Annexure 2

CIF (Customer Information File) Opening Form for Personal CIF (Relaxed KYC)

Affix recent
Passport size Photo
A ................................... Branch

I request the Bank to open account(s) / provide services opted by me and the required individual Details are given below: Customer Name & Address (ALL IN BLOCK LETTERS PLEASE) (Please wherever applicable)
Particulars of Identification
1. Any one document from each of the under-noted 2 lists, for a Photo ID and proof of residence
List I (latest/recent) put
List II (latest/recent) put
1. NREGP Card
1. NREGP Card
2. SS Pension Card
2. SS Pension Card
3. Self declaration
3. Self declaration
Others (Please specify) *
Others (Please specify) *
4.
4.
5.
5.
6.
6.
7.
7.
* subject to the Bank’s satisfaction. SIGNATURE OF THE APPLICANT : DATE : ____ / ____ / _______ Introduction from an existing account holder of the branch Name of the Introducer ........................................................................ Type of account and a/c No........................................................... Address of the introducer.............................................................................................................................................................................. ..................................................................... PIN CODE.......................... Phone No............................. Account held since ........................ I hereby introduce the above named applicant(s) and certify that I know Mr/Ms.................................................................................. for the past ........... months/years and confirm his/her occupation and address as stated in this application. I also attest his/her signature(s).
....................................................................... Signature of the Introducer
Signature of the introducer / KYC particulars are verified by me. CIF (CUSTOMER INFORMATION FILE) FOR THIS CUSTOMER MAY BE OPENED. Signature of the verifying Official ................................................................. Name of the verifying officer with SS No. ............................................................
BRANCH USE : Social Attributes (as per the codes available in CBS)
Religion - Caste
Income Category
BPL Above BPL
Physically Challenged
Special Category
Politically Exposed
Risk Category
Low Medium High
Created by : Initial _____________ Authorised by: Initial _____________ CIF No.
CDPC use : (if applicable ) Date of updation at CDPC : ____/____/____ Updated by : Authorised by : Initial. with name Initial with name & SS No.
Particulars
Details of Applicant
TITLE
MR / MRS / MS / DR. / ER. / MINOR
FIRST NAME
MIDDLE NAME
LAST NAME
FATHER/SPOUSE NAME
ADDRESS (RESIDENCE) CITY & PIN CODE STATE IF STAFF S.R.NO.:
DATE OF BIRTH
____ / ____ / _______.
GENDER
Male Female Others
MARITAL STATUS
Married Single
OCCUPATION
ID Card No.:
PHONE No. (RESI)
ADDRESS (PLACE OF WORK) CITY & PIN CODE STATE
PHONE No. (OFF)
MOBILE No.
E MAIL ID
PAN No.
AADHAR No.
RELIGION : HINDU / MUSLIM / CHRISTIAN / OTHERS
COMMUNITY: FC / OC / BC/ MBC/ SC/ ST
ANNUAL INCOME