______________________________________________________

_________________________ company registered in (mention country's name)

______________________________________________________

_______________________________________(address of the principal) I also confirm that I will inform the Bank, in case I do not renew my contract OR choose to go on a new contract OR I am unable to proceed on a new contract OR in any case in the event that my status of Non-resident Indian is altered.

I hereby confirm that I have just returned after completion of my contract with

____________________________________________(company) registered in

___________________________ (address of the principal). I am on a break for

____________days/ months and will be joining on a new contract on/ by

_____________________.

I was a holder of an Indian passport inthe past./ _¢�{dJV�_|�^maVr`�nmgnmoQ>©�YmaH$�Wm/WrPassport No./ nmgnmoQ>©�Z§.Place of issue/

Expiry Date/

Second Holder/ Xygam�YmaH$First Holder/ nhbm�YmaH$

Signature of First Applicant/ nhbo�AmdoXH$�Ho$�hñVmja Signature of Second Applicant/ Xygao�AmdoXH$�Ho$�hñVmja

Name / Zm_ Name / Zm_

I/ We understand that the NRI account/s is being opened by the bank basis the PIO declaration given by me/ us. I/ We certify that the particulars given above are true.

_¢/h_�`h�OmZVm�hÿ±/OmZVr�hÿ±�{H$�~¢H$�Ûmam�Imobm�OmZodmbm�EZ�Ama�ImVm/ImVo/h_Zo�{Xò�JE�nr�AmB©Amo�KmofUm�Ho$�AmYma�na�Imobm�OmVm�h¢&�_¢/h_�`h�Kmo{fV�H$aVm�hÿ±/H$aVr�hÿ±/H$aVo�h¢�{H$�Cna�{X`m�J`m�{ddaU�gË`�h¢&

First Holder/ nhbm�YmaH$

Name of Territory/�joÌ�H$m�Zm_

Second Holder/ Xygam�YmaH$

Name of Territory/ joÌ�H$m�Zm_

I am the spouse of an Indian Citizen/ Person of Indian Origin_�¢ ^maVr`�ZmJ[aH$/^maVr`�_by �H$o �ì`pŠVH$m/H$r�n{V/�nËZr�h±ÿ

First Holder/ nhbm�YmaH$Tick any one:/ keÀesF& SkeÀ ®egvesb:

Father’s Name/ {nVm�H$m�Zm_

Mother’s Name/ _mVm�H$m�Zm_

Grandfather’s Name/ XmXm/ZmZm�H$m�Zm_

Grandmother’s Name/ XmXr/ZmZr�H$m�Zm_

Father’s/ Mother’s/ Grandfather’s/ Grandmother’sName/ {nVm/_mVm/XmXm/ZmZm/XmXr/ZmZr H$m�Zm_

Second Holder/ Xygam�YmaH$Tick any one:/ keÀesF& SkeÀ ®egvesb:

Father’s Name/ {nVm�H$m�Zm_

Mother’s Name/ _mVm�H$m�Zm_

Grandfather’s Name/ XmXm/ZmZm�H$m�Zm_

Grandmother’s Name/ XmXr/ZmZr�H$m�Zm_

Father’s/ Mother’s/ Grandfather’s/ Grandmother’sName/ {nVm/_mVm/XmXm/ZmZm/XmXr/ZmZr H$m�Zm_

_¢�EVX²Ûmam�KmofUm�H$aVm�hÿ±/�H$aVr�hÿ±�Am¡a�nw{ï>�H$aVm�hÿ±/�H$aVr�hÿ±�{H$�_¢�EH$�A{Zdmgr�̂ maVr`�hÿ±�Am¡a�dV©_mZ�_|�(Xoe�H$m�Zm_�{bI|)�_¢�n§OrH¥$V�� H§$nZr�(Zm¡dhZ�H§$nZr�H$m�Zm_�{bI|�

(_yb�H§$nZr�H$m�nVm)�_|�g§{dXm�AmYma�na�{Z`wŠV�hÿ±&

_¢�`h�^r�nw{ï>�H$aVm�hÿ±/�H$aVr�hÿ±�{H$�`{X�_¢�AnZr�g§{dXm�H$m�ZdrH$aU�Zht�H$aVm�hÿ±/�H$aVr�hÿ±�AWdm�ZB©�g§{dXm�ñdrH$ma�H$aVm�hÿ±/�H$aVr�hÿ±�AWdm�ZB©�g§{dXm�na�amoOJma�na�OmZo�_|�Ag_W©�ahVm�hÿ±�ahVr�hÿ±�AWdm�Eogr�H$moB©�^r�pñW{V�AmZo�na�{Oggo�_oar�A{Zdmgr�̂ maVr`�h¡{g`V�_|�H$moB©�n[adV©Z�hmoVm�h¡�Vmo�_¢�~¢H$�H$mo�gy{MV�H$é±Jm/�H$é±Jr&

_¢�EVX²Ûmam�nw{ï>�H$aVm�hÿ±/�H$aVr�hÿ±�{H$�_¢��(_yb�H§$nZr�H$m�nVm)�_|�n§OrH¥$V��

��(H§$nZr)�Ho$�gmW�AnZr�g§{dXm�nyar�H$aHo$�hmb�hr�_|�bm¡Q>m/�bm¡Q>r�hÿ°§&�_¢�

��{XZm|/_hrZo�Ho$�{bE�~«oH$�na�hÿ±�Am¡a�

H$mo/VH$�ZB©�g§{dXm�H$s�{Z`w{ŠV�na�OmD±$Jm/�OmD±$Jr&

I belong to a territory that became part of India after 15th day of August 1947 and never availed citizenship of Pakistan and Bangladesh.

_¢�EH$�Eogo�joÌ�go�g§~§Y�aIVm/aIVr�h±ÿ,�Omo�AJñV�1947�H$s�15�dt�VmarI�go�^maV�H$m�{hñgm�h¡�Am¡a�_¢Zo�H$^r�^r�nm{H$ñVmZ�Am¡a�~m§½bmXoe�H$s�ZmJ[aH$Vm�Zht�àmá�H$s�h¡&

I hereby declare that the date of birth of the minor who is my____________ __________________ is__________and I am his / her natural and lawful guardian / guardian appointed by court order dated ______(copy enclosed).

I shall represent the said minor in all future transactions of any descriptions in the above account until the said minor attains majority. I also confirm that funds held in minor account would be utilized for the benefit of the minor.

I indemnify the bank against the claim of the above minor for any withdrawal / transactions made by me in his/ her account.

First Holder/ nhbm�YmaH$

Name of Spouse/ nVr/nËZr�H$m�Zm_ �

Second Holder/ Xygam�YmaH$

Name of Spouse/ nVr/nËZr�H$m�Zm_

g_mßV�hmoZo�H s � VmarIOmar�H aZo�H m�ñWmZ

Page 7

nd2 Applicant

Recent Passport Size

Photograph (Sign Across)

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nmgnmoQ>©�AmH$ma�H$m

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GENERAL DECLARATION FOR NRIs / A{Zdmgr�^maVr`m|�Ho$�{bE�gm_mÝ`�KmofUm_¢/�h_�EVX²Ûmam�KmofUm�H$aVm�hÿ±/�H$aVr�hÿ±/�H$aVo�h¢�{H$�_¢/h_�A{Zdmgr�̂ maVr`/^maVr`�_yb�H$m/�H$s/�Ho$�ì`pŠV�hÿ±/h¢&�_¢/�h_�g_PVm�hÿ±/�g_PVr�hÿ±/�g_PVo�h¡�{H$�Cn`w©ŠV�ImVm�_oao/�h_mao�Ûmam�{XE�JE�~`mZm|/�KmofUmAm|�Ho$�AmYma�na�Imobm�OmEJm�Am¡a�_¢/�h_�Bg�~mV�go�̂ r�gh_V�hÿ±/�gh_V�h¢�{H$�̀ {X�Bg_|�{X`m�J`m�H$moB©�H$WZ/�Xr�JB©�H$moB©�KmofUm�VÏ`mË_H$�Vm¡a�na�JbV�nmB©�OmVr�h¡�Vmo�Amn�_oao/�h_mao�Ûmam�H$s�JB©�O_m na��{H$gr�àH$ma�H$m�ã`mO�AXm�H$aZo�Ho$�{bE�~mÜ`�Zht�h¢&�Bg�ImVo�H$m�à`moJ�Eogo�dmñV{dH$�g§ì`dhmam|�Ho$�{bE�{H$`m�OmEJm�Omo�_oao/�h_mao�{Zdmg�Ho$�Xoe�Ho$�Am¡a�{dXoer�_wÐm�à~§Y�A{Y{Z`_,1999�Ho$�Cn~§Ym|�g{hV�̂ maV�Ho$�{H$gr�{d{Z`_/�H$mZyZm|�Ho$�{H$gr�àH$ma�Ho$�Cëb§KZ�_|�em{_b�Zht�hm|Jo&

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_¢�EVX²Ûmam�Kmo{fV�H$aVm/H$aVr�hÿ§�{H$�D$na�CnbãY�H$amB©�JB©�OmZH$mar�_oao�AZwgma�nyar�Vah�gË`�Ed§�ghr�h¡�Am¡a�Bg_|�hmoZo�dmbo�{H$gr�^r�n[adV©Z�go�g§~§{YV�OmZH$mar�_¢�AmnH$mo�Vwa§V�gy{MV�H$ê§$Jm/H$ê§$Jr �̀ {X�_oao�Ûmam�CnbãY�H$amB©�JB©�OmZH$mar�JbV,�AgË`�̀ m�̂ «m_H$�gm{~V�&hmoVr�h¡,�Vmo�_wPo�nVm�h¡�{H$�BgHo$�{bE�_wPo�{µOå_oXma�_mZm�OmEJm �_¢�EVX²Ûmam�Cn`w©ŠV�a{OñQ>S>©�Z§~a/B©_ob�nVo�na�Eg�E_�Eg/B©_ob�Ho$�µO[aE�&g|Q´>b�Ho$�dm`�gr�a{OñQ´>r�Ûmam�OmZH$mar�àmßV�H$aZo�H$s�ñdrH¥${V�XoVm/XoVr�hÿ§&

Signature of Second Applicant/ Xygao�AmdoXH$�Ho$�hñVmja

Name / Zm_

Signature of First Applicant/ nhbo�AmdoXH$�Ho$�hñVmja

Name / Zm_

st1 Applicant

Recent Passport Size

Photograph (Sign Across)

nhbm�AmdoXH$

nmgnmoQ>©�AmH$ma�H$m

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(CgHo$�D$na�hñVmja�H$a|)

I/ We hereby declare that I / we am / are Non-Resident Indian / Person of Indian Origin. I / We understand that the above account will be opened on the basis of the statements / declarations made by me / us, and I / we also agree that if any of the statements / declarations made herein is found to be incorrect in material particulars, you are not bound to pay any interest on the deposit made by me / us. The account will be put into use for bonafide transactions not involving any violation of the provisions of any regulations/ laws of the country of my residence and of India including the provisions under the Foreign Exchange Management Act,1999.

I/ we undertake to intimate the Bank immediately on my/ our return back to India with the intention of staying there for an indefinite period or for permanently and till then furnish a declaration to the Bank that I/ we continue to stay outside India and have not become residents of India under the provisions of Sec. 6 of The Income Tax Act, 1961.

I/ We agree that no claim will be made by me / us for any interest on the deposit(s) for any period after date(s) of maturity of the deposit(s).

I/ We agree to abide by the provision of the Foreign Currency (Non-Resident) Account, Non-resident (External) Account Scheme. l/ We hereby undertake to intimate you about my / our return to India for permanent residence immediately on arrival.

I/We confirm that the amounts deposited/ invested in the account/s shall be legally belonging to me and will be through legitimate sources and will not be for the purpose of the contravention of any law including Anti Money Laundering Laws.

I/ We authorize the Bank to automatically renew the deposit on due date for an identical period (unless otherwise specifically instructed before due date). The earlier receipt given to me will be treated as discharged receipt on due date. I/ We understand that the interest applicable or renewals will be at the applicable ruling rates on the date of maturity and that the renewed receipt will be made available on my/ our presenting the duly discharged original receipt on the maturity date or later for payment.

I/ We further understand that the renewal will be in accordance with the provisions of the Reserve Bank of India Scheme in force at the time of renewal.

I / We agree that if the premature withdrawal is permitted at my /our request, the payment of interest on the deposit may be allowed in accordance with the prevailing stipulations laid down by Reserve Bank of India in this regard.

I/ We shall not make available to any person resident in India, foreign currency against reimbursement in Rupees or in any other manner in India.

I/ We would confirm that all debits to my/ our accounts for the purpose of investment in India and credits representing sale proceeds of Investments in India are covered either by general or special permission of Reserve Bank of India.

I/ We have read, understood that any changes in terms and conditions applicable to this relationship would be made available to me / us on request at any Induslnd Bank Branch.

I/ We do hereby declare that information furnished in this form is true to the best of my/ our knowledge and belief.

I/ We hereby authorize issuance of Debit card and provision of Internet Banking, Mobile Banking and Phone Banking Services as above. I/ we undertake to ratify and confirm all the user/ (s) do /(es) or cause/ (s) to do through ATM, POS, Net Banking, Mobile Banking and Phone Banking Channels. This authority shall continue to be in force until anyone of us revokes by a notice in writing delivered to you.

I/ We have received the deposit rules annexed to this account opening form and agree to abide by the same.

In case of joint accounts, instructions received from one of the account holders to stop operations will be deemed to be sufficient notice to the Bank to act upon such instructions. Further operations would be allowed only upon receipt of fresh instructions from all the account holders

I/ We consent / do not consent to receive information / service updates and product updatesetc. for Marketing purposes through Telephone/Mobile/SMS/Email by the Bank/ its agents. I/ We confirm that I/ We have read and understood the above Declaration, and that the contact details provided on the form are correct.

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I under t a k e 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.

I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address.

Details of Deposit/ O_mam{e�H$m�{ddaU

Nature of Deposit &Distinguishing No.

Additional details, if any Name Address

Relationship with Depositor, if any

AgeIf nominee is a minor, his/ her date of birth

Nominee/ Zm{_Vr

_¢/�h_�EVX²Ûmam�nwpîQ>�H$aVm�hÿ±/�H$aVr�hÿ±/�H$aVo�h¢�{H$�_wPo/�h_|/�_oar/�h_mar�~¢H$�O_m�am{e�na�Zm_m§H$Z�gw{dYm�H$s�Amdí`H$Vm�Zht�h¡.

_wPo/�h_|�~¢H$�O_mam{e`m|�Ho$�g§~§Y�_|�~¢H$H$mar�A{Y{Z`_,�1949�H$s�Ymam�45�µOoS>E�Am¡a�~¢qH$J�H§$nZr�(Zm_m§H$Z)�{Z`_�1985�Ho$�{Z`_�2�(1)�Ho$�A§VJ©V�Zm_m§H$Z�H$s�Amdí`H$Vm�h¡.

____________________________________________¢/�h_

{ZåZ{b{IV�ì`pŠV(`m|)�H$mo�Zm{_V�H$aVm�hÿ±/�H$aVr�hÿ±/�H$aVo�h¢�{Ogo/�{OÝh|�_oar/�h_mao�Ad`ñH$�H$s�_¥Ë`w�hmo�OmZo�H$s�pñW{V�_|�ImVo�_|�O_m�am{e�B§S>gB§S>�~¢H$�Ûmam�bm¡Q>mB©�OmE.

**My§{H$�Zm{_Vr�AmO�H$s�VmarI�H$mo�Ad`ñH$�h¡�Bg{bE�_¢/�h_�AnZo�Ad`ñH$�H$s�Ad`ñH$Vm�Ho$�

Xm¡amZ�_oar/�h_mar/�Ad`ñH$�H$s�_¥Ë`w�hmo�OmZo�H$s� pñW{V�_|�O_m�am{e�àmßV�H$aZo�Ho$� {bE�

__________________________________H$mo�Zm{_V�H$aVm�hÿ±/�H$aVr�hÿ±/�H$aVo�h¢.

ANNEXURE I / AZwb½ZH$ INOMINATION FORM DA1 (Please choose one of the available options)Zm_m§H$Z�\$m°_©�S>rE1�(H¥$n`m�{ZåZ{b{IV�_|�go�{H$gr�EH$�H$mo�MyZ|)

We acknowledge your nomination in form DA1 relating to Account No./ h_�AnZo�`hm±� ______________________________________________ in the

name of/ Ho$� Zm_� _|� _m¡OyX� ImVm� g§.� _____________________________________________ Ho$� g§~§Y� _|� \$m°_©� S>rE1� _|� AmnHo$� Zm_m§H$Z� H$s� A{^ñdrH¥${V� XoVo� h¢.

___________________________________________________________________________________________________________________

ACKNOWLEDGEMENT / nmdVr

Page 8

O_mam{e�H$s�àd¥{ÎmEd§�nhMmZ�g§.

A{V[aŠV�{ddaU,`{X�H$moB©�hmo

O_mH$Vm©�go�[aíVm,`{X�H$moB©�hmo

`{X�Zm{_Vr�Ad`ñH$�h¡Vmo�CgH$s�OÝ_{V{W

Zm_ nVm Am`w

*Signature/s/ Thumb impression of the depositor/s

*O_mH$Vm©/�O_mH$Vm©Am|�Ho$�hñVmja/�A§JyR>m-{ZemZrWitness(es)/ gmjr�(gmjrJU)

Name/ Zm_�:

Address/ nVm�:

Signature***/ hñVmja***:

Name/ Zm_�:

Address/ nVm�:

Signature***/ hñVmja***:

*Where deposit is made in the name of minor, the nomination must be

signed by a person lawfully entitled to act on behalf of the minor.

**Strike out if nominee is not a minor.

***Thumb impression(s) shall be attested by two witnesses.

*Ad`ñH$�Ho$�Zm_�_|�O_m�{H$E�OmZo�H$s�pñW{V�_|,�Zm_m§H$Z�na�Cg�ì`pŠV�Ûmam�hñVmja�{H$`m�OmE�{Ogo�H$mZyZr�Vm¡a�na�g§ì`dhma�H$aZo�H$m�A{YH$ma�h¡.

**`{X�Zm{_Vr�Ad`ñH$�Zht�h¡�Vmo�Bgo�H$mQ>�X|.

***A§JyR>m-{ZemZr�Xmo�gm{j`m|�Ûmam�gË`m{nV�{H$`m�OmE.

Ref. No./ g§X^©�g§.: ________________________________________ Date of Registration/ n§OrH$aU�H$s�VmarI: __________________________

Manager/ à~§YH$: ____________________________________________________ Stamp/ Seal/ ñQ>mån/�_wha

I/ We hereby confirm that I/ We do not require any nomination facilityon my/our bank deposit

I/ We require nomination under Section 45ZA of the Banking Regulation Act 1949, and rule 2(1) of the Banking Companies (Nomination) Rules 1985 in respect of the bank deposits.

I/ We

nominate the following person(s) to whom in the evenet of my/our minor’s death the amount of deposit in the account may be returned by IndusInd Bank Ltd.

Page 9

ANNEXURE II/ AZwb½ZH$ IIFORM NO. 60 (In absence of PAN Card)/ \$m°_©�Z§.�60�(n¡Z�H$mS>©�Z�hmoZo�na)

D D M M Y Y Y Y2. Date of Birth

5. Floor No.

7. Block Name/No.

9. Area/ Locality

13. Pin code 14. Tel. No. (with STD code) 15. Mobile No.

18. In case of transaction in joint names, number of persons involved in the transaction

18. boZ-XoZ�g§`wº$�Zm_m|�na�hmoZo�H$s�pñW{V�_|,�boZ-XoZ�_|�em{_b�bmoJm|�H$s�g§»`mD D M M Y Y Y Y

16. Amount of transaction (`) 16.�boZ-Xoe�H$s�am{e� (`) 17. Date of transaction

17. boZ-XoZ�H$s�{V{W 19. Mode of transaction: Cash Cheque Card Draft/Banker's Cheque Online transfer Other

20. Aadhaar No. issued by UIDAI (if available) 20. UIDAI�Ûmam�Omar�{H$`m�J`m�AmYma�Z~§ a�(`{X�CnbãY�hm)o

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

21. AJa�n¡Z�Ho$�{bò�AmdoXZ�{H$`m�h¡�Am¡a�`h�~Zm�Zht�h¡,�Vmo�AmdoXZ�H$s�{V{W�Am¡a�EoŠZm°boO_|Q>�Z§~a�S>mb|D D M M Y Y Y Y

22. If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is held. Please mention income including income earned abroad during financial year.

22. AJa�n¡Z�H$m�AmdoXZ�Zht�{H$`m�J`m�h¡,�Vmo�Cg�{dÎm�df©�H$s�Hw$b�AZw_m{ZV�Am_XZr�(Am`H$a�A{Y{Z`_�H$s�Ymam�64�Ho$�AZwgma�OrdZgmWr,�Zm~m{bJ�~ƒo�H$s�Am_XZr�g_oV)�â|,�{Og_|�`h��boZ-XoZ�g§nÞ�hþAm�h¡&�Am_XZr�_|�{dÎm�df©�Ho$�Xm¡amZ�{dXoe�_|�H$_mB©�J`r�am{e�^r�em{_b�H$a|&

a. Agricultural income (`)

A. H¥${f�go�Am_XZr (`)

b. Other than agricultural income (`)

~r. H¥${f�Ho$�Abmdm�Am_XZr (`)

23. Details of document being produced in support of identify in Column 1

23.�ñV§^�1�_|�nhMmZ�Ho$�{bò�àñVwV�{H$ò�OmZo�dmbo�XñVmdoµOm|�Ho$�{ddaU&Document code / XñVmdoµO�H$moS> Name and address of the authority issuing the document

XñVmdoµO�Omar�H$aZo�dmbo�àm{YH$aU�H$m�Zm_�Am¡a�nVm

Passport number / nmgnmoQ>©�g§»`m

24. Details of document being produced in support of address in Columns 4 to 1324. ñV§^�4�go�13�_|�nVo�Ho$�à_mU�hoVw�àñVwV�{H$ò�OmZo�dmbo�XñVmdoµOm|�Ho$�{ddaU&

Verification / gË`mnZ

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

Place: (Signature of declarant)

1. Name1.�Zm_ 2.�OÝ_�{V{W

3. Father's Name (in case of individual) 3.�{nVm�H$m�Zm_�({ZOr�hmoZo�na)

4. Flat/ Room No. 4.�âb¡Q>/ê$_�Z§. 5. _§{Ob�Z§.

6. Name of premises 6.�n[aga�H$m�Zm_ 7.�ãbm°H$�H$m�Zm_/Z§.

8. Road/ Street/ Lane 8.�g‹S>H$/Jbr/boZ 9. joÌ/ñWmZ

10. Town/ City 10.�H$ñ~m/eha

13.�{nZH$moS> 14.�Q>obr.�Z§.�(EgQ>rS>r�H$moS>�Ho$�gmW) 15. _mo~mBb�Z§.

19. boZ-XoZ�H$s�nÕ{V: ZH$X MoH$ H$mS>© S´>mµâQ>/~¢H$g©�MoH$ Am°ZbmBZ�Q´>m§g\$a AÝ`

_¢,��KmofUm�H$aVm/H$aVr�hÿ§�{H$�D$na�{X`m�J`m�{ddaU�_oar�OmZH$mar�Am¡a�{dídmg�Ho$�AZwgma�ghr�h¡&�gmW�hr�_¢�KmofUm�H$aVm/H$aVr�hÿ§�{H$�_oam�H$moB©�na_mZ|Q>�AH$mC§Q>�Z§~a�(ñWm`r�ImVm�g§»`m)�Zht�h¡�Am¡a�Cn`w©º$�boZ-XoZ�Ho$�{dÎm�df©�Ho$�{bò�Am`H$a�A{Y{Z`_,�1961�Ho$�àmdYmZm|�Ho$�AZwgma�{JZr�J`r�_oar/h_mar�Hw$b�AZw_m{ZV�Am_XZr�(Am`H$a�A{Y{Z`_�H$s�Ymam�64�Ho$�AZwgma�OrdZgmWr,�Zm~m{bJ�~ƒo�H$s�Am_XZr�g_oV)�H$a�Ho$�Xmào�_|�Z�AmZo�dmbr�A{YH$V_�am{e�go�H$_�h¡&AmO, 20��Ho$ ��{XZ�na�gË`m{nVñWmZ:

KmofH$�Ho$�hñVmjaNote:1. Before signing the declaration, the declarant should satisfy himself that the

information furnished in this form is true, correct and complete in all respects. Any person making a false statement in the declaration shall be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable,

(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall not be less than six months but which may extend to seven years and with fine;

(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two years and with fine.

2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is applied for and column 21 is duly filled.

Ü`mZ�X|:�1. KmofUmnÌ�na�hñVmja�H$aZo�go�nhbo,�KmofH$�H$mo�g§Vwï>�hmo�OmZm�Mm{hò�{H$�Bg�\$m°_©�_|�Xr�J`r�

OmZH$mar�gƒr,�ghr�Am¡a�ha�VarHo$�go�nyU©�h¡&�KmofUmnÌ�_|�JbV�OmZH$mar�XoZo�dmbo�g^r�bmoJ�Am`H$a�A{Y{Z`_,�1961�H$s�Ymam�277�Ho$�VhV�A{^`moJ�Am¡a�X§S>�Ho$�nmÌ�hm|Jo,(i) Q>mbo�Jò�H$a�H$s�am{e�nƒrg�bmI�go�A{YH$�hmoZo�na,�N>…�_hrZm|�VH$�H$s�~m_we¸$V�H¡$X�hmo�

gH$Vr�h¡,�{OgH$s�Ad{Y�hOm©Zo�Ho$�gmW�gmV�df©�VH$�~‹T>mB©�Om�gH$Vr�h¡;(ii) {H$gr�^r�AÝ`�pñW{V�_|�~m_we¸$V�H¡$X�VrZ�_hrZm|�go�H$_�H$s�Zht�hmoJr,�{OgH$s�Ad{Y�hOm©Zo� Ho$�gmW�Xmo�df©�VH$�~‹T>mB©�Om�gH$Vr�h¡;

2. I§S>�22~r�_|�ì`º$�Am_XZr�H$s�am{e�Am¡a�àH¥${V�H$a�Ho$�Xmào�_|�Z�AmZo�dmbr�A{YH$V_�am{e�go�A{YH$�hmoZo�na�KmofUmnÌ�ñdrH$ma�H$aZo�dmbm�ì`{º$�KmofUmnÌ�ñdrH$ma�Zht�H$aoJm,�O~�VH$�{H$�n¡Z�Ho$�{bò�AmdoXZ�Z�{H$`m�J`m�hmo�Am¡a�ñV§^�21�nyar�Vah�Z�̂ am�J`m�hmo&

11. District 11.�{Obm

12. State 12.�amÁ`

12A. Country12A. Xoe

14A. Overseas Tel. No. (with ISD code) 14A. {dXoer�Q>obr\$moZ�Z§.�(AmBEgS>r�H$moS>�Ho$�gmW)

20A. OCI/PIO Card No. 20A. AmogrAmB/nrAmBAmo�H$mS>©�Z§.

0 6

Document code / XñVmdoµO�H$moS> Name and address of the authority issuing the document

XñVmdoµO�Omar�H$aZo�dmbo�àm{YH$aU�H$m�Zm_�Am¡a�nVm

Document Identification number / XñVmdoµO�nhMmZ�g§»`m

Sl. Nature of Document DocumentCode

Proof of Identity

Proof ofAddress

A For Individuals and HUF 1. AADHAAR Card 01 Yes Yes 2. Bank/ Post office passbook bearing photograph 02 Yes Yes of the person 3. Elector’s photo Identity Card 03 Yes Yes 4. Ration/ Public Distribution System card bearing 04 Yes Yes photograph of the person 5. Driving License 05 Yes Yes 6. Passport 06 Yes Yes 7. Pensioner Photo card 07 Yes Yes 8. National Rural Employment Guarantee Scheme 08 Yes Yes (NREGS) Job card 9. Caste or Domicile certificate bearing photo 09 Yes Yes of the person 10. Certificate of identity/ address signed by a Member of 10 Yes Yes Parliament or Member of Legislative Assembly or Municipal Councillor or a Gazetted Officer as per annexure A prescribed in Form 49A 11. Certificate from employer as per annexure B 11 Yes Yes prescribed in Form 49A 12. Kisan passbook bearing photo 12 Yes No 13. Arm’s license 13 Yes No 14. Central Government Health Scheme/ Ex-servicemen 14 Yes No Contributory Health Scheme card 15. Photo identity card issued by the government./ Public 15 Yes No Sector Undertaking 16. Electricity bill (Not more than 3 months old) 16 No Yes 17. Landline Telephone bill (Not more than 3 months old) 17 No Yes 18. Water bill (Not more than 3 months old) 18 No Yes 19. Consumer gas card/ book or piped gas bill 19 No Yes (Not more than 3 months old) 20. Bank Account Statement (Not more than 3 months old) 20 No Yes 21. Credit Card statement (Not more than 3 months old) 21 No Yes 22. Depository Account Statement 22 No Yes (Not more than 3 months old) 23. Property registration document 23 No Yes 24. Allotment letter of accommodation from Government 24 No Yes 25. Passport of spouse bearing name of the person 25 No Yes 26. Property tax payment receipt (Not more than 26 No Yes one year old)

B For Association of persons (Trusts) Copy of trust deed or copy of certificate of registration 27 Yes Yes issued by Charity Commissioner

C For Association of persons (other than Trusts) or Body of Individuals or Local authority or Artificial Juridical Person) Copy of Agreement or copy of certificate of registration 28 Yes Yes issued by Charity commissioner or Registrar of Cooperative society or any other competent authority or any other document originating from any Central or State Government Department establishing identity and address of such person.

(2) In case of a transaction in the name of a Minor, any of the above mentioned documents as proof of Identity and Address of any of parents/ guardians of such minor shall be deemed to be the proof of identity and address for the minor declarant, and the declaration should be signed by the parent/ guardian.

(3) For HUF any document in the name of Karta of HUF is required. (4) In case the transaction is in the name of more than one person, the total number

of persons should be mentioned in Sl. No. 18 and the total amount of transaction is to be filled in Sl. No. 16.

In case the estimated total income in column 22b exceeds the maximum amount not chargeable to tax, the person should apply for PAN, fill out item 21 and furnish proof of submission of application.

Z§. XñVmdoµO�H$m�àH$ma XñVmdoµOH�moS

E ì`{º$JV�Am¡a�EM`yEµ\$�Ho$�{bò 1. AmYma�H$mS>© 01 hm± hm±

2. ~¢H$/S>mH$Ka�nmg~wH$,�{Og_|�Cg�ì`{º$�H$s�Vgdra�hmo 02 hm± hm±3. _VXmVm�\$moQ>mo�nhMmZ�nÌ 03 hm± hm±4. ameZ/gmd©O{ZH$�{dVaU�àUmbr�H$mS>©,� 04 hm± hm±

{Og_|�Cg�ì`{º$�H$s�Vgdra�hmo5. S´>mBqdJ�bmBg|g 05 hm± hm±6. nmgnmoQ>© 06 hm± hm±7. n|eZa�\$moQ>mo�H$mS>© 07 hm± hm±8. amï´>r`�J«m_rU�amoµOJma�Jma§Q>r�`moOZm�(NREGS)�Om°~�H$mS>© 08 hm± hm±9. Om{V�`m�A{Ydmg�à_mUnÌ,�{Ogna�Cg�ì`{º$�H$s� 09 hm± hm±

Vgdra�hmo10. \$m°_©�49�E�_|�{Xò�Jò�n[a{eï>�E�Ho$�AZwgma�{H$gr�gm§gX� 10 hm± hm±

`m�{dYm`H$�`m�ZJanm{bH$m�nmf©X�`m�amOn{ÌV�A{YH$mar�Ûmam�hñVmj[aV�nhMmZ/nVo�H$m�à_mUnÌ�

11. \$m°_©�49�E�_|�{Xò�Jò�n[a{eï>�~r�Ho$�AZwgma�{Z`moº$m� 11 hm± hm±Ûmam�à_mUnÌ

12. {H$gmZ�nmg~wH$,�{Og_|�Vgdra�hmo 12 hm± Zht13. h{W`ma�bmBg|g 13 hm± Zht14. H|$Ð�gaH$ma�ñdmñÏ`�`moOZm/nyd©-g¡Ý`�`moJXmZ�ñdmñÏ`� 14 hm± Zht

`moOZm�H$mS>©15. gaH$ma/gmd©O{ZH$�joÌ�CnH«$_�Ûmam�Omar�{H$`m�J`m�\$moQ>mo� 15 hm± Zht

nhMmZnÌ16. {~Obr�H$m�{~b�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 16 Zht hm±17. b¢S>bmBZ�Q>obr\$moZ�{~b�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 17 Zht hm±18. nmZr�H$m�{~b�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 18 Zht hm±19. Cn^moº$m�J¡g�H$mS>©/nwpñVH$m�`m�nmBßS>�J¡g�{~b� 19 Zht hm±

(3�_hrZo�go�µÁ`mXm�nwamZm�Zht)20. ~¢H$�ImVm�ñQ>oQ>_|Q>�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 20 Zht hm±21. H«o${S>Q>�H$mS>©�ñQ>oQ>_|Q>�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 21 Zht hm±22. {S>nm°{µOQ>ar�ImVm�ñQ>oQ>_|Q>�(3�_hrZo�go�µÁ`mXm�nwamZm�Zht) 22 Zht hm±23. g§n{Îm�n§OrH$aU�XñVmdoµO 23 Zht hm±24. gaH$ma�H$s�Amoa�go�Amdmg�Amd§Q>Z�nÌ 24 Zht hm±25. OrdZgmWr�H$m�nmgnmoQ>©�{Og_|�Cg�ì`{º$�H$m�Zm_�hmo 25 Zht hm±

26.� g§n{Îm�H$a�^wJVmZ�H$s�agrX�(EH$�df©�go�µÁ`mXm�nwamZr�Zht) 26 Zht hm±

~ g§JR>Zm|�Ho$�{bò 27 hm± hm±Q´>ñQ>�H$amaZm_o�`m�M¡[aQ>r�H${_íZa�Ûmam�Omar�{H$ò�Jò�n§OrH$aU�à_mUnÌ�H$s�à{V

gr g§JR>Zm|�(Q´>ñQ>�Ho$�Abmdm)�`m�bmoJm|�H$s�g§ñWm�`m�ñWmZr`�àm{YH$aU�`m�H¥${Ì_�Ý`m{`H$�ì`{º$)H$amaZm_o�`m�M¡[aQ>r�H${_íZa�`m�H$moAm°nao{Q>d�gmogmBQ>r�Ho$�ao{OñQ´>ma� 28 hm± hm±`m�{H$gr�^r�AÝ`�gj_�àm{YH$aU�Ûmam�Omar�{H$ò�Jò�n§OrH$aU�à_mUnÌ�H$s�à{V�`m�H|$Ð�AWdm�amÁ`�gaH$ma�Ho$�{H$gr�^r�{d^mJ�Ûmam�Omar�{H$`m�H$moB©�^r�AÝ`�XñVmdoµO,�{Og_|�Eogo�ì`{º$�H$snhMmZ�Am¡a�nVo�H$m�à_mU�hmo&�

(2)�boZ-XoZ�{H$gr�Zm~m{bJ�Ho$�Zm_�na�{H$`m�J`m�hmoZo�na,�Zm~m{bJ�ì`{º$�Ho$�_mVm-{nVm/A{^^mdH$�H$s�nhMmZ�Am¡a�nVo�Ho$�à_mU�H$m�Cn`w©º$�_|�go�H$moB©�̂ r�XñVmdoµO,�Zm~m{bJ�KmofH$�H$s�nhMmZ�Am¡a�nVo�H$m�à_mU�_mZm�OmòJm,�Am¡a�KmofUmnÌ�na�_mVm-{nVm/A{^^mdH$�Ho$�hñVmja�hmoZo�Mm{hò&

