(Add Row for more KYC Details Entry)

(Delete rows)

Establishment Name

S.No.
1
2
3
4
5
6
7
8
9
10
11
12

UAN
100049467643
100002164748
100049467000
100228418905
100171818136
100044316310

Document
B-Bank
B-Bank
B-Bank
B-Bank A/c
B-Bank A/c
B-Bank A/c

Type
A/c
A/c
A/c

(Re

(Delete rows)

(Repeat Row)

Document Number
08651000708724
1425000100223653
1425001700009869
08601000051678
51462121028617
317801000021352

IFSC Code
PSIB0001029
PUNB0142500
PUNB0142500
PSIB0000860
ORBCO105146
IOBA0003178

Establishment Code:
(15 Digit Alphanumeric Code)

Name as per Document

ROHIT KUMAR
ANEETA
DIPAK
MITLESH
JALDEVI
MAMTA DEVI

MRNOI0036504000

Expiry Date (DD/MM/YYYY) of

Document Type- D/Licence |
T-Passport

I0036504000

Educational
Qualification
I
I
I
I
I
I

PH
PH (Y/N) Category

Gender
M
F
M
F
F
F

International
Worker (Y/N)
N
N
N
N
N
N

Marital
Status
M
M
M
M
M
M