Kyc Fir
Kyc Fir
Kyc Fir
Account No
PHOTO
Annual Income/Tumover
2. 1DENTIFICATION INFORMATION
OVD: Passport Voter ID Driving Licence NREGA Job Card Letterissued By National
Population Register
DOCUMENT No: IIIIIN ||1IITIIN
I submit my Aadhar number and voluntarily give my consent Please a tick mark)
Aadhar No
3.1 Current/LOCAL ADDRESS DETAILS
Line
Line 2
Line 3 City/Town/Village
Pin/Post Code State/U.T II
District
4 CONTACT DETAILS
Tel(O LIIIILTel( R e s ) 1 I I I I Moble D
Date(OD-MM-Ym Place I1
Signature/Thumb Impression of customer
6. ATTESTATION/FOR OFFICE USE ONLY
Maker Checker
This form along with the KYC Documents be sent to LCPC for storage.
ldentity/Address details to be verified with bank records.
AcknoMdadaomont to