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0008B3/6258455/1-3/RESGB/12-1

Your Base Branch : HYDERABAD BRANCH, 6-2-

1012, TGV MANSIONS, OPP INSTITUTION OF
MS.VEMULA MAMATHA ENGINEERS, KHAIRATABAD,
DIGUVA LINGASAMUDRAM,LINGASAMUDRAM,
LINGASAMUDRAM
NELLORE  Visit
ANDHRAPRADESH - INDIA - 524134
 Dial your Bank 33667777

NEVER SHARE your Card number, CVV, PIN, OTP, Internet Banking User ID, Password or URN with anyone, even if the caller claims to
be a bank employee. Sharing these details can lead to unauthorised access to your account.
STATEMENT SUMMARY for Customer ID : XXXXX7266 as on May 31, 2021

ACCOUNT DETAILS - INR

ACCOUNT TYPE A/C. BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) NOMINATION

Savings A/c XXXXXXXX3692 25,084.0 0.00 25,084.0 Registered

TOTAL 25,084.0 0.00 25,084.0

Statement of Transactions in Savings Account XXXXXXXX3692 in INR for the period May 01, 2021- May 31, 2021

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

01-05-2021 B/F 25,084.0
01-05-2021 DEBIT CARD VPS/SUPRIYA SAR/20180930165046/0 1700.00 23,384.0
01-05-2021 BIL/ONL/001545350795/RAZORPAY/B40LMKL1QMILM3 295.00 23,089.0
01-05-2021 ICICI ATM ATM/CASH WDL/01-05-21/0 1300.00 21,789.1
01-05-2021 UPI/827480472224/Payment from Ph/EURONET@ybl/Yes B 200.00 21,589.03
ank Ltd/
01-05-2021 UPI/827440638134/Payment from Ph/EURONET@ybl/Yes B 299.00 21,290.23
ank Ltd/
03-05-2021 MOBILE BANKING MMT/IMPS/827518671980/VANAJAKSHI/ANDB0000602 6792.00 14,498.23
08-05-2021 OTHER ATMS NFS/CASH WDL/07-05-21 200.00 14,298.23
08-05-2021 UPI/828108979704/UPI/pushpa9326@okic/CHATISGARH R 9,000.00 5,928.23
G/
08-05-2021 OTHER ATMS NFS/CASH WDL/08-05-21 1,700.00 3,598.23
08-05-2021 UPI/828121206790/UPI/raveendragullap/Citibank 200.00 3,798.23
09-05-2021 UPI/828208761308/UPI/navya.singraven/ICICI Bank 200.00 3,998.23
09-05-2021 MOBILE BANKING MMT/IMPS/828208207953/VANAJAKSHI/ANDB0000602 1,800.00 2,198.23
09-05-2021 UPI/828208588483/UPI/goog-payment@ok/Axis Bank Ltd 18.00 2,216.23
.
09-05-2021 OTHER ATMS NFS/CASH WDL/09-05-2021 200.00 2,016.23
09-05-2021 UPI/828213138936/UPI/pkarthika05@oki/ICICI Bank 500.00 2,516.23
09-05-2021 UPI/828221606436/Payment from Ph/8466013562@ybl/IC 200.00 2,716.23
ICI Bank
10-05-2021 UPI/828307191509/Bhargavi birthd/sujithreddy.tes/I 200.00 2,916.23
CICI Bank
15-05-2021 UPI/828613893297/UPI/balucherry007@o/ICICI Bank 180.00 2,736.23
15-05-2021 DEBIT CARD VPS/UDAY MEDICA/20181013192603/0 192.00 2,544.23
15-05-2021 BIL/ONL/001555978602/BILL DESK/BOOKMYSHOW_PICI6789 274.10 2,270.23
6
15-05-2021 DEBIT CARD VPS/Future Valu/20181015010125/0 1,348.00 922.23
15-05-2021 UPI/828810897266/UPI/pushpa9326@okic/CHATISGARH R 1,340.00 2,262.23
G
15-05-2021 UPI/828813576792/UPI/goog-payment@ok/Axis Bank Ltd 14.00 2,276.23
.
15-05-2021 OTHER ATMS NFS/CASH WDL/15-05-2021 200.00 2,076.23
16-05-2021 UPI/828908264892/Frnd/yashwanthvarma4/ICICI Bank 200.00 4,118.13
16-05-2021 OTHER ATMS NFS/CASH WDL/16-05-21 200.00 3,918.13
16-05-2021 UPI/828913708668/UPI/yashwanthvarma4/ICICI Bank 200.00 1,876.23
16-05-2021 UPI/828919503291/UPI/pushpa9326@okic/CHATISGARH R 1,500.00 3,376.23
G
Total: 4,372.00 21,208.00 3,376.23
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Statement of Transactions in Savings Account XXXXXXXX3692 in INR for the period May 1, 2021– May 31, 2021

