evsjvg`k dvbbvwÝqvj b›uwjgrÝ ... - bangladesh bank home · 1 evsjvg`k dvbbvwÝqvj b›uwjgrÝ...

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1 evsjv‡`k dvBb¨vwÝqvj B‡›Uwj‡RÝ BDwbU evsjv‡`k e¨vsK cÖavb Kvh©vjq XvKv| I‡qemvBU t www.bb.org.bd weGdAvBBD mvKz©jvi ‡jUvi bs- 01/2017 ZvwiL t e¨e¯’vcbv cwiPvjK/cÖavb wbe©vnx Kg©KZ© v evsjv‡`‡k Kvh©iZ mKj Zdwmwj e¨vsK wcÖq g‡nv`q, Zdwmwj e¨vsKmg~‡ni Rb¨ "Uniform Account Opening Form I KYC Profile Form" RvixKiY cÖm‡½| 1| gvwbjÛvwis I mš¿ vmx Kv‡h© A_©vqb cÖwZ‡iva I G msµvšÍ SuywK †gvK‡ejvq MZ 30 Ryb, 2008 Zvwi‡Li cÎ bs-GGgGjwW-1 (cwjwm)/2008-2324 Ges cieZ©x‡Z 28 wW‡m¤^i, 2014 Zvwi‡Li weGdAvBBD mvK© zjvi bs-10 Gi gva¨‡g evsjv‡`‡k Kvh©iZ mKj Zdwmwj e¨vs‡Ki Rb¨ RvixK…Z "Uniform Account Opening Form I KYC Profile Form" wewfbœ AvBbMZ ms‡kvab I AvšÍ R©vwZK gvb`‡Ûi cwieZ©‡bi m~‡Î nvjbvMv`Ki‡Yi Avek¨KZv we‡ewPZ nIqvq Zv nvjbvMv`KiZt gvwbjÛvwis cÖwZ‡iva AvBb, 2012 Gi 23 (1)(N) aviv Ges mš¿ vm we‡ivax AvBb, 2009 Gi 15(1)(N) avivq cÖ`Ë ÿgZve‡j Rvix Kiv n‡jv| 2| RvixK…Z "Uniform Account Opening Form I KYC Profile Form" mKj e¨vsK KZ©…K 01 GwcÖj, 2017 Zvwi‡Li g‡a¨ Aek¨B cÖPjb Ki‡Z n‡e Ges bZybfv‡e gyw`ªZ di‡gi GK †mU G BDwb‡U `vwLj Ki‡Z n‡e| 3| gvwbjÛvwis cÖwZ‡iva AvBb, 2012 Gi 25(1)(K) aviv †gvZv‡eK MÖvn‡Ki mwVK Ges c~Y©v½ Z_¨ msiÿ‡Yi `vwqZ¡ e¨vsKmg~n‡K h_vh_fv‡e cvjb Ki‡Z n‡e| 4| wnmve †Lvjvi mgq wb‡gœv³fv‡e digmg~n e¨envi Ki‡Z n‡e t e¨w³K wnmve A-e¨w³K wnmve 1. wnmve †Lvjvi Av‡e`b dig (e¨w³K wnmve) 2. wnmve †Lvjvi dig t e¨w³ msμÍ Z_¨vejx (Dchy³ msL¨K) 3. m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) 4. MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form) 1. wnmve †Lvjvi Av‡e`b dig (A-e¨w³K wnmve) 2. wnmve †Lvjvi dig t e¨w³ msμÍ Z_¨vejx (Dchy³ msL¨K) 3. m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) 4. MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form) 5| Awfbœ wnmve †Lvjvi di‡gi Z_¨vw` mKj e¨vs‡Ki wnmve †Lvjvi di‡g Aek¨B _vK‡Z n‡e, Z‡e †Kvb e¨vsK cÖ‡qvR‡b AwZwi³ Z_¨vw` ms‡hvRb Ki‡Z cvi‡e| 6| dig evsjvq ev Bs‡iRx‡Z ev Dfq fvlvq gy`ªY Kiv hv‡e, Z‡e di‡g DwjøwLZ Avewk¨K †¶Îmg~‡n evsjv I Bs‡iRx Dfq fvlv‡ZB Z_¨ msMÖn I msiÿY Ki‡Z n‡e| 7| mKj e¨vsK Zv‡`i wnmve mswkøó kZ© mg~n wbR¯^ wbqgvbymv‡i di‡gi mv‡_ mshy³ Ki‡e| 8| kwiqvn wfwËK e¨vsKmg~n RvixK…Z di‡g e¨eüZ Uv‡g©i cwie‡Z© cÖPwjZ I mvgÄm¨c~Y© Bmjvgx Uvg© e¨envi Ki‡Z cvi‡e| 03 gvN, 1423 16 Rvbyqvwi, 2017

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1

evsjv‡`k dvBb¨vwÝqvj B‡›Uwj‡RÝ BDwbU

evsjv‡`k e¨vsK

cÖavb Kvh©vjq

XvKv|

I‡qemvBU t www.bb.org.bd

weGdAvBBD mvKz©jvi ‡jUvi bs- 01/2017 ZvwiL t

e¨e¯’vcbv cwiPvjK/cÖavb wbe©vnx Kg©KZ©v

evsjv‡`‡k Kvh©iZ mKj Zdwmwj e¨vsK

wcÖq g‡nv`q,

Zdwmwj e¨vsKmg~‡ni Rb¨ "Uniform Account Opening Form

I KYC Profile Form" RvixKiY cÖm‡½|

1| gvwbjÛvwis I mš¿vmx Kv‡h© A_©vqb cÖwZ‡iva I G msµvšÍ SuywK †gvK‡ejvq MZ 30 Ryb, 2008 Zvwi‡Li cÎ bs-GGgGjwW-1

(cwjwm)/2008-2324 Ges cieZ©x‡Z 28 wW‡m¤^i, 2014 Zvwi‡Li weGdAvBBD mvK©zjvi bs-10 Gi gva¨‡g evsjv‡`‡k

Kvh©iZ mKj Zdwmwj e¨vs‡Ki Rb¨ RvixK…Z "Uniform Account Opening Form I KYC Profile Form" wewfbœ

AvBbMZ ms‡kvab I AvšÍR©vwZK gvb`‡Ûi cwieZ©‡bi m~‡Î nvjbvMv`Ki‡Yi Avek¨KZv we‡ewPZ nIqvq Zv nvjbvMv`KiZt

gvwbjÛvwis cÖwZ‡iva AvBb, 2012 Gi 23 (1)(N) aviv Ges mš¿vm we‡ivax AvBb, 2009 Gi 15(1)(N) avivq cÖ`Ë ÿgZve‡j

Rvix Kiv n‡jv|

2| RvixK…Z "Uniform Account Opening Form I KYC Profile Form" mKj e¨vsK KZ©…K 01 GwcÖj, 2017 Zvwi‡Li

g‡a¨ Aek¨B cÖPjb Ki‡Z n‡e Ges bZybfv‡e gyw`ªZ di‡gi GK †mU G BDwb‡U `vwLj Ki‡Z n‡e|

3| gvwbjÛvwis cÖwZ‡iva AvBb, 2012 Gi 25(1)(K) aviv †gvZv‡eK MÖvn‡Ki mwVK Ges c~Y©v½ Z_¨ msiÿ‡Yi `vwqZ¡ e¨vsKmg~n‡K

h_vh_fv‡e cvjb Ki‡Z n‡e|

4| wnmve †Lvjvi mgq wb‡gœv³fv‡e digmg~n e¨envi Ki‡Z n‡e t

e¨w³K wnmve A-e¨w³K wnmve

1. wnmve †Lvjvi Av‡e`b dig (e¨w³K wnmve)

2. wnmve †Lvjvi dig t e¨w³ msµvšÍ Z_¨vejx (Dchy³

msL¨K)

3. m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) 4. MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

1. wnmve †Lvjvi Av‡e`b dig (A-e¨w³K wnmve)

2. wnmve †Lvjvi dig t e¨w³ msµvšÍ Z_¨vejx (Dchy³

msL¨K)

3. m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) 4. MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

5| Awfbœ wnmve †Lvjvi di‡gi Z_¨vw` mKj e¨vs‡Ki wnmve †Lvjvi di‡g Aek¨B _vK‡Z n‡e, Z‡e †Kvb e¨vsK cÖ‡qvR‡b

AwZwi³ Z_¨vw` ms‡hvRb Ki‡Z cvi‡e|

6| dig evsjvq ev Bs‡iRx‡Z ev Dfq fvlvq gy`ªY Kiv hv‡e, Z‡e di‡g DwjøwLZ Avewk¨K †¶Îmg~‡n evsjv I Bs‡iRx Dfq

fvlv‡ZB Z_¨ msMÖn I msiÿY Ki‡Z n‡e|

7| mKj e¨vsK Zv‡`i wnmve mswkøó kZ©mg~n wbR¯ wbqgvbymv‡i di‡gi mv‡_ mshy³ Ki‡e|

8| kwiqvn wfwËK e¨vsKmg~n RvixK…Z di‡g e¨eüZ Uv‡g©i cwie‡Z© cÖPwjZ I mvgÄm¨c~Y© Bmjvgx Uvg© e¨envi Ki‡Z cvi‡e|

03 gvN, 1423

16 Rvbyqvwi, 2017

2

9| wnmve †Lvjvi Av‡e`b di‡g I Ab¨vb¨ mswkøó di‡g msM„nxZ Z_¨vw` MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

Gi Ask wn‡m‡e we‡ewPZ n‡e|

10| e¨w³K wnmv‡ei †¶‡Î wnmve †Lvjvi di‡gi mv‡_ mshy³ cwiwkó-1(K) G †ewbwdwkqvj Ibv‡ii ¯^v¶i msMÖ‡ni welqwU

Hw”QK wn‡m‡e we‡ewPZ n‡e, Z‡e G‡¶‡Î e¨vsK KZ©…K †ewbwdwkqvj Ibvi wPwýZKiYc~e©K e¨w³ msµvšÍ Z_¨vejx msMÖn Ki‡Z

n‡e|

G wel‡q M„nxZ e¨e¯’vw` m¤ú‡K© AvMvgx 10/04/2017 Zvwi‡Li g‡a¨ G BDwbU‡K AewnZ Kivi Rb¨ Avcbv‡`i‡K civgk©

†`qv n‡jv|

Avcbv‡`i wek¦¯Í,

ms‡hvRbxt 33 c„ôv|

(†`ecÖmv` †`ebv_)

gnve¨e¯’vcK I Acv‡ikbvj †nW

†dvb t 9530118

cÖwZwjwc bs-weGdAvBBD(cwjwm)-04/2017-17 ZvwiL t DwjøwLZ

AeMwZ I cÖ‡qvRbxq e¨e¯’v MÖn‡Yi Rb¨ cÖwZwjwc †cÖiY Kiv n‡jv (‡R¨ôZvi µgvbymv‡i bq)t

1. mKj wbe©vnx cwiPvjK, gwZwSj/PÆMÖvg/ivRkvnx/Lyjbv/wm‡jU/e¸ov/iscyi/ewikvj|

2. wcÖwÝcvj, evsjv‡`k e¨vsK ‡Uªwbs GKv‡Wwg, wgicyi-2, XvKv|

3. mKj wefvMxq cÖavb, evsjv‡`k e¨vsK, cÖavb Kvh©vjq, XvKv|

4. gnve¨e¯’vcK, evsjv‡`k e¨vsK, m`iNvU,XvKv/gqgbwmsn|

5. Mfb©i g‡nv`‡qi e¨w³MZ Kg©KZ©v, evsjv‡`k e¨vsK, cÖavb Kvh©vjq, XvKv|

6. †WcywU Mfb©i g‡nv`qM‡Yi mv‡_ mshy³ Dc cwiPvjK/mnKvix cwiPvjK, evsjv‡`k e¨vsK, cÖavb Kvh©vjq, XvKv|

7. A_©‣bwZK Dc‡`óv/wbe©vnx cwiPvjK g‡nv`qM‡Yi e¨w³MZ mnKvix, evsjv‡`k e¨vsK, cÖavb Kvh©vjq, XvKv|

8. gnvcwiPvjK, evsjv‡`k BÝwUwUDU Ae e¨vsK g¨v‡bR‡g›U, wgicyi, XvKv|

9. gnvmwPe, w` BÝwUwUDU Ae e¨vsKvm© evsjv‡`k, weGmAviGm feb, 10g Zjv, 12, KvIivb evRvi, †ZRMuvI, XvKv|

10. †Pqvig¨vb, evsjv‡`k G‡mvwm‡qkb Ae e¨vsKm, 42, Kvgvj AvZvZzK© GwfwbD, ebvbx, XvKv|

11. †Pqvig¨vb, G‡mvwm‡qkb Ae e¨vsKvm© evsjv‡`k wjwg‡UW, B÷vb© Kgvwk©qvj Kg‡cø·, 73, KvKivBj, XvKv|

(†gvt †di‡`․m Kwei)

Dc cwiPvjK

‡dvbt 9530010-75/2455

B-‡gBj- [email protected]

1

......................... e¨vsK/e¨vsK wjt

....................kvLv

wnmve †Lvjvi Av‡e`b dig

e¨w³K wnmve

ZvwiLt...............................

e¨e ’vcK

--------------e¨vsK/e¨vsK wjt

------------- kvLv|

wcÖq g‡nv`q,

Avwg/Avgiv Avcbvi kvLvq GKwU wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i wnmve msµvšÍ I e¨w³MZ we ÍvwiZ

Z_¨ wb‡gœ cÖ`vb KiwQ t

1| wnmv‡ei bvg t (evsjvq) .......................................................................................................