(3)� EM`yEµ\$�Ho$�{bò,�EM`yEµ\$�Ho$�H$Vm©�Ho$�Zm_�na�Omar�{H$gr�̂ r�XñVmdoµO�H$s�Amdí`H$Vm�hmoJr&(4)� EH$�go�µÁ`mXm�bmoJm|�Ho$�Zm_�na�boZ-XoZ�g§nÞ�hmoZo�H$s�pñW{V�_|,�bmoJm|�H$s�Hw$b�g§»`m�AZwH«$_m§H$�18�

_|�ì`º$�H$s�OmZr�Mm{hò�Am¡a�AZwH«$_m§H$�16�_|�boZ-XoZ�H$s�Hw$b�am{e�̂ ar�OmZr�Mm{hò&�ñV§^�22~r�_|�Hw$b�AZw_m{ZV�Am_XZr�H$a�Ho$�Xmào�_|�Z�AmZo�dmbr�A{YH$V_�am{e�go�A{YH$�hmoZo�na,�ì`{º$�H$mo�n¡Z�Ho$�{bò�AmdoXZ�H$aZm�Mm{hò,�ñV§^�21�̂ aZm�Mm{hò�Am¡a�AmdoXZ�O_m�{H$ò�OmZo�H$m�à_mU�àñVwV�H$aZm�Mm{hò&�

{ZX}e:(1)�XñVmdoµO,�Omo�nhMmZ�Am¡a�nVo�Ho$�à_mU�Ho$�ê$n�_|�àñVwV�{H$ò�Om�gH$Vo�h¢�(n¡Z�H$m�AmdoXZ�{H$`m�

J`m�hmoZo�Am¡a�I§S>�20�Ho$�̂ ao�OmZo�na�Amdí`H$�Zht):-

Instruction: (1) Documents which can be produced in support of identity and address (not required

if applied for PAN and item 20 is filled): -

Page 10

nhMmZ�H$m�à_mU

nVo�H$m�à_mU

Page 11

For Bank use only / Ho$db�~¢H$�Ho$�Cn`moJ�Ho$�{bE

Manager - CSOP and Branch ManagerSignature, SS No. or Employee No. &

Branch Round Stamp

à~§YH$�grEgAmonr�Ed§�emIm�à~§YH$�HohñVmja,�EgEg�g§.�AWdm�H$_©Mmar�g§.Ed§�emIm�H$s�amC§S>�ñQ>mån

Account OfficeboIm�H$m`m©b`

Indian Branch______________________________________^maVr`�emIm

DubaiXw~B©

Londonb§XZ

OthersAÝ`

gmo{gªJ�H$m`©nmbH$hñVmja,�H$_©Mmar�g§.

Sourcing ExecutiveSignature, Employee No.

CUST ID __________________________________________________

Account No. _______________________________________________

Sourcing Channel Name: _____________________________________

Sourcing Executive Name & Employee No. ______________________

Account opened in the CPU by: _______________________________

Office Stamp ______________________________________________

à{VB§S>gB§S>�~¢H$�{b{_Q>oS,>{H$gr�AÝ`�XñVmdoO/�H$ama�_|�BgHo$�à{VHy$b�{H$gr�~mV�Ho$�hmoVo�hþE�̂ r,�_¢/�h_,�AYmohñVmjar,�Amngo�AZwamoY�H$aVm/�H$aVr/�H$aVo�h¢�Am¡a�AmnH$mo�àm{YH¥$V�H$aVm�hÿ±/�H$aVr�hÿ±/�H$aVo�h¢�{H$�Amn�Eogo�{H$gr�̂ r�à`moOZ�Ho$�{bE�({Og_|�_oao/�h_mao�g^r�ImVo/�ImVm|�Ho$�n{aMmbZ�AWdm�AmnHo$�Ûmam�g_`-g_`�na�CnbãY�H$amB©�OmZo�dmbr�AÝ`�gw{dYmE§�AWdm�godmE§�em{_b�h¢,�go�g§~§{YV�AZwXoe/�nÌmMma�em{_b�h¢�qH$Vw�BVZo�VH$�gr{_V�Zht�h¡¨)�Omo�AmnHo$�̀ hm±�_m¡OyX�_oao/h_mao�ImVo�(Vm|)�H$mo�n[aMm{bV�H$aZo�Ho$�{bE�_oao/h_mao�Ûmam�AWdm�_oao/�h_mao�Ûmam�àm{YH¥$V�ì`pŠV`m|�Ûmam�\¡${g_mBb,�Anar{jV�Q>oboŠgmo¨�Am¡a�\¡$Šgm|,�Q>obrJ«m\$,�Ho$~b�AWdm�B©-_ob�Ûmam�[XE�JE�AWdm�{XE�OmZo�Ho$�A{^àm`� dmbo�AZwXoem|�AWdm�gyMZmAm|� na� H$ma©dmB©� H$a|�Am¡a� CZ� na�âmogm� H$a|.� _¢/� h_�g_PVm� hÿ±/g_PVr� hÿ±/g_PVo� h¢�Am¡a�A{^ñdrH¥${V�XoVm�hÿ±/�XoVr�hÿ±/�XoVo�h¢�{H$�AmnH$mo�\¡${g_mBb,�Anar{jV�Q>oboŠgm|�Am¡a�\¡$Šgm|,�Q>obrJ«m\$,�Ho$~b�AWdm�B©-_obm|�Ho$�O[aE�AZwXoem|�H$mo�̂ 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^dXr`,

ANNEXURE III / AZwb½ZH$ III

\¡$Šg�Am¡a�B©-_ob�go�{XE�JE�AZwXoem|�go�g§~§{YV�j{Vny{V©�nÌ

Signature of Second Applicant/ Xygao�AmdoXH$�Ho$�hñVmja

Name / Zm_

Signature of First Applicant/ nhbo�AmdoXH$�Ho$�hñVmja

Name / Zm_

E-mail ID*:B©-_ob�AmB©S>r*:*In case E-mail ID is not filled up here and you have opted for Instruction by Fax & E-mail, E- mail ID mentioned by you in the First Applicant details will be considered.

*`[X�B©-_ob�AmB©S>r�âm�Zht�J`m�h¡�Am¡a�AmnZo�AZwXoe�\¡�Šg�Ed§�B©-_ob,�B©-_ob�AmB©S>r�X²dmam�H�m�[dH�ën�MwZm�h¡�Vmo�AmnHo��X²dmam�n«W_�AmdoXH��Ho��d{daU�_|�{XE�JE�B©-_ob�AmB©S>r�na�{dMma�{H�`m�OmEJm.