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

17-05-2021 UPI/829011807086/UPI/pushpa9326@okic/CHATISGARH R 4,300.00 7,676.53
G
17-05-2021 OTHER ATMS NFS/CASH WDL/17-05-21/Fee Rs20.00 GST Rs3.60 5,823.60 1,852.63
18-05-2021 UPI/829112379721/P/ushamummidivara/ICICI Bank 500.00 2,352.63
18-05-2021 BIL/ONL/001558774440/PAYU INDIA/www.foodpanda.in75 9.00 2,343.63
48
20-05-2021 ICICI ATM ATM/CASH WDL/20-05-21/0 2,343.00 185.63
20-05-2021 ICICI ATM ATM/CASH WDL/20-05-21/0 100.00 85.63
22-05-2021 BIL/ONL/001560370714/PAYU INDIA/www.foodpanda.in75 19.00 66.63
59
23-05-2021 UPI/829660437718/Payment from Ph/EURONET@ybl/The U 50.00 16.63
daipur Mah/
23-05-2021 UPI/829620990686/Payment from Ph/EURONET@ybl/The U 9.00 7.63
daipur Mah/
24-05-2021 UPI/829701843045/PhonePe Credit/phonepemerchant/Th 50.00 57.63
e Udaipur Mah
29-05-2021 UPI/830008811482/Payment from Ph/EURONET@ybl/The U 19.00 38.63
daipur Mah/
29-05-2021 NET BANKING INF/000117576084/INCENTIVE 10,428.00 10,466.63
29-05-2021 ICICI ATM ATM/CASH WDL/29-05-21/0 200.00 10,266.63
31-05-2021 UPI/830414161618/Payment from Ph/EURONET@ybl/The U 448.00 9,818.63
daipur Mah/
31-05-2021 BIL/ONL/001566218621/FREECHARGE/183040800118924088 99.00 9,719.63
TOT 4
31-05-2021 NET BANKING INF/000117834240/SALARY 25,084.00 34,803.63
Total: 36,852.00 10,776.60 34,803.63

REWARDACCOUNT
SAVINGS POINTS SUMMARY
LINKED PAYBACK Points earned for the month of MAY, 2021
My Savings REWARD DEBIT CARD POINTS BALANCE*
NUMBER NUMBER
XXXXXXXX3692 XXXXXXXXXXXX8304 0 4 149
To get current reward points balance and for other queries, visit www.icicibank.com or call ICICI Bank Customer Care.
* As on jan 20, 2021, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the point balance.

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFS CODE NAME OF NOMINEE*
Savings XXXXXXXX3692 500229002 ICIC0000008 -
* Nominee name is displayed only on specific consent of customer.
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For ICICI Bank Limited

Legends for transactions in your account statement
VAT/MAT/NFS- Cash Withdrawal at other bank's ATM INF-Internet funds transfer in linked accounts
EBA-Transaction at ICICIDirect BIL-Internet bill payment or funds transfer to third party
Pranav Mishras VPS/IPS-Debit card transaction TOP- Mobile Recharge
RTGS-Real Time Gross Settlement (Instant transfer above Rs 2 Lakh) NEFT- National Electronic Fund Transfer
Senior General Manager
Retail Liabilities Group

• As per prevailing guidelines of the Income tax Act, 1961, if a valid PAN is not provided by
the customer then tax shall be deducted at the prevailing rate or 20%, whichever is
higher.
• As per guidelines issued by CBDT on May 13,2011, Form 16A (TDS Certificates) will be
generated through the Income tax website for which the PAN of the customer needs to
be necessarily updated in Bank's record.
• Each depositor is insured by the Deposit Insurance and Credit Guarantee Corporation
(DICGC) up to a maximum of Rs. 1 lakh, for both principal and interest amount held by
him in the same right and same capacity.
• In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
• In case your PAN is not updated in our record, please visit the nearest branch and provide
a copy of the PAN card, along with the original PAN card for verification.
• The address of the customer in Form 16A will be the last updated address in the data base
of the income tax department.
• As per PMJJY, debit of Rs.289 is towards insurance premium collected on behalf of ICICI
Prudential & Rs.41 is towards administration charges by ICICI bank (including GST). For
details refer Terms and Conditions at www.icicibank.com

www.icicibank.com
Corporate Office: ICICI Bank Ltd., ICICI Bank Towers, Bandra-Kurla complex, Mumbai - 400051, India. Category of service: Banking & Financial Services.
Registered Office: ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, Gujarat. Pin – 390 007. Registration No. MIV/ST/Bank & Finc/4.
CIN : L65190GJ1994PLC021012
This is an authenticated intimation/statement.
Customers are requested to immediately notify the Bank of any discrepancy in the statement
ROG_ SR128812020_DB_AS_SSen_26052019