Investor Name*

Address Type*

Select Address Type Residential Business Registered Office Residential or Business

Place of Birth*

Date Of Birth*

Gender*

Select Gender Male Female Others

Country of Birth*

Select Country Of Birth

Gross Annual Income details in INR*

Select Gross Annual Income Below 1 Lac 1 to 5 Lacs 5 to 10 Lacs 10 to 25 Lacs 25 Lacs - 1 Crore above 1 Crore

Net Worth in [Lakhs INR]

Nationality*

Select Nationality

Net Worth Date

Occupation*

Select Occupation Private Service Public Sector/Government Service Business Student House Wife Professional Agriculturist Retired Forex Dealer Others

Are you Politically Exposed Person [PEP]?*

Select Yes No RPEP (Related to PEP)

Source Of Income

Select Source of Wealth Salary Business Income Gift Ancestral Property Rental Income Prize Money Royalty Others

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.