In English (Block Letter) ..................................................................................

2| wnmv‡ei cÖK…wZ (wUK w`b)t mÂqx PjwZ GmGbwW Gdwm AviGdwmwW GbGdwmwW

Ab¨vb¨ ........................................................................................

3| gy`ªv (wUK w`b)t UvKv Wjvi BD‡iv cvDÛ Ab¨vb¨......

4| wnmve cwiPvjbv msµvšÍ †NvlYv (wUK w`b)t GKKfv‡e †h․_fv‡e ‡h †Kvb GKRb A_ev RxweZRb

Ab¨vb¨ ..............................................

5| wnmve †Lvjvi D‡Ïk¨ t

6| MÖvn‡Ki Ab¨ †Kvb e¨vs‡K wnmve Av‡Q wK (wUK w`b)? nu¨v bv

(DËi nu¨v n‡j wbgœiƒ‡c wee„Z Kiæb)

e¨vsK I kvLvi bvg cwiPvwjZ wnmv‡ei cÖK…wZ (wUK w`b)

(K) ........................ Rgv wnmve FY wnmve

(L) ........................ Rgv wnmve FY wnmve

(M) ......................... Rgv wnmve FY wnmve

(N) ........................... Rgv wnmve FY wnmve

(O) ........................... Rgv wnmve FY wnmve

7| e¨w³ msµvšÍ Z_¨vejx t (cwiwkó-1 (K) G mshy³ e¨w³ msµvšÍ Z_¨vejx dig c~iY Ki‡Z n‡e|)

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ..........................

(e¨vs‡Ki e¨env‡ii Rb¨)

2

8| GK ev GKvwaK wnmveavix bvevjK n‡j t

Avwg wbgœewY©Z wnmveavixi AwffveK wn‡m‡e GB g‡g© †NvlYv KiwQ †h, wnmveavix bvevjK| Zvi cÖ‡qvRbxq Z_¨ mshy³

di‡g cÖ`vb Kiv n‡jv| wnmveavix mvevjK bv nIqv ch©šÍ wKsev Avgvi cieZx© †NvlYv bv †`qv ch©šÍ AwffveK wn‡m‡e

wnmvewU Avgvi ¯vÿ‡i cwiPvwjZ n‡e|

(AwffveK ej‡Z evev A_ev gv A_ev Ab¨ †Kvb AvBbMZ AwffveK‡K eySv‡e)

(K) wnmveavix (bvevjK) Gi bvg t...........................................................Rb¥ ZvwiL t ...................

(L) Awffve‡Ki bvg t............................................................bvevj‡Ki mv‡_ m¤úK© t ..................

Awffve‡Ki ¯v¶i t............................................................

(bvevjK Ges AwffveK - Df‡qi Rb¨B cwiwkó-1 (K) G mshy³ Òe¨w³ msµvšÍ Z_¨vejxÓ dig c~iY Ki‡Z n‡e Ges bvevjK Av‡e`bKvixi †¶‡Î Dfq

di‡gB Av‡e`bKvixi ¯^v¶‡ii ¯’‡j AwffveK KZ©„K ¯^vÿi Ki‡Z n‡e|)

9| cwiPq`vbKvixi Z_¨ t

(K) bvg t.................................................................

(L) wnmv‡ei bvg t..................................................................

(M) wnmve bs t..................................................................

(N) kvLvi bvg t..................................................................

(O) MÖvn‡Ki mv‡_ cwiwPwZi m~Î/m¤úK© t..........................................................

(P) ‡hvMv‡hvM gva¨g t †dvb bs .....................†gvevBj bs ....................

(Q) ¯vÿi I ZvwiL t..................................................................

cwiPq`vbKvixi Z_¨ cÖZ¨vqbKvix mswkøó e¨vsK kvLvi Kg©KZ©vi bvg I ¯vÿi (wmj I ZvwiLmn) t................

10| cÖv_wgK Rgvi cwigvY t ..........................

11| bwgwb msµvšÍ Z_¨vejx t cwiwkó-2 G mshy³ bwgwb msµvšÍ Z_¨vejx dig c~iY Ki‡Z n‡e|

bwgwbi msL¨vt....................

12| m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) msµvšÍ Z_¨vejx t cwiwkó-3 G mshy³ TP msµvšÍ

Z_¨vejx dig c~iY Ki‡Z n‡e|

13| A‡_©i Drm/Drmmg~n (mywbw`©ó I we ÍvwiZ D‡jøL Ki‡Z n‡e)t ..........................................................

........................................................................................................................................................

........................................................................................................................................

14| †NvlYv I ¯vÿi t

Avwg/Avgiv GB g‡g© wbðqZv cÖ`vb KiwQ †h, Avwg/Avgiv wnmve msµvšÍ hveZxq wbqgvejx/kZv©ejx c‡owQ Ges D³

wbqgvejx/kZv©ejx †g‡b Pj‡Z eva¨ _vKe| Avwg/Avgiv mÁv‡b †NvlYv KiwQ †h, DwjøwLZ Z_¨vw` mZ¨| Avwg/Avgiv

cÖ`Ë Z‡_¨i AwZwi³ mswkøó †h †Kvb cÖ‡qvRbxq Z_¨/`wjjvw` e¨vs‡Ki Pvwn`v †gvZv‡eK mieivn Kie|

1g Av‡e`bKvixi ¯vÿi, bvg I ZvwiL 2q Av‡e`bKvixi ¯vÿi, bvg I ZvwiL

e¨vs‡Ki e¨env‡ii Rb¨

gšÍe¨ t.....................................................................................................................................

.........................

.........................

wnmve †Lvjvi mv‡_ mswkøó Kg©KZ©vi

bvghy³ wmjmn ¯vÿi I ZvwiL

.........................

.........................

Aby‡gv`bKvix Kg©KZ©vi (kvLv e¨e ’vcK)

bvghy³ wmjmn ¯vÿi I ZvwiL

3

........................ e¨vsK / e¨vsK wjt

...............................kvLv

wnmve †Lvjvi Av‡e`b dig

A-e¨w³K wnmve

ZvwiLt...............................

e¨e ’vcK

-------------e¨vsK/e¨vsK wjt

------------- kvLv|

wcÖq g‡nv`q,

Avwg/Avgiv Avcbvi kvLvq GKwU wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i, cÖwZôv‡bi Ges wnmv‡ei we¯ÍvwiZ

Z_¨ wb‡gœ cÖ`vb KiwQt

1| wnmv‡ei bvg t (evsjvq)......................................................................................................

In English (Block Letter) ..................................................................................

2| cÖwZôv‡bi aiY (wUK w`b)t GKK gvwjKvbv Askx`vix †h․_ D‡`¨vM cÖvB‡fU wjt †Kv¤úvwb

cvewjK wjt †Kv¤úvwb miKvix Avav miKvix/¯vqËkvwmZ Uªv÷ GbwRI/GbwcI

K¬ve/†mvmvBwU wkÿv cÖwZôvb agx©q cÖwZôvb

Ab¨vb¨ (wbw`©ófv‡e D‡jøL Kiæb)........................................

3| wnmv‡ei cÖK„wZ (wUK w`b)t mÂqx PjwZ GmGbwW Gdwm Ab¨vb¨.....

4| gy`ªv (wUK w`b)t UvKv Wjvi BD‡iv cvDÛ Ab¨vb¨......

5| wnmve †Lvjvi D‡Ïk¨ t

6| cÖwZôv‡bi wVKvbv t

(K) wbeÜbK…Z wVKvbv t..............................................................................................

(L) e¨emv¯’j/Awd‡mi wVKvbv t..............................................................................................

(M) KviLvbv/wkí cÖwZôv‡bi wVKvbv t.............................................................................................

7| †UªW jvB‡mÝ b¤^i t .................................................... ZvwiL t .....................................

Bmy¨Kvix KZ©„cÿ t.......................................................................................................

8| wbeÜb b¤^i t...................................................... ZvwiL t ..................................

9| wbeÜb KZ©…cÿ I †`k t......................................................................................................

(†`kx /we‡`kx Dfq ai‡Yi Rb¨)

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt .........................

(e¨vs‡Ki e¨env‡ii Rb¨)

4

10| B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤^i t.......................................................................................

11| f¨vU †iwRt b¤i/BIN (hw` _v‡K) .........................................................................................

12| e¨emv msµvšÍ Z_¨ t

(K) e¨emvi aiY t †UªwWs †mev Drcv`b

(L) cY¨ ev †mevi aiYt ......................................................

(M) e¨emvq wb‡qvwRZ †gvU Rbej( ’vqx Ges A¯’vqx) t............................

(N) evwl©K Uvb©Ifvit ........................

(O) cÖwZôv‡bi wbU m¤ú`...............................................

(P) Ab¨vb¨ Z_¨ (cÖ‡hvR¨ †¶‡Î) t........................

13| MÖvn‡Ki Ab¨ †Kvb e¨vsK wnmve Av‡Q wK? nu¨v bv

(DËi nu¨v n‡j wbgœiƒc wee„Z Kiæb )

e¨vsK I kvLvi bvg cwiPvwjZ wnmv‡ei cÖK…wZ (wUK w`b)

(K) ........................ Rgv wnmve FY wnmve

(L) ........................ Rgv wnmve FY wnmve

(M) ......................... Rgv wnmve FY wnmve

(N) ........................... Rgv wnmve FY wnmve

(O) ........................... Rgv wnmve FY wnmve

14| cwiPq`vbKvixi Z_¨ t (miKvix/Avav miKvix/¯^vqËkvwmZ/÷K gv‡K©‡U wj‡÷W †Kv¤úvwb e¨ZxZ Ab¨vb¨ cÖwZôv‡bi

wnmve †Lvjvi †ÿ‡Î)

(K) bvg t............................................................................................................

(L) wnmv‡ei bvg t............................................................................................................

(M) wnmve bs t................................................................. ..........................................

(N) kvLvi bvg t............................................................... .............................................

(O) ‡hvMv‡hvM gva¨g t †dvb bs .....................†gvevBj bs ....................

(P) ¯vÿi (ZvwiLmn) t ............................................................................................................

(Q) MÖvnK/ wnmve cwiPvjbvKvix (MY) Gi mv‡_ cwiwPwZi m~Î/m¤úK© .....................................................

cwiPq`vbKvixi Z_¨ cÖZ¨qbKvix mswkøó e¨vsK kvLvi Kg©KZ©vi bvg I ¯vÿi (wmj I ZvwiLmn) t.........................

15| cÖv_wgK Rgvi cwigvY t..........................................................................................................

16| m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) msµvšÍ Z_¨vejx t cwiwkó-3 G mshy³ TP msµvšÍ

Z_¨vejx dig c~iY Ki‡Z n‡e|

17| A‡_©i Drm/Drmmg~n t (wbw`©ó I we ÍvwiZ D‡jøL Ki‡Z n‡e)............................................................

18| wnmve cwiPvjbvKvix msµvšÍ †NvlYv I ¯vÿit

Avwg/Avgiv GB g‡g© wbðqZv cÖ`vb KiwQ †h, Avwg/Avgiv wnmve msµvšÍ hveZxq wbqgvejx/kZv©ejx c‡owQ Ges D³

wbqgvejx/kZv©ejx †g‡b Pj‡Z eva¨ _vKe| Avwg/Avgiv mÁv‡b †NvlYv KiwQ †h, Dc‡ivwjøwLZ Z_¨vw` mZ¨| Avwg/Avgiv

cÖ`Ë Z‡_¨i AwZwi³ mswkøó †h †Kvb cÖ‡qvRbxq Z_¨/`wjjvw` e¨vs‡Ki Pvwn`v †gvZv‡eK mieivn Kie|

5

Av‡e`bKvix/Av‡e`bKvixM‡Yi ¯vÿi, bvg, c`ex I ZvwiL

1| ...................

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2| ...................

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3| ...................

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4| ...................

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5| ...................

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ÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑÑ

e¨vs‡Ki e¨env‡ii Rb¨

gšÍe¨ t

................................................................................................................................................

................................................................................................................................................

........................

wnmve †Lvjvi mv‡_ mswkøó Kg©KZ©vi

bvghy³ wmjmn ¯vÿi I ZvwiL

.........................

Aby‡gv`bKvix Kg©KZ©vi (kvLv e¨e ’vcK)

bvghy³ wmjmn ¯vÿi I ZvwiL

6

........................ e¨vsK / e¨vsK wjt

....................kvLv

wnmve †Lvjvi Av‡e`b dig

e¨w³K I A-e¨w³K wnmve

(Gd.wW.Avi. I we‡kl w¯‥g Gi ‡ÿ‡Î cÖ‡hvR¨)

ZvwiLt...............................

e¨e ’vcK

-------------e¨vsK/e¨vsK wjt

------------- kvLv|

wcÖq g‡nv`q,

Avwg/Avgiv Avcbvi kvLvq GKwU wnmve †Lvjvi Rb¨ Av‡e`b KiwQ| Avgvi/Avgv‡`i, cÖwZôv‡bi Ges wnmv‡ei

we ÍvwiZ Z_¨ wb‡gœ cÖ`vb KiwQt

1| wnmv‡ei bvg t

(evsjvq)......................................................................................................

In English (Block Letter) ..................................................................................

2| Gd.wW.Avi. msµvšÍ Z_¨t cwigvYt.....................................gy`ªv t..............................

†gqv`Kvj t eQi gvm w`b | ‡gqv`c~wZ©i ZvwiLt.............................

my`/gybvdvi nvit ...............................................

bevq‡bi †ÿ‡Î t Avmj Ges my`/gybvdv bevqb Kiæb

ïaygvÎ Avmj bevqb Kiæb, my`/gybvdv .......................b¤i wnmv‡e Rgv Kiæb

cÖ‡hvR¨ b‡n|

3| we‡kl w¯‥g msµvšÍ Z_¨t

w¯‥‡gi bvgt.............................................................................................................................

w¯‥‡gi †gqv`t.................. GKKvjxb Rgv/ wKw Íi cwigvYt ................ wKw Íi msL¨v (evwl©K) t..............

†gqv`v‡šÍ cÖ‡`qt.............................................. gvwmK cÖ‡`qt.....................................................

4| wnmve cwiPvjbv msµvšÍ †NvlYv (wUK w`b)t GKKfv‡e †h․_fv‡e ‡h †Kvb GKRb A_ev

RxweZRb Ab¨vb¨ .................................................................................................

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ..................

(e¨vs‡Ki e¨env‡ii Rb¨)

7

5| wnmve †Lvjvi D‡Ïk¨ t

6| MÖvn‡Ki Ab¨ †Kvb e¨vs‡K cwiPvwjZ wnmve Av‡Q wK (wUK w`b)? nu¨v bv

(DËi nu¨v n‡j wbgœiƒ‡c wee„Z Kiæb)

e¨vsK I kvLvi bvg cwiPvjbvK…Z wnmv‡ei cÖK…wZ (wUK wPý w`b)

(K) ........................ Rgv wnmve FY wnmve

(L) ........................ Rgv wnmve FY wnmve

(M) ......................... Rgv wnmve FY wnmve

(N) ........................... Rgv wnmve FY wnmve

(O) ........................... Rgv wnmve FY wnmve

7| e¨w³ msµvšÍ Z_¨vejx t cwiwkó-1(K) G mshy³ e¨w³ msµvšÍ Z_¨vejx dig c~iY Ki‡Z n‡e|

8| wnmveavix bvevjK n‡j t

Avwg wbgœewY©Z wnmveavixi •ea AwffveK wn‡m‡e GB g‡g© †NvlYv KiwQ †h, wnmveavix bvevjK| Zvi cÖ‡qvRbxq

Z_¨ mshy³ di‡g cÖ`vb Kiv n‡jv| wnmveavix mvevjK bv nIqv ch©šÍ wKsev Avgvi cieZx© †NvlYv bv †`qv ch©šÍ

AwffveK wn‡m‡e wnmvewU Avgvi ¯vÿ‡i cwiPvwjZ n‡e|

(AwffveK ej‡Z evev A_ev gv A_ev Ab¨ †Kvb AvBbMZ AwffveK‡K eySv‡e)

(K) wnmveavix (bvevjK) Gi bvg t...................................... Rb¥ ZvwiLt .....................................

(L) Awffve‡Ki bvg t............................................................bvevj‡Ki mv‡_ m¤úK© t ..................

Awffve‡Ki ¯v¶i t............................................................

(bvevjK Ges AwffveK - Df‡qi Rb¨B cwiwkó-1 (K) G mshy³ Òe¨w³ msµvšÍ Z_¨vejxÓ dig c~iY Ki‡Z n‡e Ges bvevjK Av‡e`bKvixi †¶‡Î

Dfq di‡gB Av‡e`bKvixi ¯^v¶‡ii ¯’‡j AwffveK KZ©„K ¯^vÿi Ki‡Z n‡e|)

9| cwiPq`vbKvixi Z_¨t (e¨vs‡K MÖvn‡Ki Ab¨ †Kvb mwµq wnmve _vK‡j cÖ‡qvRb †bB)

(K) bvg t.................................................................

(L) wnmv‡ei bvg t.................................................................

(M) wnmve bs t..................................................................

(N) kvLvi bvg t..................................................................

(O) MÖvn‡Ki mv‡_ m¤úK© t..................................................................

(P) ‡hvMv‡hvM gva¨g t †dvb bs t .....................†gvevBj bs t....................

(Q) ¯vÿi (ZvwiLmn) t..................................................................

cwiPq`vbKvixi Z_¨ cÖZ¨vqbKvix mswkøó e¨vsK kvLvi Kg©KZ©vi bvg, wmj I ¯vÿi t................................

10| bwgwb msµvšÍ Z_¨vejx t cwiwkó-2 G mshy³ bwgwb msµvšÍ Z_¨vejx dig c~iY Ki‡Z n‡e|

8

11| A‡_©i Drm/Drmmg~n (mywbw`©ó I we ÍvwiZ D‡jøL Ki‡Z n‡e)t ..........................................................

................................................................................................................................................

12| wbU m¤ú` (Ae¨w³K wnmv‡ei †ÿ‡Î) t ..........................

13| †NvlYv I ¯vÿi t

Avwg/Avgiv GB g‡g© wbðqZv cÖ`vb KiwQ †h, Avwg/Avgiv wnmve msµvšÍ hveZxq wbqgvejx/kZv©ejx c‡owQ Ges

D³ wbqgvejx/kZv©ejx †g‡b Pj‡Z eva¨ _vKe| Avwg/Avgiv mÁv‡b †NvlYv KiwQ †h, DwjøwLZ Z_¨vw` mZ¨|

Avwg/Avgiv cÖ`Ë Z‡_¨i AwZwi³ mswkøó †h †Kvb cÖ‡qvRbxq Z_¨/`wjjvw` e¨vs‡Ki Pvwn`v †gvZv‡eK mieivn

Kie|

1g Av‡e`bKvixi ¯vÿi, bvg I ZvwiL 2q Av‡e`bKvixi ¯vÿi, bvg I ZvwiL

e¨vs‡Ki e¨env‡ii Rb¨

gšÍe¨ t.....................................................................................................................................

.........................

.........................

wnmve †Lvjvi mv‡_ mswkøó Kg©KZ©vi

bvghy³ wmjmn ¯vÿi I ZvwiL

.........................

.........................

Aby‡gv`bKvix Kg©KZ©vi (kvLv e¨e ’vcK)

bvghy³ wmjmn ¯vÿi I ZvwiL

9

cwiwkó-1(K)

(GB digwU c~iYc~e©K e¨w³K I A-e¨w³K wnmve †Lvjvi Av‡e`‡bi g~j As‡ki mv‡_ mshy³ Ki‡Z n‡e|)

ZvwiLt...............................

1. wnmv‡ei bvg t ................................................................................................................

2. MÖvnK/ †ewbwdwmqvj Ibvi/ wnmve cwiPvjbvKvixi bvg t ........................................................

3.wnmv‡ei mv‡_ m¤úK© (bx‡P cÖ‡hvR¨ †ÿ‡Î wUK w`b) t

1g Av‡e`bKvix 2q Av‡e`bKvix 3q Av‡e`bKvix cwiPvjK Askx`vi GKK ¯Z¡vwaKvix

wnmveavix bvevjK AwffveK GUwb© †nvìvi wnmve cwiPvjbvKvix Uªvw÷

†ewbwdwmqvj Ibvi Ab¨vb¨

4. wcZvi bvg t..............................................................................................

5. gvZvi bvg t..............................................................................................

6. ¯vgx/ ¿xi bvg t.............................................................................................

7. RvZxqZv t..............................................................................................

(we‡`kx bvMwiK n‡j wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e MÖnY Ki‡Z n‡e)

8. †iwm‡W›U ÷¨vUvm (wUK w`b) t †iwm‡W›U bb-†iwm‡W›U

(cÖ‡qvRbxq †ÿ‡Î e¨vsK KZ©…K MvBWjvBÝ di d‡ib G·‡PÄ Uªvb‡RKkbm& Gi wb‡`©kbv AbymiY Ki‡Z n‡e)

9. Rb¥ ZvwiL t.............................................................................................

10. Rb¥ ’vb (‡`kmn) t.............................................................................................

11. wj½ (wUK w`b) t cyiæl gwnjv Z…Zxq wj½

12. †ckvt (c`exmn we ÍvwiZ)...............................................................

13. gvwmK Avq (e¨w³K wnmv‡ei †ÿ‡Î) t........................................................................

(13 bs µwg‡Ki †¶‡Î we¯ÍvwiZ D‡jøLc~e©K cÖ‡hvR¨ †ÿ‡Î e¨vs‡Ki Pvwn`v †gvZv‡eK `wjjvw` cÖ`vb Ki‡Z n‡e)

14. cwiwPwZcÎ t

K) RvZxq cwiPqcÎ b¤^i t .....................................................................

L) cvm‡cvU© b¤i t......................................... †gqv` t ..................

M) Rb¥ wbeÜb mb`cÎ b¤^i t ..................................................................

......................... e¨vsK / e¨vsK wjt

....................kvLv

wnmve †Lvjvi dig t e¨w³ msµvšÍ Z_¨vejx

e¨w³i

Av‡jvKwPÎ

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt .....................

(e¨vs‡Ki e¨env‡ii Rb¨)

10

N) B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤^i t .............................

O) WªvBwfs jvB‡mÝ b¤^i t .......................................... †gqv` t ..........................

P) Ab¨vb¨ (wbw`©ófv‡e D‡jøL Ki‡Z n‡e) t ...........................................................

[K n‡Z M b¤^i µwg‡K ewY©Z `wjjvw` n‡Z Avewk¨Kfv‡e †h †Kvb GKwU `wjj cÖ`vb Ki‡Z n‡e| Z‡e Rb¥ wbeÜb mb` c Ö`vbc~e©K wnmve

†Lvjvi †ÿ‡Î Rb¥ wbeÜb mb`c‡Îi AwZwi³ MÖvnK/wnmve cwiPvjbvKvixi Av‡jvKwPÎmn Ab¨ †h †Kvb cwiwPwZ cÎ cÖ`vb Ki‡Z n‡e| bb-

†iwm‡W›U Ges we‡`kx bvMwiK‡`i †¶‡Î mswkøó wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e cÖ`vb Ki‡Z n‡e| Av‡jvKwPÎmn cwiwPwZ cÎ bv

_vK‡j †m wel‡q e¨vs‡Ki mš‘wó mv‡c‡ÿ Zv‡`i wbKU MÖnY‡hvM¨ mgv‡Ri MY¨gvb¨ e¨w³1 KZ…©K cÖ`Ë cwiP‡qi cÖZ¨qbcÎ cÖ`vb Ki‡Z n‡e|

D³ cwiwPwZ cÎ ev cÖZ¨qbcÎ MÖvnK/wnmve cwiPvjbvKvixi Av‡jvKwPÎmn (Av‡jvKwP‡Îi Dc‡ii c„‡ô mZ¨vwqZmn) n‡Z n‡e| GQvov,

cÖ‡Z¨K e¨vsK h_vh_fv‡e MÖvn‡Ki cwiwPwZi wel‡q wbwðZ nIqvi j‡ÿ¨ e¨vs‡Ki mš‘wó mv‡c‡ÿ Dc‡ii N n‡Z P b¤^i µwg‡K ewY©Z

`wjjvw`mn AwZwi³ Av‡iv ‡Kvb `wjjvw` Ges GB di‡g DwjøwLZ Z_¨vw`i AwZwi³ Z_¨ msMÖn Ki‡Z cvi‡e|]

15. eZ©gvb wVKvbv (Avevm ’j) t.....................................................

16. ’vqx wVKvbv t........................................................

17. †ckvMZ wVKvbv t.........................................................

18. †hvMv‡hvMt

(K) wVKvbvt eZ©gvb ¯’vqx ‡ckvMZ

(L) †Uwj‡dvb b¤^i t (1) evmv ......................................... (2) Awdm .......................................

(M) †gvevBj b¤i t (1) ................................... (2) ...............................................

(N) B-†gBj t......................................... (O) d¨v· b¤^i t ...............................

19. Riæix cÖ‡qvR‡b †hvMv‡hv‡Mi Rb¨ g‡bvbxZ e¨w³ t

bvg t ...................................................................

wVKvbv t ..................................................................

wnmveavix/wnmve cwiPvjbvKvixi mv‡_ m¤cK© t ...................... †gvevBj b¤^i t .....................

B-‡gBj wVKvbv t .....................

20. †µwWU KvW© msµvšÍ Z_¨ (hw` _v‡K) t

Bm¨yKvix cÖwZôvb/e¨vsK (GKvwaK n‡j mKj e¨vs‡Ki bvg) t

(K) ’vbxq (Local Card) t........................................

(L) AvšÍR©vwZK (International Card) t.............................

1 *MY¨gvb¨ e¨w³ ej‡Z msm` m`m¨, wmwU K‡c©v‡ik‡bi †gqi, †WcywU †gqi I KvDwÝjiMY, RvZxq †eZb †¯‥‡ji 9g I Z`~aŸ© †MÖ‡Wi

†M‡R‡UW Kg©KZ©v, cvewjK wek¦we`¨vj‡qi wkÿK, Dc‡Rjv cwil‡`i †Pqvig¨vb I fvBm †Pqvig¨vb, BDwbqb cwil‡`i †Pqvig¨vb,

†c․imfvi †gqi I †c․i KvDwÝjiMY, †emiKvix wek¦we`¨vj‡qi Aa¨vcK, †emiKvix K‡j‡Ri Aa¨ÿ, †emiKvix D”P we`¨vj‡qi cÖavb

wkÿK, RvZxq •`wbK cwÎKvi m¤úv`K, †bvUvwi cvewjK, AvavmiKvix/¯^vqËkvwmZ/ivóªvqZ¡ ms¯’vi RvZxq †eZb †¯‥‡ji 7g ev Z`~aŸ©

†MÖ‡Wi Kg©KZ©vMY Ges evsjv‡`k e¨vs‡Ki RvZxq †eZb †¯‥‡ji 9g I Z`~aŸ© †MÖ‡Wi Kg©KZ©vMY‡K eySv‡e|

* weGdAvBBD mvKz©jvi ‡jUvi bs- 03/2017, ZvwiLt 30 Rvbyqvwi, 2017 Gi gva¨‡g cÖwZ¯’vwcZ|

MÖvnK/wnmve cwiPvjbvKvixi

Proof of address Gi mc‡ÿ

WKz‡g›Um cÖ`vb Ki‡Z n‡e

(Kgc‡ÿ 1 wU wVKvbvi mc‡ÿ)

11

Av‡e`bKvixi ¯vÿi I bvg

(ZvwiLmn)

......................... ............................

......................... ............................

wnmve †Lvjvi mswkøó Kg©KZ©vi Aby‡gv`bKvix Kg©KZ©vi (kvLv e¨e ’vcK)

bvghy³ wmjmn ¯vÿi bvghy³ wmjmn ¯vÿi

12

cwiwkó-1 (L)

(GB digwU c~iYc~e©K miKvix wnmve †Lvjvi Av‡e`‡bi g~j As‡ki mv‡_ mshy³ Ki‡Z n‡e|)

ZvwiLt...............................

1. wnmv‡ei bvg t ................................................................................................................

2. wnmve cwiPvjbvKvixi bvg t ..............................................................................

3.wnmv‡ei mv‡_ m¤úK© (bx‡P cÖ‡hvR¨ †ÿ‡Î wUK w`b) t

cÖavb wbe©vnx Kg©KZ©v GUwb© †nvìvi wnmve cwiPvjbvKvix Ab¨vb¨t (mywbw`©ófv‡e D‡jøL

Kiæb)....................................

4. wcZvi bvg t..............................................................................................

5. gvZvi bvg t..............................................................................................

6. ¯vgx/ ¿x Gi bvg t.............................................................................................

7. RvZxqZv t..............................................................................................

(we‡`kx bvMwiK n‡j wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e MÖnY Ki‡Z n‡e)

8. Rb¥ ZvwiL t.............................................................................................

9. Rb¥ ’vb (‡`kmn) t.............................................................................................

10. wj½ (wUK w`b) t cyiæl gwnjv Z…Zxq wj½

11. †ckv I c`gh©v`v (we ÍvwiZ D‡jøLc~e©K cÖ‡hvR¨ †ÿ‡Î e¨vs‡Ki Pvwn`v †gvZv‡eK `wjjvw` cÖ`vb Ki‡Z n‡e) t

...............................................................................................................................................

12. cwiwPwZcÎ t

K) RvZxq cwiPqcÎ b¤^i t ..........................................................................

L) cvm‡cvU© b¤i t ............................................. †gqv` t ................

M) Ab¨vb¨ (wbw`©ófv‡e D‡jøL Ki‡Z n‡e) t ...........................................................

(K Ges L b¤^i µwg‡K ewY©Z `wjjvw` n‡Z Avewk¨Kfv‡e †h †Kvb GKwU `wjj cÖ`vb Ki‡Z n‡e| bb-†iwm‡W›U Ges we‡`kx bvMwiK‡`i

†¶‡Î mswkøó wfmvmn cvm‡cv‡U©i Kwc Avewk¨Kfv‡e MÖnY Ki‡Z n‡e|)

13. eZ ©gvb wVKvbv (Avevm ’j) t....................................................

14. ’vqx wVKvbv t.....................................................

15. †ckvMZ wVKvbv t.....................................................

......................... e¨vsK / e¨vsK wjt

....................kvLv

wnmve †Lvjvi dig t e¨w³ msµvšÍ Z_¨vejx (miKvix wnmve)

e¨w³i

Av‡jvKwPÎ

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ...............

(e¨vs‡Ki e¨env‡ii Rb¨)

MÖvnK/wnmve cwiPvjbvKvixi

Proof of address Gi mc‡ÿ

WKz‡g›Um cÖ`vb Ki‡Z n‡e

(Kgc‡ÿ 1 wU wVKvbvi mc‡ÿ)

13

16. †hvMv‡hvMt

(K) wVKvbvt eZ©gvb ¯’vqx ‡ckvMZ

(L) †Uwj‡dvb b¤^i t (1) evmv ......................................... (2) Awdm .......................................

(M) †gvevBj b¤i t (1) ................................... (2) ...............................................

(N) B-†gBj t......................................... (O) d¨v· b¤^i t ...............................

17. Riæix cÖ‡qvR‡b †hvMv‡hv‡Mi Rb¨ Awdm KZ©…K g‡bvbxZ weKí Kg©KZ©vi Z_¨vejx t

bvg t ...................................................................

c`ex t ...................................................................

Awd‡mi wVKvbv t ..................................................................

†gvevBj b¤i t ....................... B-‡gBj wVKvbv t .....................

wnmve cwiPvjbvKvixi ¯vÿi I bvg (ZvwiLmn)

......................... ............................

......................... ............................

wnmve †Lvjvi mswkøó Kg©KZ©vi Aby‡gv`bKvix Kg©KZ©vi (kvLv e¨e ’vcK)

bvghy³ wmjmn ¯vÿi I ZvwiL bvghy³ wmjmn ¯vÿi I ZvwiL

14

cwiwkó-2

......................... e¨vsK / e¨vsK wjt

....................kvLv

wnmve †Lvjvi dig t bwgwb msµvšÍ Z_¨vejx

(ïaygvÎ e¨w³K wnmv‡ei ‡ÿ‡Î cÖ‡hvR¨ n‡e Ges G‡Ki AwaK bwgwb n‡j

GKvwaK bwgwb dig c~iY Ki‡Z n‡e|)

Avwg/Avgiv G wnmv‡ei A_© Avgvi/Avgv‡`i g„Z y¨i ci wb‡gœv³fv‡e wb‡gœ ewY©Z e¨w³/e¨w³MY‡K cÖ`v‡bi

Rb¨ g‡bvbxZ Kijvg| Avwg/Avgiv DwjøwLZ g‡bvbqb †h †Kvb mgq evwZj ev cwieZ©‡bi AwaKvi msiÿY Kwi|

Avwg/Avgiv GB g‡g© Av‡iv m¤§wZ Ávcb KiwQ †h, Avgvi/Avgv‡`i wb‡`©kbv †gvZv‡eK e¨vsK A_© cÖ`vb Ki‡e

Ges GRb¨ e¨vsK †Kv‡bvfv‡e `vqe× n‡ebv|

1. wnmv‡ei bvg t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. ..

2. wnmve b¤i t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. ..

3. bwgwbi bvg t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. ..

4. wcZvi bvg t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

5. gvZvi bvg t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

6. ¯vgx/¯¿xi bvg t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. ..

7. Rb¥ ZvwiL t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .

8. eZ©gvb wVKvbv t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

9. ’vqx wVKvbv t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

10. †ckv t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

11. bwgwbi cwiwPwZcÎ t

K) RvZxq cwiPqcÎ b¤^i t ................................................................

L) cvm‡cvU© b¤i t ............................................... †gqv` t ............

M) Rb¥ wbeÜb mb`cÎ b¤^i t ................................................................

N) B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤^i t ..........................................................

O) WªvBwfs jvB‡mÝ b¤^i t ............................................. †gqv` t ..............

P) Ab¨vb¨ (wbw`©ófv‡e D‡jøL Ki‡Z n‡e) t .........................................................

[K n‡Z M b¤^i µwg‡K ewY©Z `wjjvw` n‡Z Avewk¨Kfv‡e †h †Kvb GKwU `wjj cÖ`vb Ki‡Z n‡e| Z‡e Rb¥ wbeÜb mb`

cÖ`v‡bi †ÿ‡Î Rb¥ wbeÜb mb`c‡Îi AwZwi³ bwgwbi Av‡jvKwPÎmn Ab¨ †h †Kvb cwiwPwZ cÎ cÖ`vb Ki‡Z n‡e| bb-

†iwm‡W›U Ges we‡`kx bvMwiK‡`i †¶‡Î cvm‡cv‡U©i Kwc Avewk¨Kfv‡e cÖ`vb Ki‡Z n‡e| Av‡jvKwPÎmn cwiwPwZ cÎ bv

bwgwbi

Av‡jvKwPÎ

(MÖvnK KZ©„K

mZ¨vwqZ)

(÷¨vcj Kiæb)

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ..................

(e¨vs‡Ki e¨env‡ii Rb¨)

15

_vK‡j †m wel‡q e¨vs‡Ki mš‘wó mv‡c‡ÿ Zv‡`i wbKU MÖnY‡hvM¨ mgv‡Ri MY¨gvb¨ e¨w³1 KZ…©K cÖ`Ë cwiP‡qi cÖZ¨qbcÎ

cÖ`vb Ki‡Z n‡e| D³ cwiwPwZ cÎ ev cÖZ¨qbcÎ MÖvnK/wnmve cwiPvjbvKvixi Av‡jvKwPÎmn (Av‡jvKwP‡Îi Dc‡ii c„‡ô

mZ¨vwqZmn) n‡Z n‡e| GQvov, cÖ‡Z¨K e¨vsK h_vh_fv‡e MÖvn‡Ki cwiwPwZi wel‡q wbwðZ nIqvi j‡ÿ¨ e¨vs‡Ki mš‘wó

mv‡c‡ÿ Dc‡ii N n‡Z P b¤^i µwg‡K ewY©Z `wjjvw`mn AwZwi³ Av‡iv ‡Kvb `wjjvw` Ges GB di‡g DwjøwLZ Z_¨vw`i

AwZwi³ Z_¨ msMÖn Ki‡Z cvi‡e|]

12. wnmveavixi mv‡_ m¤úK© t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

13. kZKiv nvi t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

14. bwgwb bvevjK n‡j Zvi/Zv‡`i bvevjK _vKv Ae¯’vq wnmveavix/wnmveavixM‡Yi g„Z¨yi †¶‡Î

e¨vsK †Kv¤cvwb AvBb, 1991 Gi 103 (2) aviv Abyhvqx Avgvb‡Zi UvKv MÖnYKvixi Z_¨ t

K) bvg t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

L) wcZv/ ¯vgx Gi bvg t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

M) Rb¥ ZvwiL t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

N) eZ©gvb wVKvbv t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

O) ’vqx wVKvbv t.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

S) µwgK 11 Abymv‡i •ea Awffve‡Ki cwiwPwZcÎ msµvšÍ Z_¨ t

.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

T) bwgwbi mv‡_ m¤cK© t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..

(‡Kvb Awbevmx‡K bwgwb Kiv n‡j Ges H Awbevmx mswkøó wnmv‡ei A_© cÖvß n‡j cÖvß A_© we‡`‡k †cÖi‡Yi †ÿ‡Î we`¨gvb ‣e‡`wkK gy`ªv

wbqš¿Y AvB‡bi wewa weavb cÖ‡hvR¨ n‡e|)

......................................................................

bwgwbi ¯v¶i I ZvwiL (Hw”QK)

....................................................................... ......................................................................

1g Av‡e`bKvixi ¯vÿi, bvg I ZvwiL 2q Av‡e`bKvixi ¯vÿi, bvg I ZvwiL

......................................................................

MÖvn‡Ki ¯v¶i hvPvBKvix e¨vsK Kg©KZ©vi bvghy³ wmjmn ¯^v¶i

1 *MY¨gvb¨ e¨w³ ej‡Z msm` m`m¨, wmwU K‡c©v‡ik‡bi †gqi, †WcywU †gqi I KvDwÝjiMY, RvZxq †eZb †¯‥‡ji 9g I Z`~aŸ© †MÖ‡Wi

†M‡R‡UW Kg©KZ©v, cvewjK wek¦we`¨vj‡qi wkÿK, Dc‡Rjv cwil‡`i †Pqvig¨vb I fvBm †Pqvig¨vb, BDwbqb cwil‡`i †Pqvig¨vb,

†c․imfvi †gqi I †c․i KvDwÝjiMY, †emiKvix wek¦we`¨vj‡qi Aa¨vcK, †emiKvix K‡j‡Ri Aa¨ÿ, †emiKvix D”P we`¨vj‡qi cÖavb

wkÿK, RvZxq •`wbK cwÎKvi m¤úv`K, †bvUvwi cvewjK, AvavmiKvix/¯^vqËkvwmZ/ivóªvqZ¡ ms¯’vi RvZxq †eZb †¯‥‡ji 7g ev Z`~aŸ©

†MÖ‡Wi Kg©KZ©vMY Ges evsjv‡`k e¨vs‡Ki RvZxq †eZb †¯‥‡ji 9g I Z`~aŸ© †MÖ‡Wi Kg©KZ©vMY‡K eySv‡e|

* weGdAvBBD mvKz©jvi ‡jUvi bs- 03/2017, ZvwiLt 30 Rvbyqvwi, 2017 Gi gva¨‡g cÖwZ¯’vwcZ|

16

cwiwkó-3

wnmve †Lvjvi dig t m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile)

e¨w³K I Ae¨w³K wnmve

1. wnmv‡ei bvg t

2. gvwmK m¤¢ve¨ Avqt

3. gvwmK m¤¢ve¨ Uvb©Ifvi (cÖwZôv‡bi †¶‡Î)t

weeiY

gvwmK m¤¢ve¨

Rgvi msL¨v

gvwmK m¤¢ve¨ ‡gvU

Rgvi cwigvY

GKK m‡ev©”P Rgvi

cwigvY

Rgvt

bM` (AbjvBb I GwUGgmn)

UªvÝdvi/ BÝUªy‡g›U Gi gva¨‡g

d‡ib BbIqvW© †iwgU¨vÝ

ißvwb eve` cÖvß

BO (cuywR evRvi) wnmve n‡Z Rgv/ ’vbvšÍi

Ab¨vb¨ (wbw`©ófv‡e)...........................

me©‡gvUt

weeiY

gvwmK m¤¢ve¨

D‡Ëvjb msL¨v

gvwmK m¤¢ve¨ ‡gvU

D‡Ëvj‡bi cwigvY

GKK m‡ev©”P

D‡Ëvj‡bi cwigvY

D‡Ëvjbt

bM` (AbjvBb I GwUGgmn)

UªvÝdvi/BÝUªy‡g›U Gi gva¨‡g cwi‡kva

d‡ib AvDUIqvW© †iwgU¨vÝ

Avg`vwb eve` cwi‡kva

BO (cuywR evRvi) wnmv‡e Rgv/ ’vbvšÍi

Ab¨vb¨ (wbw`©ófv‡e)...........................

me©‡gvUt

......................... e¨vsK / e¨vsK wjt

....................kvLv

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ..................

(e¨vs‡Ki e¨env‡ii Rb¨)

17

Avwg/Avgiv wbgœ¯vÿiKvix (MY) G g‡g© wbðqZv cÖ`vb KiwQ †h, m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv

Avgvi/cÖwZôv‡bi ¯vfvweK cÖK…Z †jb‡`b| Avwg/Avgiv Av‡iv wbðqZv cÖ`vb KiwQ †h, cÖ‡qvRb‡ev‡a Avwg/Avgiv

m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv ms‡kvab/nvjbvMv` Kie|

1| MÖvnK/wnmve cwiPvjbvKvix 2| MÖvnK/wnmve cwiPvjbvKvix

¯^vÿi t ¯^vÿi t

bvg t

ZvwiL t

bvg t

ZvwiL t

e¨vs‡Ki e¨env‡ii Rb¨

evsjv‡`k dvBb¨vwÝqvj B‡›Uwj‡RÝ BDwb‡Ui wb‡ ©kbv †gvZv‡eK MÖvn‡Ki m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction

Profile) ch©v‡jvPbv Kiv n‡jv|

MÖvn‡Ki m¤¢ve¨ †jb‡`‡bi AbywgZ gvÎv (Transaction Profile) cwieZ©b Kiv/ bv Kivi KviYt

........................................................................

cÖZ¨qbKvix e¨vsK Kg©KZ©vi bvghy³ wmjmn ¯v¶i I ZvwiL

18

............e¨vsK/ e¨vsK wjt

.............kvLv

MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

(we‡kl w¯‥g/ ’vqx Avgvb‡Zi †¶‡Î cÖ‡hvR¨)

1. wnmv‡ei bvg t

2. wnmv‡ei cÖK…wZ t

3. MÖvn‡Ki †ckv (we ÍvwiZ) t

4. MÖvn‡Ki gvwmK m¤¢ve¨ Avq t

5. A‡_©i Drm/Drmmg~n (we ÍvwiZ) t

6. A‡_©i Drm wbwðZ Kivi †¶‡Î †hme `wjjvw` msMÖn Kiv n‡q‡Q t

1| .................

2| ..................

3| ..................

msM„nxZ `wjjvw` hvPvB Kiv n‡q‡Q wK bv t nu¨v bv

7. wnmveavixi wVKvbv wKfv‡e hvPvB Kiv n‡q‡Q (we ÍvwiZ)? ....................................................

8. wnmv‡ei cÖK…Z myweav‡fvMx (Beneficial Owner) wba©viY Kiv n‡q‡Q wK-bvt

nu¨v bv

DËi nu¨v n‡j cÖ‡Z¨K cÖK…Z myweav‡fvMx m¤úwK©Z Z_¨vw` cwiwkó-1(K) †gvZv‡eK msMÖn Ki‡Z n‡e t

(‡Kv¤úvwbi †ÿ‡Î wbqš¿YKvix †kqvi †nvìvi A_ev 20% ev Z yaŸ© GKK †kqvi †nvìvi‡K wnmv‡ei cÖK„Z myweav‡fvMx we‡ePbvq

Zvi/Zv‡`i cwiwPwZi Z_¨ cwiwkó-1(K) †gvZv‡eK msMÖn I msiÿY Ki‡Z n‡e| e¨w³K wnmv‡ei †ÿ‡ÎI cÖK…Z myweav‡fvMx

wPwýZKiZt †KIqvBwm m¤úv`b Ki‡Z n‡e)

9. cwiwPwZcÎ t

Kwc M„nxZ hvPvBK…Z [wUK (√) w`b]

K) cvm‡cvU© b¤^i t ........................................ (cÖ‡hvR¨ †¶‡Î)

L) RvZxq cwiPqcÎ b¤i t ............................. (cÖ‡hvR¨ †¶‡Î)

M) Rb¥ wbeÜb mb`cÎ b¤^i t ............................ (cÖ‡hvR¨ †¶‡Î)

N) B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤i t ....... (cÖ‡hvR¨ †¶‡Î)

O) f¨vU †iwRt b¤^i t ...................................... (cÖ‡hvR¨ †¶‡Î)

P) cÖwZôv‡bi wbeÜb b¤^i t ................................ (cÖ‡hvR¨ †¶‡Î)

Q) WªvBwfs jvB‡mÝ b¤^i t ................................. (cÖ‡hvR¨ †¶‡Î)

R) Ab¨vb¨ t ...............................................................................................

10. Awbevmx (Non-resident) Ges we‡`kx‡`i †ÿ‡Î wnmve †Lvjvi D‡Ïk¨t

...................................................................................................................

(K) wfmvi cÖK…wZ.......................................... †gqv` DËx‡Y©i ZvwiLt.............................

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ............

19

(L) Kg©vbygwZ (Work Permit) cÖv߇`i wnmve †Lvjvi †ÿ‡Î Kg©vbygwZ (Work Permit) cÎ I e¨vsK

wnmve †Lvjvi Rb¨ h_vh_ KZ©„c‡ÿi Aby‡gv`b i‡q‡Q wKbv? t n¨uv / bv (cÖ‡hvR¨ †ÿ‡Î)

..................................................................................................................................

(Awbevwm evsjv‡`kx‡`i †¶‡Î Avewk¨Kfv‡e cvm‡cv‡U©i Kwc Ges we‡`kx‡`i †¶‡Î Avewk¨Kfv‡e wfmvmn cvm‡cv‡U©i Kwc msMÖn Ki‡Z n‡e)

11. MÖvnK Politically Exposed Person (PEP)/cÖfvekvjx e¨w³ (IP)/ AvšÍR©vwZK ms ’vi cÖavb ev

D”P ch©v‡qi Kg©KZ©v Ges Zv‡`i cwiev‡ii m`m¨ ev close assosiates wK bv (weGdAvBBD

KZ©…K RvixK…Z mvK©yjv‡i ewY©Z msÁv Abymv‡i)? t

n¨vu bv

DËi nu¨v n‡j t

K. wmwbqi g¨v‡bR‡g›U n‡Z Aby‡gv`b †bqv n‡q‡Q wK bv? n¨uv bv

L. MÖvn‡Ki gy‡LvgywL mvÿvrKvi †bqv n‡q‡Q wK bv? n¨uv bv

12. mswkøó AvBb, wewagvjv I mvKz©jv‡ii Av‡jv‡K MÖvn‡Ki bvg RvwZms‡Ni wbivcËv cwil‡`i wewfbœ

†iRjy¨k‡bi AvIZvq mš¿vmx Kv‡h©, mš¿vmx Kv‡h© A_©vq‡b I e¨vcK aŸsmvZ¥K A ¿ we Ív‡ii A_©vq‡b

RwoZ m‡›`‡n ZvwjKvfy³ †Kvb e¨w³ ev mËv Ges evsjv‡`k miKvi KZ©„K ZvwjKvfy³ ‡Kvb e¨w³ ev

wbwl× †NvwlZ mËvi bv‡gi ZvwjKvi mv‡_ hvPvBevQvBc~e©K †Kvbiƒc wgj cvIqv wM‡q‡Q wKbv ?

n¨uv bv

K) DËi nu¨v n‡j G welqK M„nxZ e¨e ’vi weeiY t

13. wi¯‥ †MÖwWs t

D”P wb¤œ

(gšÍe¨ As‡k Subjective we‡ePbvq MÖvn‡Ki SuywK m¤ú‡K© Avewk¨Kfv‡e gšÍe¨ Ki‡Z n‡e| MÖvn‡Ki SuywK wbiæc‡Yi †ÿ‡Î MÖvn‡Ki

†ckvi we¯ÍvwiZ aviYv we‡kølYKiZt e¨emv‡qi †ÿ‡Î e¨emv‡qi cÖK…wZ, A‡_©i gvÎv, e¨emv‡qi GjvKv, e¨emv‡qi AvKvi, wnmv‡ei cÖK…Z

myweav‡fvMx BZ¨vw`mn Ab¨vb¨ we‡kl w`K we‡ePbvq wb‡q MÖvnK‡K D”P ev wb¤œ SyuwK m¤úbœ wn‡m‡e †kªYxKiY Ki‡Z n‡e| PvKzwii †ÿ‡ÎI

Abyiƒcfv‡e we¯ÍvwiZ aviYv jvf KiZt we‡kl K‡i PvKzwii cÖK…wZ I `vq `vwq‡Z¡i wbwi‡L SzuwK wbiæcY Ki‡Z n‡e| MÖvnK D”P SzuwKc~Y© n‡j

wbqwgZ Z`viwK Ki‡Z n‡e)

cÖ ‘ZKvix t

(wnmve †Lvjvi Kg©KZ©v/wi‡jkbwkc

g¨v‡bRvi)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

ch©v‡jvPbv I wbwðZKvix Kg©KZ©v t

(kvLv gvwbjÛvwis cÖwZ‡iva cwicvjb

Kg©KZ©v)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

20

.................................................................

(PEP/IP/AvšÍR©vwZK ms ’vi EaŸ©Zb Kg©KZ©v Gi †ÿ‡Î Aby‡gv`bKvix EaŸ©Zb Kg©KZ©v)

bvghy³ wmjmn ¯vÿi I ZvwiL

16. wnmve I MÖvnK msµvšÍ Z_¨vw` me©‡kl ch©v‡jvPbv Ges nvjbvMv` (Review & Update ) Kivi ZvwiLt

................................................................................................................................

ch©v‡jvPbv Ges nvjbvMv`Kvix Kg©KZ©vi

bvg (wmjmn) ¯v¶i I ZvwiL

21

............e¨vsK/ e¨vsK wjt

.............kvLv

MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

(e¨w³K wnmve †Lvjvi †ÿ‡Î e¨envh©)

1. wnmv‡ei bvg t

2. wnmv‡ei cÖK…wZ t

3. MÖvn‡Ki †ckv (we ÍvwiZ) t

4. MÖvn‡Ki gvwmK m¤¢ve¨ Avq t

5. A‡_©i Drm/Drmmg~n (we ÍvwiZ) t

6. A‡_©i Drm wbwðZ Kivi †¶‡Î †hme `wjjvw` msMÖn Kiv n‡q‡Q t

1| .................

2| ..................

3| ..................

msM„nxZ `wjjvw` hvPvB Kiv n‡q‡Q wK bv t nu¨v bv

7. wnmveavixi wVKvbv (mg~n) wKfv‡e hvPvB Kiv n‡q‡Q (we ÍvwiZ)? .............................................

...............................................................................................................................

8. wnmv‡ei cÖK…Z myweav‡fvMx (Beneficial Owner) wba©viY Kiv n‡q‡Q wK-bvt

n¨uv bv cÖ‡hvR¨ bq

(DËi n¨uv n‡j cÖ‡Z¨K cÖK…Z myweav‡fvMx m¤úwK©Z Z_¨vw` cwiwkó-1(K) †gvZv‡eK msMÖn Ki‡Z n‡e|)

9. cwiwPwZcÎ t

Kwc M„nxZ hvPvBK…Z [wUK (√) w`b]

K) cvm‡cvU© b¤^i t ........................................ (cÖ‡hvR¨ †¶‡Î)

L) RvZxq cwiPqcÎ b¤i t ............................. (cÖ‡hvR¨ †¶‡Î)

M) Rb¥ wbeÜb mb`cÎ b¤^i t ............................ (cÖ‡hvR¨ †¶‡Î)

N) B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤i t ....... (cÖ‡hvR¨ †¶‡Î)

O) WªvBwfs jvB‡mÝ b¤^i t ................................. (cÖ‡hvR¨ †¶‡Î)

P) Ab¨vb¨ t ...............................................................................................

10. Awbevmx (Non-resident) Ges we‡`kx‡`i †ÿ‡Î wnmve †Lvjvi D‡Ïk¨t

...............................................................................................................................

(K) wfmvi cÖK…wZ............................................. †gqv` DËx‡Y©i ZvwiLt.............................

(L) Kg©vbygwZ (Work Permit) cÖv߇`i wnmve †Lvjvi †ÿ‡Î Kg©vbygwZ (Work Permit) cÎ I e¨vsK

wnmve †Lvjvi Rb¨ h_vh_ KZ©„c‡ÿi Aby‡gv`b i‡q‡Q wKbv? (cÖ‡hvR¨ †ÿ‡Î)

n¨uv bv

(Awbevwm evsjv‡`kx‡`i †¶‡Î Avewk¨Kfv‡e cvm‡cv‡U©i Kwc Ges we‡`kx‡`i †¶‡Î Avewk¨Kfv‡e wfmvmn cvm‡cv‡U©i Kwc msMÖn Ki‡Z n‡e)

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ............

22

11. MÖvnK Politically Exposed Person (PEP)/cÖfvekvjx e¨w³ (IP)/ AvšÍR©vwZK ms ’vi cÖavb ev

D”P ch©v‡qi Kg©KZ©v Ges Zv‡`i cwiev‡ii m`m¨ ev close assosiates wK bv (weGdAvBBD

KZ©…K RvixK…Z mvK©yjv‡i ewY©Z msÁv Abymv‡i)? t

n¨vu bv

DËi nu¨v n‡j:

K. wmwbqi g¨v‡bR‡g›U n‡Z Aby‡gv`b †bqv n‡q‡Q wK bv? n¨uv bv

L. MÖvn‡Ki gy‡LvgywL mvÿvrKvi †bqv n‡q‡Q wK bv? n¨uv bv

12. mswkøó AvBb, wewagvjv I mvKz©jv‡ii Av‡jv‡K MÖvn‡Ki bvg RvwZms‡Ni wbivcËv cwil‡`i wewfbœ

†iRyjyk‡bi AvIZvq mš¿vmx Kv‡h©, mš¿vmx Kv‡h© A_©vq‡b I e¨vcK aŸsmvZ¥K A ¿ we Ív‡ii A_©vq‡b

RwoZ m‡›`‡n ZvwjKvfy³ †Kvb e¨w³ ev mËv Ges evsjv‡`k miKvi KZ©„K ZvwjKvfy³ ‡Kvb e¨w³ ev

wbwl× †NvwlZ mËvi bv‡gi ZvwjKvi mv‡_ hvPvBevQvBc~e©K †Kvbiƒc wgj cvIqv wM‡q‡Q wKbv ? t

n¨uv bv

K) DËi nu¨v n‡j G welqK M„nxZ e¨e¯’vi weeiY t

13. wi¯‥ †MÖwWst

K) MÖvnK Kx K‡ib/Kx ai‡Yi ‡ckvq wb‡qvwRZ i‡q‡Q?

µwgK bs cÖK…wZ wi¯‥ ‡¯‥vi

1. Ry‡qjvwi/¯‡Y©i e¨emv /g~j¨evb avZzi e¨emv 5

2. gvwb †PÄvi /Kzwiqvi mvwf©m/‡gvevBj e¨vswKs G‡R›U 5

3. wi‡qj G‡÷U †Wfjcvi/ G‡R›U 5

4. wbg©vY cÖKí †cÖv‡gvUvi/ wVKv`vi 5

5. wPÎKjv/A¨vw›U‡Ki wWjvi 5

6. ‡iu‡ Íviv/evi/bvBU K¬ve /AvevwmK †nv‡Uj/cvj©vi e¨emv 5

7. Avg`vwb/ißvwb 5

8. Rbkw³ ißvwb e¨emv 5

9. A‡¯¿i e¨emv 5

10. Mv‡g©›Um e¨emv/ Mv‡g©›Um G‡·mwiR/ evwqs nvDR 5

11. cvBjU / d¬vBU G‡Ub‡W›U 5

12. Uªvw÷ 5

13. ‡kqvi/÷K e¨emvq wewb‡qvMKvix 5

14. mdU&Iq¨vi e¨emv/ Z_¨ I cÖhyw³i e¨emv 5

15. GKm&c¨vUwiAvU (evsjv‡`‡k Kg©iZ we‡`kx e¨w³) 5

16. Uªv‡fj G‡R›U 4

17. evwl©K 1 †KvwU UvKvi AwaK A_© jMœxKvix e¨emvqx 4

18. ‡d«BU/wkwcs/Kv‡Mv© G‡R›U 4

19. A‡Uv e¨emv (bZzb/wiKwÛkvb Mvox) 4

20. e¨emv ( Pvgov I PvgovRvZ cY¨) 4

23

µwgK bs cÖK…wZ wi¯‥ ‡¯‥vi

21. evox wbgv©Y mvgMÖxi e¨emv 4

22. ‡ckvRxex (mvsevw`K , AvBbRxex, Wv³vi, BwÄwbqvi, PvU©vW©

GKvDb‡U›U)

4

23. wW‡i±i ( cÖvB‡fU/ cvewjK wjwg‡UW †Kv¤úvwb ) 4

24. eûRvwZK cÖwZôv‡bi EaŸ©Zb Kg©KZ©v 4

25. M„wnYx 4

26. Z_¨-cÖhyw³ ‡ÿ‡Î PvKzwi 4

27. †L‡jvqvo/ wgwWqv †mwj‡eªwU/ cÖwWDmi/wbg©vZv 4

28. wd«j¨vÝ mdU&Iq¨vi ‡W‡fjcvi 4

29. e¨emv-G‡R›U 3

30. miKvix PvKzix 3

31. evoxIqvjv 3

32. myZv e¨emvqx / SzU e¨emvqx 3

33. cwienb Acv‡iUi 3

34. ZvgvK I wmMv‡i‡Ui e¨emv 3

35. we‡bv`bKvix cÖwZôvb/cvK© 3

36. ‡gvUi cvU©m / IqvK©mc Gi e¨emv 3

37. cÖvB‡fU mvwf©m g¨v‡bRvwiqvj 3

38. wkÿK (miKvwi/‡emiKvwi/¯vqËkvwmZ wkÿv cÖwZôvb) 2

39. PvKzix (‡emiKvix) 2

40. ¶z`ª e¨emvqx (evwl©K Uvb©Ifvi 50 jÿ UvKvi bx‡P) 2

41. ¯D‡`¨vMx †ckvRxex 2

42. Kw¤úDUvi/†gvevBj †dv‡bi wWjvi 2

43. Drcv`bKvix (A ¿ e¨ZxZ) 2

44. QvÎ 2

45. PvKzix n‡Z Aemi MÖnYKvix 1

46. K…wlRxex/kÖgRxex/grmRxex 1

47. Ab¨vb¨ (mywbw`©ófv‡e D‡jøL Kiæb) 1-5

(MÖvn‡Ki SuywK wbiæc‡Yi †ÿ‡Î MÖvn‡Ki †ckvi we ÍvwiZ Z_¨ we‡kølYKiZt e¨emv‡qi †ÿ‡Î e¨emv‡qi cÖK…wZ, A‡_©i gvÎv, e¨emv‡qi

GjvKv, e¨emv‡qi AvKvi, wnmv‡ei cÖK…Z myweav‡fvMx BZ¨vw`mn Ab¨vb¨ we‡kl w`K we‡ePbvq wb‡q MÖvnK‡K D”P ev wb¤œ SyuwK m¤úbœ

wn‡m‡e †kªYxKiY Ki‡Z n‡e| PvKzwii †ÿ‡ÎI Abyiƒcfv‡e we ÍvwiZ Z_¨ jvf KiZt we‡kl K‡i PvKzwii cÖK…wZ I `vq `vwq‡Z¡i wbwi‡L

SzuwK wbiæcY Ki‡Z n‡e| Gme welqmg~n we‡ePbvq wb‡q MÖvnK †f‡` 16-46 bs †ÿ‡Î ewY©Z †¯‹vi A‡cÿv D”PZi †¯‹vi cÖ`vb Ki‡Z

cvi‡e|)

L) MÖvn‡Ki gvwmK Av‡qi (Monthly Income) cwigvY t

cwigvY (UvKvq) wi¯‥ ‡¯‥vi

1 j¶ ch©šÍ 0

>1 n‡Z 3 jÿ ch©šÍ 1

3 j¶vwaK 3

24

M) wnmve †Lvjvi aiY t

aiY wi¯‥ ‡¯‥vi

wi‡jkbwkc g¨v‡bRvi/kvLv KZ©„K 0

WvB‡i± †mjm& G‡R›U KZ©„K 3

B›Uvi‡bU/ Non Face to Face 3

¯cÖ‡Yvw`Zfv‡e/Walk-In 3

N) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi cwigvY t

PjwZ wnmv‡e †jb‡`‡bi

cwigvY (j¶ UvKvq)

mÂqx wnmv‡e †jb‡`‡bi

cwigvY (j¶ UvKvq)

wi¯‥ ‡¯‥vi

0-10 0-5 0

>10-20 >5-10 1

>20 >10 3

O) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi msL¨v t

PjwZ wnmv‡e †jb‡`‡bi msL¨v mÂqx wnmv‡e †jb‡`‡bi msL¨v wi¯‥ ‡¯‥vi

0-15 0-10 0

16-25 11-20 1

>25 >20 3

P) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi cwigvY t

PjwZ wnmv‡e †jb‡`‡bi

cwigvY (jÿ UvKvq)

mÂqx wnmv‡e †jb‡`‡bi

cwigvY (jÿ UvKvq)

wi¯‥ ‡¯‥vi

0-5 0-2 0

>5-10 >2-5 1

>10 >5 3

Q) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi msL¨v t

PjwZ wnmv‡e †jb‡`‡bi

msL¨v

mÂqx wnmv‡e †jb‡`‡bi

msL¨v

wi¯‥ ‡¯‥vi

0-10 0-5 0

11-20 6-10 1

>20 >10 3

14. mvgwMÖK SzuwK/wi¯‥ †iwUs wbiƒcY (Dc‡ii K n‡Z Q µwgK ch©šÍ wi¯‥ ‡¯‥v‡ii †hvMdj) t

wi¯‥ ‡¯‥v‡ii †hvMdj mvgwMÖK wi¯‥ †iwUs

>=14 D”P

<14 wbgœ

gšÍe¨ t

25

(* wi¯‥ †iwUs 14 Gi Kg n‡jI Beneficial Owner -Gi D”P SuywK we‡ePbvq wb‡q KviY D‡jøLc~e©K Subjective we‡ePbvq

MÖvnK‡K D”P SuywK m¤úbœ wn‡m‡e wbiƒcY Kiv †h‡Z cv‡i)

cÖ ‘ZKvix t

(wnmve †Lvjvi Kg©KZ©v/wi‡jkbwkc

g¨v‡bRvi)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

ch©v‡jvPbv I wbwðZKvix Kg©KZ©v t

(kvLv gvwbjÛvwis cÖwZ‡iva cwicvjb

Kg©KZ©v)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

.................................................................

(PEP/IP/AvšÍR©vwZK ms ’vi EaŸ©Zb Kg©KZ©v Gi †ÿ‡Î Aby‡gv`bKvix EaŸ©Zb Kg©KZ©v)

bvghy³ wmjmn ¯vÿi I ZvwiL

15. wnmve I MÖvnK msµvšÍ Z_¨vw` me©‡kl ch©v‡jvPbv Ges nvjbvMv` (Review & Update ) Kivi ZvwiLt

ch©v‡jvPbv Ges nvjbvMv`Kvix Kg©KZ©v t

¯^v¶i (wmjmn) t

bvg t

ZvwiL t

26

............e¨vsK/ e¨vsK wjt

.............kvLv

MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

(cÖwZôv‡bi wnmve †Lvjvi †ÿ‡Î e¨envh©)

1. wnmv‡ei bvg t

2. wnmv‡ei cÖK…wZ t

3. cÖwZôv‡bi cÖK…wZ (we ÍvwiZ) t

4. cÖwZôv‡bi wbU m¤ú` (Net Worth) t

5. A‡_ ©i Drm/Drmmg~n (we ÍvwiZ) t

6. A‡_©i Drm wbwðZ Kivi †¶‡Î †hme `wjjvw` msMÖn Kiv n‡q‡Q t

1| .................

2| ..................

3| ..................

msM„nxZ `wjjvw` hvPvB Kiv n‡q‡Q wK bv t n¨uv bv

7. cÖwZôv‡bi wVKvbv (mg~n) wKfv‡e hvPvB Kiv n‡q‡Q (we ÍvwiZ)? .............................................

...............................................................................................................................

8. wnmv‡ei cÖK…Z myweav‡fvMx (Beneficial Owner) wba©viY Kiv n‡q‡Q wK-bvt

n¨uv bv

DËi n¨uv n‡j cÖ‡Z¨K cÖK…Z myweav‡fvMx m¤úwK©Z Z_¨vw` cwiwkó-1(K) †gvZv‡eK msMÖn Ki‡Z n‡e t

(‡Kv¤úvwbi †ÿ‡Î 20% ev Gi AwaK GKK †kqvi †nvìvi Gi we¯ÍvwiZ Z_¨vw` cwiwkó-1(K) †gvZv‡eK msMÖnc~e©K †KIqvBwm

m¤úv`b Ki‡Z n‡e| GQvovI †Kv¤úvwbi wbqš¿YKvix †kqvi‡nvìvi Gi we¯ÍvwiZ Z_¨vw` msMÖnc~e©K †KIqvBwm m¤úv`b Ki‡Z

n‡e|)

Kwc M„nxZ hvPvBK…Z [wUK (√) w`b]

9. B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤^i t ....... (cÖ‡hvR¨ †¶‡Î)

10. f¨vU †iwRt b¤i t ...................................... (cÖ‡hvR¨ †¶‡Î)

11. cÖwZôv‡bi wbeÜb b¤i t .............................. (cÖ‡hvR¨ †¶‡Î)

12. Ab¨vb¨ bw_ t ---------------------------------- (cÖ‡hvR¨ †¶‡Î)

13. we‡`kx †Kv¤úvwb/cÖwZôv‡bi wnmve †Lvjvi D‡Ïk¨t (cÖ‡hvR¨ †ÿ‡Î)

...............................................................................................................................

(K) mswkøó wbqš¿YKvix KZ…©c‡ÿi bvg t ............................................................................

(L) Aby‡gv`b msµvšÍ Z_¨ t ..........................................................................................

14. MÖvnK cÖwZôv‡bi mv‡_ ‡Kvb Politically Exposed Person (PEP)/cÖfvekvjx e¨w³ (IP)/

AvšÍR©vwZK ms ’vi cÖavb ev D”P ch©v‡qi Kg©KZ©v Ges Zv‡`i cwiev‡ii m`m¨ ev close

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ............

27

assosiates mswkøó wK bv (weGdAvBBD KZ©…K RvixK…Z mvK©yjv‡i ewY©Z msÁv Abymv‡i)? (cÖ‡hvR¨

†ÿ‡Î)t

n¨uv bv

DËi n¨uv n‡j-

K. wmwbqi g¨v‡bR‡g›U n‡Z Aby‡gv`b †bqv n‡q‡Q wK bv? n¨uv bv

L. MÖvn‡Ki gy‡LvgywL mvÿvrKvi †bqv n‡q‡Q wK bv? n¨uv bv

15. mswkøó AvBb, wewagvjv I mvKz©jv‡ii Av‡jv‡K MÖvn‡Ki bvg RvwZms‡Ni wbivcËv cwil‡`i wewfbœ

†iRjy¨k‡bi AvIZvq mš¿vmx Kv‡h©, mš¿vmx Kv‡h© A_©vq‡b I e¨vcK aŸsmvZ¥K A ¿ we Ív‡ii A_©vq‡b

RwoZ m‡›`‡n ZvwjKvfy³ †Kvb e¨w³ ev mËv Ges evsjv‡`k miKvi KZ©„K ZvwjKvfy³ ‡Kvb e¨w³ ev

wbwl× †NvwlZ mËvi bv‡gi ZvwjKvi mv‡_ hvPvBevQvBc~e©K †Kvbiƒc wgj cvIqv wM‡q‡Q wKbv ? t

n¨uv bv

K) DËi nu¨v n‡j G welqK M„nxZ e¨e ’vi weeiY t

16. wi¯‥ †iwUst

K) cÖwZôvb wK ai‡bi e¨emv/Kg©Kv‡Û wb‡qvwRZ i‡q‡Q?

µwgK bs cÖK…wZ wi¯‥ ‡¯‥vi

1. Ry‡qjvwi/¯‡Y©i e¨emv /g~j¨evb avZzi e¨emv 5

2. gvwb †PÄvi /Kzwiqvi mvwf©m/‡gvevBj e¨vswKs G‡R›U 5

3. wi‡qj G‡÷U †W‡fjcvi/ G‡R›U 5

4. wbg©vY cÖKí †cÖv‡gvUvi/ wVKv`vi 5

5. Ad‡mvi / bb †iwm‡W›U K‡c©v‡ikb 5

6. ‡iu‡ Íviv/evi/bvBU K¬ve /AvevwmK †nv‡Uj/cvj©vi e¨emv 5

7. Avg`vwb/ißvwb I Avg`vwb/ißvwb G‡R›U 5

8. Mv‡g©›Um e¨emv/ Mv‡g©›Um G‡·mwiR/c¨v‡KwRs/evwqs nvDR 5

9. ‡kqvi/÷K wWjvi, †eªvKvi, †cvU©‡dvwjI g¨v‡bRvi, gv‡P©›U e¨vsKvi 5

10. GbwRI/GbwcI 5

11. Rbkw³ ißvwb e¨emv 5

12. Pjw”PÎ cÖ‡hvRbv/cwi‡ekbv ms ’v 5

13. A‡¯¿i e¨emv 5

14. †gvevBj †dvb Acv‡iUi/B›Uvi‡bU A_ev K¨vej wUwf Acv‡iUi 5

15. Rwg/evox †Kbv‡ePvi †eªvKvi (cÖvwZôvwbK) 5

16. e¨vsK/wjwRs/dvBb¨vÝ †Kv¤úvwb 5

17. cwienb Acv‡iUi 5

18. BÝy¨‡iÝ/†eªvKv‡iR G‡RwÝ 5

19. agx©q cÖwZôvb/ms¯’v I wkÿv cÖwZôvb 5

20. Uªv÷ 5

21. e¨emv (†c‡Uªvj cv¤ú/ wmGbwR †÷kb) 5

22. ZvgvK I wmMv‡i‡Ui e¨emv 5

28

µwgK bs cÖK…wZ wi¯‥ ‡¯‥vi

23. mdU&Iq¨vi e¨emv 5

24. wkc †eªwKs e¨emv 5

25. e¨emv (wK¬qvwis I diIqvwW©s G‡R›U) 4

26. e¨emv ( wWjvi/wWw÷ªweDUi/G‡R›U ) 4

27. e¨emv (Bb‡Ww›Us) 4

28. e¨emv (AvDU‡mv©wms) 4

29. B‡f›U g¨v‡bR‡g›U 4

30. PvU©vW© GKvDb‡U›U 4

31. K‡cv©‡iU Kv÷gvi 4

32. j dvg©/BwÄwbqvwis dvg©/KÝvj‡UwÝ dvg© 4

33. R¡vjvbx I we`¨yr Drcv`b †Kv¤úvwb 4

34. wcÖ›U/ B‡jKUªwbK wgwWqv 4

35. Uªv‡fj G‡R›U/Uz¨wiRg †Kv¤úvwb 4

36. A‡UvwWjvi (wiKwÛkÛ Mvox) 4

37. ‡d«BU/wkwcs/Kv‡Mv© G‡R›U/wmGbGd G‡R›U 4

38. A‡Uv cÖvBgvwi (bZzb Mvox) e¨emv 4

39. evox wbgv©Y mvgMÖxi e¨emv 4

40. e¨emv (Pvgov I PvgovRvZ cY¨) 4

41. ‡UwjKwgDwb‡Kkb †Kv¤úvwb 4

42. ‡PBb †÷vi/kwcs gj 4

43. ‡U·UvBj/w¯úwbs 3

44. we‡bv`bKvix cÖwZôvb/cvK© 3

45. ‡gvUi cvU©m/ IqvK©mc Gi e¨emv 3

46. e¨emv-G‡R›U 3

47. e¨emv ( Jla cÖ ‘Z I evRviRvZKiY) 3

48. wngvwqZKiY e¨emv ( †Kvì †÷v‡iR ) 3

49. e¨emv ( wngvwqZ Lv`¨ ) 3

50. e¨emv (nvW©Iqvi) 3

51. e¨emv (weÁvcY) 3

52. mvwf©m †cÖvfvBWvi 3

53. Kw¤úDUvi/†gvevBj †dv‡bi wWjvi 2

54. ‡cvwëª /†WBwi/wdwks dvg© 2

55. G‡MÖv weR‡bm/ivBm wgj weR‡bm/†efv‡iR 2

56. Drcv`bKvix (A ¿ e¨ZxZ) 2

57. ‡`vKvb (LyPiv e¨emv) 2

58. Ab¨vb¨ (mywbw`©ófv‡e D‡jøL Kiæb) 1-5

(MÖvn‡Ki SuywK wbiæc‡Yi †ÿ‡Î MÖvn‡Ki †ckvi we ÍvwiZ Z_¨ we‡kølYKiZt e¨emv‡qi †ÿ‡Î e¨emv‡qi cÖK…wZ, A‡_©i gvÎv, e¨emv‡qi

GjvKv, e¨emv‡qi AvKvi, wnmv‡ei cÖK…Z myweav‡fvMx BZ¨vw`mn Ab¨vb¨ we‡kl w`K we‡ePbvq wb‡q MÖvnK‡K D”P ev wb¤œ SyuwK m¤úbœ

wn‡m‡e †kªYxKiY Ki‡Z n‡e| Gme welqmg~n we‡ePbvq wb‡q MÖvnK †f‡` 25-57 bs †ÿ‡Î ewY©Z †¯‹vi A‡cÿv D”PZi †¯‹vi cÖ vb

Ki‡Z cvi‡e|)

29

L) cÖwZôv‡bi wbU m¤ú‡`i (Net Worth) cwigvY t

cwigvY (UvKvq) wi¯‥ ‡¯‥vi

0-1†KvwU 0

>1†KvwU - 3 †KvwU 1

> 3 †KvwU 3

M) wnmve †Lvjvi aiY t

aiY wi¯‥ ‡¯‥vi

wi‡jkbwkc g¨v‡bRvi/kvLv KZ©„K 0

WvB‡i± †mjm G‡R›U KZ©„K 3

B›Uvi‡bU/ Non Face to Face 3

¯cÖ‡Yvw`Zfv‡e/ Walk In 3

N) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi cwigvY t

PjwZ wnmv‡e †jb‡`‡bi

cwigvY (j¶ UvKvq)

mÂqx wnmv‡e †jb‡`‡bi

cwigvY (j¶ UvKvq)

wi¯‥ ‡¯‥vi

0-10 0-5 0

>10-50 >5-20 1

>50 >20 3

O) MÖvn‡Ki AbywgZ gvwmK †jb‡`‡bi msL¨v t

PjwZ wnmv‡e †jb‡`‡bi msL¨v mÂqx wnmv‡e †jb‡`‡bi msL¨v wi¯‥ ‡¯‥vi

0-100 0-20 0

101-250 21-50 1

>250 >50 3

P) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi cwigvb t

PjwZ wnmv‡e †jb‡`b

(jÿ UvKvq)

mÂqx wnmv‡e †jb‡`b

(jÿ UvKvq)

wi¯‥ ‡¯‥vi

0-10 0-2 0

>10-25 >2-7 1

>25 >7 3

Q) MÖvn‡Ki AbywgZ gvwmK bM` †jb‡`‡bi msL¨v t

PjwZ wnmv‡e †jb‡`‡bi msL¨v mÂqx wnmv‡e †jb‡`‡bi msL¨v wi¯‥ †¯‥vi

0-15 0-5 0

16-30 6-10 1

>30 >10 3

17. mvgwMÖK SzuwK/wi¯‥ †iwUs wbiƒcY (Dc‡ii K n‡Z Q µwgK ch©šÍ wi¯‥ ‡¯‥v‡ii †hvMdj) t

wi¯‥ ‡¯‥v‡ii †hvMdj mvgwMÖK wi¯‥ †iwUs

>=14 D”P

<14 wbgœ

30

gšÍe¨ t

(*wi¯‥ †iwUs 14 Gi Kg n‡jI Beneficial Owner -Gi D”P SuywK we‡ePbvq wb‡q KviY D‡jøLc~e©K Subjective we‡ePbvq

MÖvnK‡K D”P SuywK m¤úbœ wn‡m‡e wbiƒcY Kiv †h‡Z cv‡i)

cÖ ‘ZKvix t

(wnmve †Lvjvi Kg©KZ©v/wi‡jkbwkc

g¨v‡bRvi)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

ch©v‡jvPbv I wbwðZKvix Kg©KZ©v t

(kvLv gvwbjÛvwis cÖwZ‡iva cwicvjb

Kg©KZ©v)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

.................................................................

(PEP/IP/AvšÍR©vwZK ms ’vi EaŸ©Zb Kg©KZ©v Gi †ÿ‡Î Aby‡gv`bKvix EaŸ©Zb Kg©KZ©v)

bvghy³ wmjmn ¯vÿi I ZvwiL

18. wnmve I MÖvnK msµvšÍ Z_¨vw` me©‡kl ch©v‡jvPbv Ges nvjbvMv` (Review & Update ) Kivi ZvwiLt

ch©v‡jvPbv Ges nvjbvMv`Kvix Kg©KZ©v t

¯^v¶i (wmjmn) t

bvg t

ZvwiL t

31

............e¨vsK/ e¨vsK wjt

.............kvLv

MÖvnK cwiwPwZ m¤úwK©Z dig (KYC Profile Form)

(miKvix cÖwZôv‡bi wnmv‡ei †ÿ‡Î e¨envh©)

1. wnmv‡ei bvg t

2. wnmv‡ei cÖK…wZ t

3. cÖwZôv‡bi cÖK„wZ (we ÍvwiZ) t

4. A‡_©i Drm/Drmmg~n (we ÍvwiZ) t

5. A‡_©i Drm wbwðZ Kivi †¶‡Î †hme `wjjvw` msMÖn Kiv n‡q‡Q t

1| .................

2| ..................

3| ..................

msM„nxZ `wjjvw` hvPvB Kiv n‡q‡Q wK bv t n¨uv bv

6. cÖwZôv‡bi wVKvbv (mg~n) wKfv‡e hvPvB Kiv n‡q‡Q (we ÍvwiZ)? ...........................

...............................................................................................................................

7. cÖwZôvb msµvšÍ bw_mg~nt

Kwc M„nxZ hvPvBK…Z [wUK (√) w`b]

(K) B‡jKUªwbK-U¨v· AvBwW (E-TIN) b¤i t ....... (cÖ‡hvR¨ †¶‡Î)

(L) f¨vU †iwRt b¤i t .................................. (cÖ‡hvR¨ †¶‡Î)

(M) e¨vs‡K wnmve cwiPvjbv msµvšÍ wm×všÍ t........ (cÖ‡hvR¨ †¶‡Î)

(N) Ab¨vb¨ bw_ t ...................................... (cÖ‡hvR¨ †¶‡Î)

8. wi¯‥ †MÖwWst

D”P SuywK/wb¤œ SuywK

(* Subjective we‡ePbvq MÖvn‡Ki SuywK wbiƒcY Ki‡Z n‡e)

cÖ ‘ZKvix t

(wnmve †Lvjvi Kg©KZ©v/wi‡jkbwkc

g¨v‡bRvi)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

ch©v‡jvPbv I wbwðZKvix Kg©KZ©v t

(kvLv gvwbjÛvwis cÖwZ‡iva

cwicvjb Kg©KZ©v)

¯vÿi (wmjmn) t

bvg t

ZvwiL t

wnmve b¤it ............................

BDwbK Kv÷gvi AvBwW †KvWt ............

32

9. wnmve msµvšÍ Z_¨vw` me©‡kl ch©v‡jvPbv Ges nvjbvMv` (Review & Update ) Kivi ZvwiLt

ch©v‡jvPbv Ges nvjbvMv`Kvix Kg©KZ©v t

¯^v¶i (wmjmn) t

bvg t

ZvwiL t

33

Ae¨w³K wnmv‡ei Rb¨ cÖ‡qvRbxq Z_¨vw`i wb‡`©kK (Indicative) ZvwjKv|

(cÖ‡Z¨K e¨vsK h_vh_fv‡e MÖvn‡Ki cwiwPwZ I Customer Due diligence m¤úv`b Kivi D‡Ï‡k¨ e¨vs‡Ki mš‘wó mv‡c‡ÿ G ZvwjKvq

ewY©Z Z‡_¨i AwZwi³ Z_¨ I `wjjvw` msMÖn Ki‡Z cvi‡e| Ôe¨vs‡Ki mš‘wó mv‡c‡ÿÕ Gi e¨vL¨v weGdAvBBD mvK©zjvi bs-10 Gi 3.2 (3)

Aby‡”Q‡` cÖ`vb Kiv n‡q‡Q|)

(K) K‡c©v‡iU ev e¨emvwqK cÖwZôv‡bi wnmve t

(1) e¨w³ gvwjKvbvaxb cÖwZôvb t †UªW jvB‡mÝmn wnmve cwiPvjbvKvixi (cÖwZôv‡bi ¯^Z¡vwaKvixi) wel‡q cwiwkó-1(K)

†gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ dig h_vh_fv‡e c~iY Ki‡Z n‡e|

(2) cvU©bviwkc t cvU©bviwkc wWW, †UªW jvB‡mÝmn Askx`viM‡Yi cwiwPwZi wel‡q cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ

Z_¨vejxÓ dig h_vh_fv‡e c~iYmn †ewbwdwkqvj Ibvi Gi msÁv Abyhvqx cÖ‡Z¨K cvU©bvi/‡kqvi‡nvìv‡ii dig c~iY

Ki‡Z n‡e|

(3) wjwg‡UW †Kv¤úvwb t mvwU©wd‡KU Ae BbK‡c©v‡ikb, AvwU©‡Kjm Ae G‡mvwm‡qkb, †g‡gv‡iÛvg Ae G‡mvwm‡qkb,

†ev‡W©i mfvq M„nxZ AvbyôvwbK wm×všÍ (resolution), cwiPvjK m¤úwK©Z †NvlYv Ges wnmve cwiPvjbvKvixi wel‡q

cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ dig h_vh_fv‡e c~iYmn †ewbwdwkqvj Ibvi Gi msÁv Abyhvqx

cÖ‡Z¨K cwiPvj‡Ki/‡kqvi‡nvìv‡ii cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ dig c~iY Ki‡Z n‡e|

(†Kv¤úvwb ev Zvi cwiPvjKM‡Yi wel‡q cÖ‡qvR‡b Z_¨vw`i mwVKZv hvPvB‡qi j‡ÿ¨ †iwR÷ªvi Ae R‡q›U ÷K

†Kv¤úvwbR GÛ dvg©m& Gi mvnvh¨ MÖnY Kiv †h‡Z cv‡i| evsjv‡`‡ki evB‡i wbewÜZ †Kv¤úvwbi †ÿ‡Î wbeÜb `wjjvw`

†h ¯’vb n‡Z Bmy¨K…Z n‡q‡Q, cÖ‡qvR‡b ‡mLv‡b †hvMv‡hvM K‡i `wjjvw`i h_v_©Zv m¤ú‡K© wbwðZ nIqv ‡h‡Z cv‡i)|

†Kv¤úvwbi †ÿ‡Î m‡e©v”P †kqviavix by¨bZg 5 Rb cwiPvjK ev †hme †ÿ‡Î 5 R‡bi Kg †m‡ÿ‡Î mK‡ji/Ab¨vb¨

cÖ‡hvR¨ †ÿ‡Î wbe©vnx KwgwUi m`m¨M‡Yi e¨w³ msµvšÍ Z_¨ msMÖn Ki‡Z n‡e|

(L) miKvix wnmve (wewfbœ gš¿Yvjq, wefvMmn), miKvix gvwjKvbvaxb cÖwZôvb, Avav miKvix ev ¯^vqËkvwmZ cÖwZôv‡bi

wnmve, wewfbœ gš¿Yvj‡qi Aax‡b cwiPvwjZ cÖK‡íi wnmve t wnmve †Lvjv I cwiPvjbvi Rb¨ mswkøó Dchy³ KZ©„cÿ

KZ©„K cÖ`Ë AbygwZ cÎmn wnmve cwiPvjbvKvixi Òe¨w³ msµvšÍ Z_¨vejxÓ c„_K dig {cwiwkó-1 (L)} h_vh_fv‡e

c~iY Ki‡Z n‡e|

(M) Ab¨vb¨ msMV‡bi wnmve t

(1) K¬ve/†mvmvBwU t cwiPvjbv cl©`, evB-jR ev msweavb, wnmve †Lvjvi †iRjy¨kb, †iwR÷vW© n‡j miKvix Aby‡gv`bcÎ

BZ¨vw`mn mswkøó mfvcwZ, m¤úv`K, †Kvlva¨ÿ I Ab¨vb¨ wnmve cwiPvjbvKvixi Rb¨ cwiwkó-1(K) †gvZv‡eK Òe¨w³

msµvšÍ Z_¨vejxÓ dig h_vh_fv‡e c~iY Ki‡Z n‡e|

(2) mgevq mwgwZ/wjwg‡UW †mvmvBwU t †Kv-Acv‡iwUf Kg©KZ©v KZ©„K mZ¨vwqZ evB-jR, Awdm Kg©KZ©v‡`i (office

bearers) weeiY, wnmve ‡Lvjvi wel‡q wm×všÍ (resolution), mvwU©wd‡KU Ae †iwR‡÷ªkb BZ¨vw`mn mswkøó wnmve

cwiPvjbvKvixi wel‡q cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ dig h_vh_fv‡e c~iY Ki‡Z n‡e|

(3) ‡emiKvix ¯‥zj, K‡jR, gv`ªvmv t Mfwb©s ewW ev g¨v‡bwRs KwgwUi m`m¨M‡Yi c~Y© cwiwPwZ, wnmve ‡Lvjvi wel‡q wm×všÍ

(resolution) BZ¨vw`mn mswkøó wnmve cwiPvjbvKvixi wel‡q cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ

dig h_vh_fv‡e c~iY Ki‡Z n‡e|

(4) Uªvw÷ t wWW Ae Uªv÷ Gi mvwU©dvBW Kwc, Uªvw÷ †evW© Gi m`m¨M‡Yi c~Y© cwiwPwZ, wnmve ‡Lvjvi wel‡q wm×všÍ

(resolution) BZ¨vw`mn mswkøó wnmve cwiPvjbvKvixi wel‡q cwiwkó-1(K) †gvZv‡eK Òe¨w³ msµvšÍ Z_¨vejxÓ dig

h_vh_fv‡e c~iY Ki‡Z n‡e|