Important Instructions: ‘AvFelis mated th “are marcato ls ) Lester Stata UTease as pe Intan Wotor ence, 1888 ava a he ne Plas the frm in Engi adn BLOCK ers FF List oo character 150 2108 county cose is vai a the end Pace le ato 9 DUR VHF ora (G) YC nunter of apseant is mandatary ler updst apleaton. 1 Pease ead seclon wise dela gudetnesnstrcions _H Ferpanicuer sacton update, leas ik Wa the bos avaabie before the atthe end ‘soon narer an ste ofthe sero nol equied to be dates For office use only Asplication Tyee" CINew — C1Update (Ge be fied ty franc msitvton) KC Number | | TL |) LL | |) ) Mandatory for KY update request) Account Type" — E]Nermal [Simplified (for low risx customers) CE] Small Prete Fst Mame este Name Las Name D1 Name* (same as 0 pra Maiden Nameqtany") Father / Spouse Name* | Mother Name* cor Gr Fonte sang Citzenshio* DIN incian Clotrers (180 3188 Country Code| |) Bee ered a (2 eRieAPPUeANLE CRESS FOR THE AURRCEES WJUREDIONS) CUTSOE NDIA Pe nae ADOITIONAL DETAILS REQUIRED (ansatay ony it eeci0n 2 i kis) 1S0 3166 Country Code of Jurisdiction of Residence” Co “ax ldentfeaton Numbero:eauivalentifisues oy usdeteme | TTL PELL) PacesciyotBith® = | |) | |) | | | ||) 1803168 Country Code of Bitn® (ented copy oaawan2ct ne toto #0 fatty} nee fo be tated) Cl APassporthumber [LL Passport Expiry Date Davoren PPT tr) Dernce oP Oi o-pring tierce TT) Driving Licence Expy Date Deuoradnaan CLEP iT) iti t tl) De nrceatoboad (01 1 Z-omers ary document ottea bythe cena govermment) [|| [| T1111] tentiteation number [1D TTT TTT TT) C1 S:Simpited Measures Account = Document Type soc teentfeation Number 1 TTP) 1 (1147 CURRENT PERMMANENT/ OVERSEASADDRESS DETAILS (Please see nsttutonDal te ens) (Cora copy afavane afte fotowng Prof ofAdaress [Poa needs oe subitea) [w[m)—[yy [voy mia) AddressTyee* Residential Susiness. ——-EUResidental Business TRecistered tice Dunspecities Proof ofAccress’ Passport Toriving Licence UID (Aadhaar Dioter identity care TNREGA ob Card Dlothers Simaitied Measures Account - Document Type code Address tine CTT TTT TTT TT Trt tt ttt tt ttt tt TT TTT TTT TT] unez [TT TTTT TTT Trt ttt try tt tt ttt TTT TT TT PETE ryt TT] Cr ee ee | City Town Milage [| TT TT LL piste «TTT TT pinvPostcose [|| || States UT Coder |) 1803165 County Code" |||[142 CORRESPONDENCE / [OCA ADDRESS DETAILS * (Pka6e ze instuctontEatthe end) 1D seme as Curent Penman / OverseasAddrss detas (in case of mutole comespendence local adesses, please 14"Annexure AT) er eee TT) une2 LLIETTEPTE Pitt ttt rit tit tit tei ti itt tit tit tri tititt) tines LILLT TET Pitti tt i it LETT TT city town iMitages TTT TTT District" Pin Post Cove State UT Cod" 180 3166 County Code" 1 < SAODRESS INTHE JURISDICTION DETAILS WHERE APPLICANT IS RESIDENT OUTSIDE INDIA FOR TAX PURPOSES” (Apsicabe f s2cion 2s tickes) same as cen Permanent Oversees Ades detas LL Sate as Conespondence/LocalAoiess cals | | ures COE ETE ety town rvitages CT) State 2P Post Coae* 150 3166 County Cose* |_| Ton T-l ee, I FAX. CLIT LEE T TET) emio CLT TPT PPT TP rrr rit ttt itt TéesterotRettes Seon Delton of Rese Person KeChurber cf Reiated Person faveabie| | |) | 1) 111111) Related Person Type" Guan of Miror Tassgoce Authorized Represertatve Prelt Fs Name