Axis Bank|Public

Additional KYC Declaration

(To be used for CASA Non-Individual Onboarding/Re-Kyc/BO updation/Profile Updation)

Barcode Number* ____________________________________

Name of the Entity* ____________________________________________________________________

Is your Principal Place of Business same as? (Choose one of the below options)*

Registered Address
Communication/Local Address
Others

If “Others”, provide the complete address below along with supporting address proof

Address Line 1:

Address Line 2:

Landmark:

City:

State:

PIN Code: Country:

Declaration for Updation/Periodic Updation of KYC:

I/We will ensure that any update/change in any information or documents provided by me/us in future is intimated/informed to the
Bank promptly, i.e. within 30 days from the date of change.

(Signature of the Authorized Signatory/Director/Proprietor/Partner/Trustee)

Name:

Designation:

Place:

Date: