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Kyc Declaration Form

The document is a declaration from an account holder at IndusInd Bank providing updated personal information including their account number, residential and office addresses, preferred mailing address, PAN number, contact details, and copies of identity and address proofs. The account holder declares that the information provided is correct and the documents submitted are true verification documents. They agree to notify the bank of any address changes along with required proof.

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Prasad Mungekar
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© Attribution Non-Commercial (BY-NC)
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206 views1 page

Kyc Declaration Form

The document is a declaration from an account holder at IndusInd Bank providing updated personal information including their account number, residential and office addresses, preferred mailing address, PAN number, contact details, and copies of identity and address proofs. The account holder declares that the information provided is correct and the documents submitted are true verification documents. They agree to notify the bank of any address changes along with required proof.

Uploaded by

Prasad Mungekar
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
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Declaration of KYC Document Submission

To
IndusInd Bank Limited

__________________ Branch

Dear Sir / Madam,

My/Our Savings / Current A/c No is: __ __ __ __ - __ __ __ __ __ __ - __ __ __

I____________________________________ (Account Holder/s) do hereby solemnly declare that the information given below with
respect to my/our bank account mentioned above is correct and up-to-date. The documents provided as proof of identity & proof of
address and the photograph attached are my/our true verification documents.

Residence Address Office Address

I would prefer my mailing address to be (please tick as appropriate): Residence Address Office Address

Changes to any of my addresses will be intimated to your bank along with the required proof of address.
My Permanent Account Number and contact details are given below:

PAN Number Residence Phone Office Phone Mobile E-mail Address

I also confirm having enclosed a self-attested copy of the following documents as the proof of identity and proof of address
(Kindly tick the relevant document in the list below):
Identity Proof Address Proof

Passport Passport
Driving License Driving License
PAN Card Voter ID Card
Voter ID Card Latest Electricity Bill
Photo Ration Card Latest Telephone Bill
Other (please mention) Ration Card
Life Insurance Policy Receipt
Property / Water Tax Receipt
Other (please mention)

Full Name of the Account Holder/s:

Signature of the Account Holder/s: Date:


Note: In case of joint accounts or accounts with multiple signatories, the declaration has to be filled and submitted for each individual holder.

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