Abu DhabiA~y�Ym~r

ToInduslnd Bank Limited,Notwithstanding anything to the contrary contained in any other document/ agreement, I/ We, the undersigned, hereby request and authorize you to act and rely on any instructions or communications for any purpose (including but not limited to the instructions/ communications pertaining to the operation of all my / our accounts or to any other facilities or services that may be provided by you from time to time) which may from time-to-time be or purport to be given by facsimile, untested telexes and faxes, telegraph, cable or email by me/ us including such instructions/ communications as may be purported to be given by those authorized to operate my/ our account(s) with you. I/ We understand and acknowledge that there are inherent risks involved in sending the instructions to you via facsimile, untested telexes and faxes, telegraph, cable or e-mails and hereby agree and confirm that all risks shall be fully borne by me/ us and I/ we assume full responsibility for the same, and I/ we will not hold the Bank liable for any losses or damages including legal fees arising upon your acting, or your failure to act, wholly or in part in accordance with the instructions so received.In view of you agreeing, subject to the terms and conditions hereunder, to act upon the instructions as aforesaid, I/ We hereby irrevocably agree and undertake:That the Bank shall be entitled to act as you see fit, without incurring any liability whatsoever to me/ us or to any other person, upon any instructions for any purpose which may from time to time be or purport to be given by facsimile, untested telexes and faxes, telegraph, cable or e-mail by me/ us (including such instructions as may be or purported to be given by those authorized to operate my/ our account(s) with you), even if such instructions or communications are not followed up by written confirmation to the Bank.That the instructions shall be conclusively presumed for your benefit to be duly authorized by and legally binding on me/ us, and I/ We shall be fully responsible for the same.You shall not be responsible to ensure the authenticity, validity or source of any instructions and shall not be liable if any instructions turned out to be unauthorized, erroneous or fraudulent.That you shall be entitled (but not obliged) to keep records of our instructions given or made by facsimile, untested telexes and faxes, telegraph, cable or any other form of electronic communication in such form, physical or electronic, as you may in your sole discretion deem fit, and your records shall be conclusive and binding on me/ us. You shall be entitled to dispose of or destroy any such records at any time and determined by your sole discretion.That you shall be authorized to disclose all instructions as you may deem fit, to your affiliated, counter parties, service providers, regulators and other authorities or where you are required by law to do so or to protect the interest of your bank.That you shall be entitled to require any instruction in any form to be authenticated by use of any password, identification code or test as may be specified by you from time to time and I/ We shall ensure the secrecy and security of such password, code or test and I/ We shall be solely responsible for any improper use of the same and I/ We shall not make any claim on you.That, notwithstanding the above you may, under circumstances determined by you in your absolute discretion, require from me/ us confirmation of any instructions in such form as may specify before acting on the same; and I/ We shall submit such confirmation to you immediately upon receipt of your request. Pursuant to receipt of instructions, you shall have the right but not the obligation to act upon such instructions.That you shall not be liable to me/ us or any third party for, and that I/ We (jointly and severally) shall indemnify you and keep you indemnified from and against all claims either by me/ us or any other, actions, demands, liabilities, costs, charges, damages, losses, expenses and consequences of whatever nature (including legal fees on a full indemnity basis) and howsoever arising which may be brought or preferred against you or that you may suffer, incur or sustain by reason or on account of you having so acted whether wrongly or mistakenly or not, or of your failing to act wholly or in part in accordance with the instructions and the terms of this letter.That I/ We confirm that I/ We have the capacity and authority to accept this document and that this document constitutes our valid, legal, effective and enforceable obligation.That this undertaking cum indemnity letter shall be governed and construed in accordance with the laws of India and I/ We hereby submit to the exclusive jurisdiction of the courts in Mumbai.This undertaking is an irrevocable letter and binding on my/our heirs and assigns.

Yours faithfully,

Mode of Account Opening/ Face to Face/ Non Face to Face/ImVm ImobZo H m VarH m J¡a CnpñWVCnpñWV

To/ à{V,Date/ {XZm§H$�:

The Branch Manager/ emIm�à~§YH$IndusInd Bank Limited/ B§S>gB§S>�~¢H$�{b.

Branch/ emIm

Dear Manager/ {à`�à~§YH$,

Sub: Request to add a Mandate Holder/ {df`�:�A{YXoe�YmaH$�H$m�Zm_�Omo‹S>Zo�hoVw�AZwamoY

I/ We wish to add a mandate in the account. Mentioned below are the details/ _¢/�h_�ImVo�_|�EH$�Zm_�Omo‹S>Zm�MmhVm�hÿ±/�MmhVr�hÿ±/�MmhVo�h¢�{OgH$m�{ddaU�ZrMo�{X`m�J`m�h¡�:

Name of Account Holder(s)/ ImVmYmaH$(H$m|)�H$m/�Ho$�Zm_�: (1)

A{YXoe�YmaH$�H$m�Zm_�Omo‹S>Zo�hoVw�AZwamoY�(EZAmaB©�Ed§�EZAmaAmo�ImVm�Ho$�{bE)Note: Mandate Holder must be a resident Indian/ {Q>ßnUr:�A{YXoe�YmaH$�A{Zdm`©�ê$n�go�^maVr`�ZmJ[aH$�hmo�

Page 12

Photo of Mandate Holder

35 x 40 mm

A{YXoe�YmaH$H$m�\$moQ>mo

35 x 40 E_E_

Facility that I wish to make available to the mandate holder / gw{dYm�Omo�_¢�A{YXoe�YmaH$�H$mo�CnbãY�H$amZm�MmhVm�hÿ±

Permanent address/ ñWm`r�nVm�:

E-mail address/ B©-_ob�nVm�:

Given below are the details of the mandate holder/ A{YXoe�YmaH$�Ho$�{ddaU�ZrMo�{Xò�JE�h¢

Account Number/ ImVm�g§�:and/ Am¡a�(2)

Name of Mandate holder/ A{YXoe�YmaH$�H$m�Zm_�:

Date of Birth:/ OÝ_�{V{W�: Gender/ qbJ�:

Telephone Number/ Q>obr\$moZ�Z§~a�: Mobile Number/ _mo~mBb�Z§~a�:

Regular Debit Card (For Domestic Use only)/ ao½`wba�S>o{~Q>�H$mS>©�(Ho�db�Kaoby�BñVo_mb�Ho��{bE)

{Q>ßn{U`m§�:

1) A{YXoe�YmaH��Ho$�nmg�XñVmdoOr�à_mU�Ho$�ê$n�_|�{ZåZ{b{IV�XñVmdoOm|�H$s�\$moQ>mo�à{V`m§�gmW�_|�hmoZr�Mm{hE&�·�nhMmZ�à_mU�·�nVo�H$m�à_mU�·1�\$moQ>moJ«m\$

2) A{YXoe�YmaH$�H$mo�gË`mnZ�à`moOZ�Ho$�{bE�_yb�XñVmdoO�̂ r�AnZo�gmW�aIZo�Mm{hE&

3) A{YXoe�Omo‹S>Zo�Ho$�{bE�g^r�ImVmYmaH$m|�Ho$�hñVmja�A{Zdm`©�h¢&

Declaration by the account holder/s-

I/ We, the Account Holder(s) and the Mandatee (Holder of the Mandate Facility) have read and understood the IndusInd Bank Account Terms and Conditions in the Account Application Form as well as the Mandate Form. I/We, the Account Holder(s) and the Mandatee, agree to the bound by the said Terms and Conditions excluding/ limiting your liability. I/ We, the Account Holder(s) also confirm that the Mandatee can avail of all facilities as provided/ will be provided to me/ us by IndusInd bank and I/ We authorize the Mandatee to conduct all local transactions permitted as per FEMA/ receive information on my/ our behalf.

I/ We, the Account Holder(s) accept that at my/ our request you have agreed to provide the Mandatee (details as provided by me/ us above) the facility of carrying out banking transaction by ATM Card/ Cheque book. All communication for the Mandatee shall be addressed at the Mandatee mailing address as provided by me/ us. I/ We, the Account Holder(s) unconditionally agree that:

(i) I/ We shall not hold the Bank liable on account of the Bank acting on instructions from the Mandatee;

(ii) in following such instructions, the Bank will be doing so on a best-effort basis and I/ we/ the Mandatee shall not hold the Bank liable on account of delay or inability on the part of the Bank to act immediately or at all on any of my/ our/ the Mandatee instructions;

(iii) the Bank may in its discretion, withdraw or suspend the facility wholly or in part at any time;

(iv) in case of a Joint Account, the Bank may act on Instructions from either/ any of us/ the Mandatee;

(v) the Bank may in its discretion decide not to carry out any instructions where the Bank has reason to believe (which decision of the Bank I/ we shall not question or dispute) that the instructions are not genuine or otherwise improper or unclear or raise a doubt;

ImVmYmaH$/�H$m|�Ûmam�KmofUm:

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(v)�~¢H$�AnZo�{ddoH$�na�Eogo�{H$gr�̂ r�AZwXoe�na�H$ma©dmB©�H$aZo�go�_Zm�H$a�gH$Vm�h¡�Ohm±�~¢H$�Ho$�nmg�`h�_mZZo�H$m�H$maU�hmo�(~¢H$�Ho$�Eogo�{ZU©`�na�_¢/�h_�Z�Vmo�H$moB©�àíZ�H$ê±$Jm/�H$ê±$Jr/�H$a|Jo�Am¡a�Z�hr�{ddmX�H$ê±$Jm/�H$ê±$Jr/�H$a|Jo)�{H$�AZwXoe�dmñV{dH$�Zht�h¡�AWdm�AÝ`�àH$ma�go�AZw{MV�AWdm�AñnîQ>�AWdm�g§XohmñnX�h¡;

Relationship with the first named account holder/ nhbo�Zm_moëbo{IV�ImVmYmaH$�go�[aíVm _____________________________________________________

(mention relationship/ CëboI�H$a|)

ANNEXURE IV/ AZwb½ZH$ IV

Customer ID of Mandate Holder (For Existing Customer only)/�A{YXoe�YmaH$�H$m�J«mhH$�AmB©S>r�(Ho$db�_m¡OyXm�J«mhH$�Ho$�{bE)

CKYC ID:grHo dm`gr�AmBS© r:

Page 13

Signature of First Account Holder

nhbo�ImVmYmaH$�Ho$�hñVmjaSpecimen Signature of Mandate Holder

A{YXoe�YmaH$�Ho$�Z_yZm�hñVmjaSignature of Second Account Holder

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· Cgr�J«mhH$�AmB©S>r�Ho$�AYrZ�ImVmYmaH$(H$m|)�Ho$�Zm_dmbo�ImVo/�Vm|�_|�CnbãY�eof�am{e`m|�_|�go�EZAmaB©�gmd{Y�O_m�H$aZm�Am¡a�A{YXoe�YmaH$�Ûmam�{b{IV�ê$n�_|�Xr�JB©�Ad{Y`m|�Ho$�{bE�Eogr�O_mAmo¨�H$mo�ZdrH¥$V�H$aZm

· ^maV�_|�{Zdoe�H$aZo�Ho$�{bE�ImVmYmaH$�H$s�nmÌVm�Ho$�AZwgma�^maV�_|�{Zdoe�H$aZo�hoVw�ImVo�H$mo�n[aMm{bV�H$aZm

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· {ZpîH«$`�XO}�dmbo�ImVo�H$mo�g{H«$`�H$aZm

· ImVmYmaH$�Ûmam�̂ maV�go�~mha�Ym[aV�ImVo�_|�am{e�ào{fV�H$aZm

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· A{YXoe�YmaH$�ImVmYmaH$�Ho$�Zm_�_|�gmd{Y�O_m/�AmdVu�O_m�ImVo�_|�{Z{Y`m|�Ho$�A§VaU�Ho$�Abmdm�Zò�ImVo�Zht�Imob�gH$Vm�h¡&�Zò�ImVo�A{Zdmgr�ImVmYmaH$�Ûmam�ñd`§�ImobZo�hm|Jo

· {Zdmgr�A{YXoe�YmaH$/�_w»VmaZm_m�YmaH$�H$mo�A{Zdmgr�ImVm�YmaH$�Ho$�Abmdm�Bg�ImVo�_|�Ym[aV�am{e�H$mo�^maV�go�~mha�àË`md{V©V�H$aZo�H$s�AZw_{V�Zht�h¡�Am¡a�dh�A{Zdmgr�ImVm�YmaH$�H$s�Amoa�go�{H$gr�{Zdmgr�H$mo�Cnhma�Ho$�O[aE�^wJVmZ�AWdm�Bg�ImVo�go�{H$gr�Xÿgao�EZAmaAmo�ImVo�_|�{Z{Y`m±�A§V[aV�Zht�H$a�gH$Vm�h¡

· A{YXoe�YmaH$�ImVo�H$mo�~§X�Zht�H$a�gH$Vm�h¡�AWdm�gmd{Y�O_m/�AmdVu�O_m�H$mo�n[anŠdVm�Ad{Y�go�nhbo�n[ag_mßV�Zht�H$a�gH$Vm�h¡

· A{YXoe�YmaH$�ImVmYmaH$�Ûmam�hñVmja�H$mo�AZwà_m{UV�Am¡a�gË`m{nV�{H$E�{~Zm�{gñQ>_�_|�AnZo�ñd`§�Ho$�hñVmja�H$mo�n[ad{V©V�Zht�H$a�gH$Vm�h¡/�gH$Vr�h¡

· A{YXoe�YmaH$�ImVmYmaH$�Ho$�{bE�ImVmYmaH$�EQ>rE_�H$mS>©,�ImVmYmaH$�H$s�{nZ�H$mo�nwZ:�Omar�H$aZo�Ho$�{bE�AZwamoY�Am¡a�ImVmYmaH$�Ho$�{bE�nVo�_|�n[adV©Z�hoVw�AZwamoY�Zht�H$a�gH$Vm�h¡

· A{YXoe�YmaH$�EZAmaB©�ImVo�_|�{dXoer�_wÐm�O_m�Zht�H$a�gH$Vm�h¡

· A{YXoe�YmaH$�B§Q>aZoQ>�~¢qH$J�Ho$�O[aE�ImVo�H$mo�n[aMm{bV�Zht�H$a�gH$Vm�h¡

`

(vi) In the event there is a discrepancy in the particulars or details of any transactions carried out by the Bank in any of my/ ourAccount(s), I/ we shall be obliged to intimate to you in writing any discrepancy in my/our Account(s) within 10 days of receiving your advice or within 10 days from the date of receipt of my/ our periodic statement of account, whichever is earlier, failing which the transaction shall be deemed to be correct and as accepted by me/ us. In consideration of your providing the said facility, I/ We agree to indemnify and hereby keep you indemnified from and against all actions, claims, demands, proceedings, losses, damages, costs, charges and expenses whatsoever which your Bank may at any time incur, sustain, suffer or be put to as a consequence of or by reason of or arising out of providing me/ us the said facility or by reason of your Bank in good faith taking or refusing to take or omitting to take action on my/ our/ the Mandatee instructions. I/We further certify that the details in my/ our/ the Mandatee relationship record are correct. I/ We, the Account Holder(s) and the Mandatee further understand that the usage of the Mandatee ATM Card is restricted to India. I/ We, the Account Holder(s) and Mandatee understand and acknowledge that Induslnd Bank reserves the absolute right to accept or reject this application in its sole discretion without assigning any reason thereof.

Yours truly,

NR

IAO

F/0

2/1

7

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