ele tame Las Name Name* RE ee ee eee eee ee POOF 0 C7 A-Passporttumber (TT 111111] Passport Expiry Date imi Dawe ers | PTT Tr) Depwer Fo Do-cirousmes CCT bring Leenee Expy Oats (6[0]~[aw]—¥] a a a a sTITY(Po] OF RELATED PERSON (Pease se insrucisn #2 tne end) E-UIO iAadhaary F-NREGA Job Card BEERS EEE Z-Otherstary dosnt cota ty ne cantatoovemmens | [|| LLL LLL) teenticaton number [LEE E EEL T) S- Simplified Measures Account - Document Type cece [| | teentfeation Number LL | ‘Pasn imesaty eneay srewarioesce stan beukeat eh saesrgs sesseariy ler ataia hy afeeste on [Sersue Thurs mpesson Bate : [6[B] ~[w[m|-[¥]¥I¥I¥) pace: [TTT TIT TT TIT Sgr Thanbimpssar eters Documents Received []Certiied Copies K#C VER CATION CARRIED OUTEY INSTiTUTiCN DETAILS cate [plo mm\_yiyiyiy) Name COD LLL ELLE ELL) Emp. Name CLEC TTT TTT TTT) ote PTT TT TTT TTT TTT ATA TTA) emcee CREEP EEE} Eve Cesveie TTT Ere eaet COOoneal netrction Tek Wuteeerepoiae Pua the fo in og shan BDC Pail den BORMWOVTYT erat Wherever sete cde and out cade soe ised he sare shove the wen Cuber soporte upset oF AE de 9 Inchteaf Small Account spe any persona detals a section number 1 ard, protopaph sigmtureandsetcercation required. os per nun Moreh, 185 ond OSLSBcounty soe A. lrteation uidines on filing Prana et’ eon oot tle to bereft : 2 Ethelathersnemeorspusesrane Sts aor urihed incase PA re able fates ne = mandaon. 5 Claiiction / Guidelines on lig eta it appicat sien for ax purposes in jistions ous aia 1 tan etfzaon Humber (TH oes tsb tpores Ft enor Poets the ee =n, Roweve, fe sid ju dicton has ted 3 hh regi van yh an eaolrt uo eraeat (y-Perctorl equwlen) ne someway be pert Sampo tat peal ncrbe lor needle sl © lrteation uittines on iling en of entity [Po seton To Tlevenglearse numero ports soled proof ony ther acy date ioe mana ened 3 Incase of smelled Measures Azcounts for verifying he ident ofthe acplcant, any ove the allowing doamen can alzobe submitted and undernoted relevant ese iy be menor 2088 Bh Tourertcade Betrpton o deny er wh agpenr phar aph ied by Cone Sse GowervertOeparment Sahn Regnery Autores, Dl Sec Users nga Seveulad CormrecelaetsondPube srseal et sior® a late ued bye goetidetfor, whe duly etantedptopash he persen 1 chavieavion Guidlines o ig Prot of Ades P08) «Caen Paenanet/ Overseas kar dea’ section 2 State /U7 Cased Pont Code mnt be ranestrylar Oversees ade, 4S Incaseclsmaldieseasues Acauttorserng headssse! se app corsa nee! the flonirsdoaments can euobe subritedendurdemota relat, bi oz Prot Maris Texte 03 Exrcsteuntsr Die susan ateut asm ot Fear fry arson saan cra (P04) ates ove enoyeeby Goveranent Seprtnento Pu sete Leas if Boy sortainthe een public sectorensetalins,schesled corr beks, nena st tao en sted com tithaich ensiogers sting iil seonmnsston ermloer aad by Sate Cee Goverrert peta sentry of epatory be, Charation/Gidtnes on ig Poa des P08] -Cmesponence Las Adess deta’ seton 1D Tove edonyineneiteokisnel te sea asin aks here Hncaniraricrentyardng Neepstte Pad reques ta be sbi 2 Insstectmultpeamanndence/ sisassrrses Pearet Ronen A F cheatin Guidlines on ling oma deta’ section 2 Dentads' nthe begining sf Mbe ure “ 6 cliteationGuseinesonfing elated Person deta section Do Prose oumber festa petuon fase abe H Clicatin/Gudetos on ing Relies Person deta —Pret of Key Po] of Related Peon section Denon aortas ference sure’ f 20ers eny Secret rales the cet goermert 8 SledBria Prades 42 Jammu Kashmit a Ponyab PB | | | Assam as Komateka ka sikkin sk Chandigarh cH Lakshatey ib Telangana ws | | | Dadi and Magar veh bn Maharastra i Uttar Pradesh up | | beh ot Meat alaya Mu West Bengal we | | | cuore a Nagalane nL | | tae ge amr sam en — = —— “ = —e in tier et oT ae ieee a Se — eho aa i tie en tae rd = oe ona mene oe a Cee i ates a te meh tenner teres fe ee a a 7 e ‘conker cee (tae Foonuns teva tea Ue cm els (teen fo = (cence Semen hone ree enn eens % ‘om Te tne incl? Ware Fe aslemetanrs oe a a ira tee — cs Certeie fee ano mee 2Annexure At Important instructions: ‘Fields mathe th “are manta kis Lis of Stale Tene a per nian Mote Milt, 88 vane ate en 5) Pease hee in English and n BLOCK eters F) List oft character $0 2160 county codes fala athe end Please essen DD-MNYYY font )KYC number taplostis mandatory fr vada aplzaon, Dy Phase ea secon vise died gudelnesnsiuctons Fo arcu secon ups, ease tek he bx avaiable ‘re he athe ond secon niet an sie fhe Seton nal requed oe updated For office use only Appicaton Tyee CINew CUndate (M petite ty inanootmstaaon KYE Number — LL LLL LLL LLL 11] eanoeten fork update request i same as Content: Permanent Overseas Aastess deta tinet* = [TT TT ELT TTT T TT Ti TT T a I I iat TPT TT TTT ttt tt itt I [TTT Tit Ti tt I LETT TTT \oty town vitages TT TT TT TTT TT LI | District Pin/ Post Cose" ‘state UTCode* 190 3168 County ¢ I I I se* [ [| }-[ TT) mikes (TTT | FLEET TTT EE) emanio (TTT TTT PPT TTP rr rt tit tt tt rr one + (6/6) [aim [sate rune inaesson pace: CECI aAAnnexure Bt Important instructions: ‘Ay Pek saree th “aan Lit State Teas apendan Matra, 188 stable al en {Pac fine ormin Ele ania ALOK rs F) Lat foo character 60 395 cour codes atl a ne ns Pies fhe ae n INET omat YC nantrf paca smarty ous open Oy Paes ead secon vse dead gues sitions} For pal secon pdt, lease 2k) athe bx alae tothe atten section ramber and ste he secrete oe pas For office use only ‘AopiicalonTypet CINew ChUpeate hope te by inanoai nsession) KE Number — | | LL LL LL) |) Mandatory fr K¥C update request) LteaterotReates Person] teton of Rees Person KvC Murbe oad Ferson ave able Relates Person Type" CGuatdian of Minar Diassgnce authorized Representative Prot Fs Name ile tame Las Name Name* CLO CLT Ti ttt tt) CIT it ttt) OTT rit tit) oie Slow dso (716C number ang nar: jon a oral PROOF OF GENTTY Po} GF RELATED PERSON (Pune enc # ah A-Passpen Nunber CEE T TELL) Passport Expry Date —_[B[0]-[alw|-[FLVI¥I¥] i craved | cowmouine CECE TIT bmg Leenee Expy ate (B[0]~ [ww] -[¥I¥I¥I¥] E- UID tAadhnaar) F-NREGA Job Card BEE EE EEE EEL Z- Others tary document ates bye cent soxermens [|| [LT] 1 [1] tentiteation number [DTT T PPTL TT) 8: Simpifed Measures Account = Document Type coe [| | teentfeation Number 111 LLP) 11 cate ()e) wm pace: CLDDILCTT TT RTE | S-ATTESTATION / FOR OFFICE USE ONLY Documents Received LlCotfe copes rc ieneemouosmAen cure nstrunew oes vate nm Emp, Name COCOTTET ETAT ATTA TTT) om FT TTT TTT TT TTT TT Ty rt) tmcae | CLEC EEELEELLLLLL) Emp Cespeton CCCP CCELCCE Lo) fme.boreh CECE CE EECoEe)