Investor Name*

Address Type*

Place of Birth*

Date Of Birth*

Gender*

Country of Birth*

Select Country Of Birth

Gross Annual Income details in INR*

Net Worth in [Lakhs INR]

Nationality*

Select Nationality

Net Worth Date

Occupation*

Are you Politically Exposed Person [PEP]?*

Source Of Income

Other KYC Related Information

Are you a Tax Resident In any country other than India*

No Yes

In Case Tax Identification Number is not available,kindly provide its functional equivalent
Reason A-The Country Where the account holder is liable to pay tax does not issue Tax Identification Number to its Residents
Reason B-No TIN Required (Select this reason only if the authorities of the respective country of tax residence not require the TIN be collected )
Reason C-Others,Please state the reason

I have understood the information requirements of this Form (read along with the FATCA & CRS Instructions ) and hereby confirm that information Form is true,correct,and complete. I also confirm that I have read and understood the FATCA & CRS Terms and Conditions below and hereby accept.