One Pager Declaration Sole Proprietor
One Pager Declaration Sole Proprietor
One Pager Declaration Sole Proprietor
(To be filled by applicant only. Please fill the form in CAPITAL LETTERS & BLACK ink only)
*Entity Name
Insta Kit Acknowledgement (If applicable): I/We confirm having received the Welcome Kit in an untampered / sealed condition and confirm that the below deliverable have been received by me.
$
Welcome Letter 10 Non-personalized cheques MSE Booklet Most Important Terms & Conditions AU QR
I/we confirm that the below signatures are applicable for above mentioned declarations and terms & conditions in the AOF.
FATCA/CRS Declaration
I/we declare that the entity is tax resident of any country other than India. Yes No Yes No
The controlling person / ultimate beneficial owner/ proprietor is tax resident of any country other than India (If yes please fill separate FATCA/CRS Form)
1. Under penalty of perjury, I certify that: a. The number shown on the form is the correct identification number of the applicant, and b. The applicant is (i) an applicant
taxable as a US person under the laws of the United States of America (“U.S.”) or any state or political subdivision thereof or therein, including the District of Columbia or
any other states of the U.S., (ii) an estate the income of which is subject to U.S. federal income tax regardless of the source thereof. (This clause is applicable only if the A/c
holder is identified as a US person) OR c. The applicant is taxable as a tax resident under the laws of country outside India. (This clause is applicable only if the account
holder is a tax resident outside of India)
2. I/ We understand that the Bank is relying on this information for the purpose of determining my status in compliance with FATCA/CRS. The Bank is not able to offer any
tax advice on FATCA/CRS or its impact. I shall seek advice from professional tax advisor for any tax questions.
3. I/ We agree to submit a new form within 30 days if any information or certification on this form gets changed.
4. I/ We agree that as may be required by regulatory authorities, Bank shall be required to report, reportable details to CBDT or close or suspend my account.
5. I / We certify that I/ We provide the information on this form and to the best of my knowledge and belief the certification is true, correct, and complete including the Specimen Signature
taxpayer identification number / functional equivalent number of the applicant.
with Stamp
Certification: I have understood the information requirements of this Form (read along with the FATCA/CRS Instructions) and hereby confirm that the information provided
by me on this Form is true, correct, and complete. I also confirm that I have read and understood the FATCA / CRS Terms and Conditions and hereby accept the same.
CKYC Declaration : I/We confirm that the Bank can seek my/our records from CKYC registry for account opening & periodic updation.
I/We confirm that the below signatures are applicable for the details provided in AOF, Declaration and Terms & Conditions.
SOLE PROPRIETORSHIP FIRM DECLARATION
I refer to the current account opened in your bank and declare as under I, the undersigned, am the sole proprietor of the firm and am solely responsible for the liabilities thereof. I shall advise you in writing of any change that
takes place in the constitution of the firm, and I will be liable to you for any obligation which may be standing in the firm's name in your books on the date of receipt of such notice and until all such obligations shall have been
liquidated. I agree to indemnify and hold the Bank harmless in case of any loss suffered by the Bank, its customers or a third party or any claim or action brought by a third party which is in any way the result of availing of
services by me. I agree that all the information disclosed in this document is correct and agree to inform you of any change in the information provided in this form or in related documents. I have furnished to the Bank the
Power of Attorney authorizing the person(s) as indicated hereinbefore for operating the account.
Version May, 2024
Signature
To be filled by the sourcing staff
I confirm that I have personally met Proprietor at Business/Registered/Communication address. I also confirm that the customer has completed all account opening documentation formalities and signed the AOF,
documents and other annexures in my presence.
Emp Name & Designation: ________________________________________________________ Emp Code : ________________ Signature of Sourcing Staff _______________________________________
Tear Off
AU Small Finance Bank Ltd. (Acknowledgement / Customer Copy)
drawn on Minimum Average Balance requirement (Monthly) (Please refer applicable schedule of charges document for charge details)
I/ We is/ are desirous of opening a Current Account with AU Small Finance Bank Limited (“AU SFB”).
