Professional Documents
Culture Documents
Customer Updation Form For Non Individual
Customer Updation Form For Non Individual
Customer Updation Form For Non Individual
Account Number :
Customer ID:
Account Number :
Current account
Exchange Earners Foreign Currency Account(EEFC)
Special Saving Account
Others:_________________
FCRA Account:
Yes
No ( Please tick the applicable box)
FCRA Utilization Account:
Yes
No ( Please tick the applicable box)
Account Title /
Name :
Address:
In case of any changes in address or contact details please visit the branch
There is no change in our mailing address
I / We wish to change our mailing address as below
Building Name:
House No. :
Building Level.:
Street No:
Land
Mark :
City:
Street Name:
Locality:
State:
Country:
PIN code :
(R)
(Please specify if
other than India)
Mobile No. :
(O)
E-mail ID:
Customer Profile
1. Education (For Individual / Sole proprietor accounts only) :
2. Occupation (For individual accounts only):
Self Employed
Services
Under Graduate
Trading
Doctor
Salaried
CA/CS
Manufacturing
Graduate
Retired
Lawyer
Post Graduate
Housewife
Architect
Consultant
Agriculture Related
Professionals
Student
Famer
Engineer
Retailing
Others __________
Others ____________
Stock Broker
Real Estate
Others ______________________
5. Annual Sales Turnover (in `):
<40 lac
40 Lac to < 5 Cr
5Cr to < 25 Cr
25 Cr to < 100 Cr
# Code :
6. Type of industry:
7. Source of Funds :
8. Whether
Exports
Involved in :
Business Income
Imports
Rental income
Agriculture Income
IEC
Code
Grants
Value of Export :
Other __________________
Value of Import :
Authorised Signatory 2
Signature
Signature
(Name:-__________________________________)
(30mm X 40 mm)
Authorised Signatory 3
Signature
(Name:-__________________________________)
(30mm X 40 mm)
Please enclose
1. Existence proof of entity :
2. Address proof of entity :
3. Identity proof of Authorised Signatory 1:
4. Identity proof of Authorised Signatory 2 :
5. Identity proof of Authorised Signatory 3 :
(Name:-__________________________________)
Authorised Signatory 4
Signature
(30mm X 40 mm)
Donation
(30mm X 40 mm)
(Name:-__________________________________)
#Code numbers to be viewed from Intranet (address : Business Groups>WBG>Support group>General Banking group>GBO>Current account>list of codes) and appropriate codes to be written.
Account
Title/Name :
1.Name
(Mr./Mrs./Ms./Dr)
Date of Birth:
Nationality:
Designation: Directors
Beneficial owner
Shareholder
Partner
Proprietor
Trustee
Grantors
Settlors and beneficiaries of Trust
Karta
Communities Members for Society/Club/ Association
Joint Account holders
Others
____________________
Signatory Status: Authorised Signatory
PAN :
DIN/DPIN:
Gender :
Male
Female
Male
Female
Communication Address
(House Office/Shop No.):
Floor No. :
Premises/Building Name :
Street No. :
Street Name:
Landmark:
Locality:
City:
State:
PIN code:
Country:
(O)
(O)
STD Code :
I/We have existing relationship with ICICI Bank
Mobile : +91
No.
E-mail ID:
Yes
2.Name
(Mr./Mrs./Ms./Dr)
Date of Birth:
Designation: Directors
Beneficial owner
Settlors and beneficiaries of Trust
Joint Account holders
Others
Nationality:
Shareholder
Partner
Proprietor
Trustee
Grantors
Karta
Communities Members for Society/Club/ Association
____________________
PAN :
DIN/DPIN:
Gender :
Communication Address
(House Office/Shop No.):
Floor No. :
Premises/Building Name :
Street No. :
Landmark:
Street Name:
Locality:
City:
State:
PIN code:
Country:
(O)
(O)
STD Code :
I/We have existing relationship with ICICI Bank
Mobile : +91
No.
E-mail ID:
Yes
3.Name
(Mr./Mrs./Ms./Dr)
Date of Birth:
Designation: Directors
Beneficial owner
Settlors and beneficiaries of Trust
Joint Account holders
Others
Signatory Status: Authorised Signatory
Nationality:
Shareholder
Partner
Proprietor
Trustee
Grantors
Karta
Communities Members for Society/Club/ Association
____________________
Non Authorised Signatory
PAN :
DIN/DPIN:
Gender :
Male
Female
Male
Female
Communication Address
(House Office/Shop No.):
Premises/Building Name :
Floor No. :
Street No. :
Street Name:
Landmark:
Locality:
City:
State:
PIN code:
(O)
STD Code :
Mobile : +91
No.
Country:
E-mail ID:
(O)
Yes
4.Name
(Mr./Mrs./Ms./Dr)
Nationality:
Date of Birth:
Designation: Directors
Beneficial owner
Settlors and beneficiaries of Trust
Joint Account holders
Others
Shareholder
Partner
Proprietor
Trustee
Grantors
Karta
Communities Members for Society/Club/ Association
____________________
PAN :
DIN/DPIN:
Gender :
Communication Address
(House Office/Shop No.):
Premises/Building Name :
Floor No. :
Street No. :
Landmark:
Locality:
City:
State:
PIN code:
(O)
STD Code :
Street Name:
Mobile : +91
No.
Country:
E-mail ID:
(O)
Yes
Customer Declaration :
I /We declare, confirm and agree to inform ICICI Bank regarding any changes in my/our residence / communication address and to provide new address
to the Bank within two weeks of such a change
Date :
DVU done by
Employee Number :
Date :
Employee Number :
_____________________________
Signature of Bank official
DVU seal :
Place : _______________________
_____________________________
Signature of Bank official