KNOW YOUR CUSTOMER FORM

As mandated by Indian Customs vide CBEC Circulars 09/2010, dated 08.04.2010 as amended for

identification/verification of importers/exporters for customs clearance performed on their behalf by

M/s __________________________________________________________acting as an Authorized

Custom Broker on behalf of the Customers.

1. Category
□ Individual

□ Proprietary firm

Company
□ Trust / Foundation

□ Partnership firm

2. Name (Legal Name of individual/proprietor/ SKALAR ANALYTICAL INDIA PVT LTD

Firm/Company)

3. Permanent / registered address 7/4 PAPPATHIAMMAL STREET

KODMABAKKAM
CHENNAI-600024

044-24837007
Telephone No Mobile

No 91 9940618272

Email address
Adminindia@skalar.com
Website www.skalar.com

4. Principal business address/es from Same as above

which business is transacted

Telephone No

Mobile No
5. Name and title of authorized Rajnarayanan. J
signatory Director
Please provide proof of authority i.e. Power of Attorney
6. IEC No (attach copy) 0407008764
7. PAN No (attach copy) AAKCS8428B
8. Certificate of Incorporation & Memorandum of U72200TN200FTC063376
Association
(attach copy)
 9. Partnership Deed (attach copy) NA
10. BANK ACCOUNT DETAILS IDBI BANK
Name & Address : Bank Account No: : 045102000025364
Account No :
Branch Code : PC 36, Razak garden main road, MMDA,
Arumbakkam, Chennai-106

11. Registered under Goods & Service Tax

YES
□ NO

12. GSTIN/UIN NO. (attach copy) GSTIN/UIN: 33AALCS8428B1ZF

13. Particulars of Partner/Director with J. RAJNARAYANAN

complete address & mobile no. B2 CHATHURBUJA , 4/5 6 TH CROSS
STREET, UI COLONY KODMABKKAM,
CHENNAI-600024
(i) Particulars of Second Partner/Director

(ii) Particulars of Third Partner/Director

(iii) Particulars of Fourth Partner/Director

Paste Passport Size Photograph Paste Passport Size Photograph Paste Passport Size Photograph Paste Passport Size Photograph
Of the Prop. /First Of the second Partner/Director Of the third Partner/Director Of the fourth Partner/Director
Partner/Director And Sign across And Sign across And Sign across
And Sign across

Declaration:-

I/We hereby declare that the particulars given herein above and the documents attached are true, correct
and complete to the best of my/our knowledge and belief, and the documents submitted in support of this
KYC Form are genuine and obtained legally from the respective issuing authority and nothing has been
concealed therefrom. In case of any change in any of the aforementioned particulars, I/we undertake to
notify the same in writing on my own to my Custom Broker and all concerned. I/We hereby authorize you to
submit the above particulars to customs and other regulatory authorities on my/our behalf as may be
required.

Place_________ Signature

Date_________ Name
Official Seal (for all other than individuals)
 CHECKLIST
Please provide the following documents as per the checklist below:

a) Any two documents (certified by individual/authorized signatory) to verify identity and address proof.
b) Individuals (not proprietary firms) may submit a single document if it contains both identity and address
proof.
c) Any one document (certified by authorized signatory) to verify authority granted to signatory.
d) Certified copy of government-issued ID of authorized signatory
Note: the name and address on the KYC documents must match the address and name mentioned
on the Air Waybill / invoice.

Category Documents Required

Individual/
Proprietary
□ Passport
firm □ PAN card

□ Voter card

□ Driving license

□ Bank statement

□ Ration card

□ Aadhar card
Company To verify identity and address
Certificate of Incorporation
Memorandum and Articles of Association
Telephone bill in the name of the company
PAN card
To verify authority of signatory
Power of Attorney/Board Resolution granted to its managers, officers
or employees totransact business on its behalf
Trust or To verify identity and address
Foundation □ Certificate of Registration

□ PAN card

□ Telephone bill in the name of trust/foundation

To verify authority of signatory
□ Power of Attorney (POA) granted to transact business on its behalf

□ Any officially valid document identifying the trustees, settlers, beneficiaries and
those holding the POA, founders/managers/directors and their addresses
□ Resolution of the managing body of the foundation/association
Partnership firm To verify identity and address
□ Certificate of Registration

□ Partnership deed

□ PAN card

□ Telephone bill in the name of firm or partners

To verify authority of signatory
□ Power of Attorney (POA) granted to a partner or an employee to transact business
on its behalf
□ Any officially valid document identifying the partners and the person holding the POA