I/ We understand that in accordance with RBI Circular DOR.No.BC/7/21.04.048/2020-21 on 'Opening of Current Account by Banks – Need for Discipline' dated August 06, 2020 and the related circulars thereafter , all
scheduled commercial banks have been permitted to open Current Accounts for customers under following scenarios with an undertaking from the borrowers that they shall inform the bank(s), as and when the credit
facilities availed by them from the banking system reaches ₹ 5 crore or more.
In case of availing CC/OD facilities from banking system and having exposure to banking system of ₹ 5 crore or more, such borrowers can maintain Current Accounts with any one of the banks with which it has CC/OD
facility, provided that the Bank has at least 10 per cent of the exposure or has the highest exposure (in case no Bank has exposure >=10%) of the banking system to that borrower.
Consequent to the above, I/ We hereby confirm and undertake that: (Tick any one of the below)
[ ] I/We are not availing Credit facility from any Bank .
OR
[ ] I/ We are availing single/ multiple credit facilities (including CC/ OD) of less than 5Cr from any/ all banks.
OR
[ ] I/ We are availing single/ multiple credit facilities (none of it is of CC/OD nature) of Rs 5 to 50Cr from any/ all banks and AU SFB is one of lender
OR
[ ] I/ We do not have a Current account and am/are availing single/ multiple credit facilities (including CC/ OD) of greater than or equal to Rs 5Cr from any/ all banks including AU SFB and AU SFB Share is >=10% of total
exposure or AU SFB has highest exposure.
OR
[ ] I/ We are opening Collection Account as AU SFB exposure is <10%. Standard Instructions will be setup in this account wherein funds will be remitted to lender's CC/OD/escrow act. within 2 working days of receiving
such funds.
OR
[ ] I/ We are opening Current account which is exempted from “Opening of Current Account-Need for discipline RBI guidelines
Real Estate Projects Collection Purpose IPO/NFO/FPO/Share Buyback/Dividend Payment/Issuance of Commercial Papers/Allotment of Debentures/Gratuity Special Instruction of Govts (Central/State)
Stock Broking Account for holding the funds (i.e., Client Account), for settlement purposes (i.e., Settlement Account) Under Specific Statute_________________________________
I/We shall inform/ update AU SFB immediately in writing to customercare@aubank.in or to the branch in the event of any change in my/ our exposure from the Banking System.
I/ We understand that the information furnished by myself/ ourselves is accurate and the AU SFB can take necessary action for closure of my/ our account in the event any discrepancy is identified by the AU SFB in the
undertaking submitted by me/ us.
Cash Pickup Frequency - Beat Cash Pickup Frequency - On Call Cash Delivery
Note : For availing Cash Pickup and Delivery Service, separate agreement needs to be executed as per Bank's policy.
I/We confirm that I/We are aware of the possible risks involved in connections with the pickup/delivery of cash/cheque on our request to and from our office/workplace. You are hereby
irrevocably and unconditionally authorised to act on my request for said facility, and the Bank shall not be held liable for any circumstances whatsoever.
I/We undertake to keep up indemnified at all time against and to save you harmless from all actions, proceedings, claims, loss, damage, cost and expenses which may be brought
against you or suffered or incurred by you and which shall have arisen either directly or indirectly out of or in connections with your accepting my/our request or instructions for
extending cheque pickup service through the services provider for & on our behalf from me/us acting thereon, whether or not the same are confirmed in writing by me/us.
I/ We, the undersigned, being customer of AU Small Finance Bank Ltd. (here in after referred to as the 'Bank’) hereby confirm that I/We have read, understood and agree to abide and
be bound by all the provisions of the Terms and Conditions and Services Fee Reckoner as displayed on www.aubank.in (#herein after referred to as the 'T&C’) which govern, all of
my/our accounts, present, past and future, maintained/opened/to be maintained/to be opened with the Bank from time to time, and also provisions of the various services/facilities
provided at present/that may be provided in future.