<Annexure 1>

<Request letter on the Letter Head>

Date: <Mon DD, YYYY>

To,

The Branch Manager,

ICICI Bank Limited
<Branch Name>

Issuance of Solvency Certificate

Dear Sir/Madam,

We are holding a Current Account number _______________________ in the name of

_______________________________ with your branch since _______________________.

This is with regards to Solvency Certificate to be issued in the name of <Authority Name>.
We require solvency certificate to be issued to the Authority <Authority Name and
Address> for the purpose of <Purpose>.

Please find enclosed the latest certified Audited Balance Sheet/Financials, Schedules/Notes
to account/tax audit report (as applicable) for your reference.

Please issue Solvency Certificate for an amount of Rs <Amount>.

I hereby authorise Bank to debit the applicable service charges and taxes, for the issuance of
Solvency Certificate from my Account number _______________________________________.

I hereby authorise ICICI Bank to generate my CIBIL/Bureau reports for assessment on my

behalf, if required.

Sincerely,

Customer’s Signature with Stamp:

<Annexure 2>

Branch Due Diligence Certificate

Sr. If No; ZH I-process

Parameters Yes/No
No. Approval taken
1 If Account Vintage > 6 months
2 If last 6 months MAB > Rs 50,000
No cheque returns or NMMAB charges in the
account in the last 6 months (if customer has
3
multiple accounts, all the accounts need to be
checked)

I confirm that I have done the due diligence of customer

M/s._____________________________________________ on (date)_______________________
and met owner/partner/director ___________________________________________________

I hereby confirm that,

 Request Letter has been signed by the customer in my presence
 I have verified the financial documents with original
 I have verified the UDI Number of the Chartered Accountant from the website:
https:/udin.icai.org

Name of Branch Manager/Deputy Branch Manager: ___________________________________

Employee ID: ______________________________________________________________________
Branch Name and SOL ID: __________________________________________________________

Signature with Branch Stamp

<Annexure 3>

Strictly Private & Confidential

Solvency Certificate

<Mon DD, YYYY>

To,
<Authority Name>
<Authority Address>

This is to certify that to the best of our knowledge and information, M/s <Customer/Entity
Name and Address>, a customer of our Bank is respectable and can be treated as good up
to a sum of Rupees <Approved Solvency Amount in words> <(Approved Solvency
Amount in figures)>.

It is clarified that this information is furnished in strict confidence and without any risk and
responsibility on our part or on the part of any of the Bank’s officials in any respect
whatsoever more particularly either as guarantor or otherwise.

This certificate is issued based on the financial documents provided for FY______ at the
specific request of the customer.

This certificate is valid till Mar 31 of the next financial year from the FY for which the
documents have been provided.

Branch Manager’s Signature:

Branch Stamp: