Extended KYC Annexure - Individuals (including sole-proprietors)
(Applicable for Resident and Non-Resident Customers)(Mandatory)
(Please consult your professional tax advisor for further guidance on your tax residency, if required)
SECTION A AOF Number:
Please ll the information below as
requested
First Account Holder Second Account Holder
Name of the Account Holder
Customer ID
Maiden Name (if any)
Father’s Name (mandatory )
Spouse’s Name
Marital Status
□ Married □ Unmarried □ Others □ Married □ Unmarried □ Others
Identication Type- Document
submitted as proof of identity of the
individual
(Passport No & Expiry date are man-
datory for NRI/PIO/Foreign National)
□ Passport Date of Expiry ___/___/____
□ Driving License Date of Expiry
___/___/____
□ Letter from national population register
□ Aadhaar card / letter
□ Voter’s ID card □ NREGA Card
□ Passport Date of Expiry ___/___/____
□ Driving License Date of Expiry
___/___/____
□ Letter from national population register
□ Aadhaar card / letter
□ Voter’s ID card □ NREGA Card
Identication Number - for the
identication type mentioned above
Please mention your Residential Status
if it is any one of these
(Visa Type & Visa expiry date are
mandatory for NRI/Foreign National)
□ Resident Individual □ Non Resident Indian
□ Foreign National □ Person of Indian Origin
Visa Type
□ Employment Visa □ Student Visa
□ Business Visa □ Multiple Entry Visa
□ Tourist Visa □ Others ( pls specify)
□ Visa Expiry Date: ____/___/______
□ Resident Individual □ Non Resident Indian
□ Foreign National □ Person of Indian Origin
Visa Type
□ Employment Visa □ Student Visa
□ Business Visa □ Multiple Entry Visa
□ Tourist Visa □ Others ( pls specify)
□ Visa Expiry Date: ____/___/______
Proof of Address
□ Passport □ Driving License
□ UID (Aadhaar) □ Voter Identity Card
□ NREGA Job Card
□ Letter from national population register
□ Utility Bill □ Property or Municipal Tax Recpt
□ Pension Payment Order
□ Letter of allotment & L and L Agrmt
□ Passport □ Driving License
□ UID (Aadhaar) □ Voter Identity Card
□ NREGA Job Card
□ Letter from national population register
□ Utility Bill □ Property or Municipal Tax Recpt
□ Pension Payment Order
□ Letter of allotment & L and L Agrmt
Please tick if Address Type is other
than Residential
□ Residential and Business
□ Business
□ Registered Oce
□ Residential and Business
□ Business
□ Registered Oce
Nationality (if national of more than one
country, please mention all the countries
separated by a comma).
SECTION B Foreign tax residency details if any (Please consult your professional tax advisor for further guidance on your tax
residency, if required)
Please tick, if you are a tax resident of any country outside India. If you do not tick, it is your armation that you are a tax resident
of India and not of any other foreign country
- First account holder : □ (To tick, especially in cases where the individual is a citizen/green card holder of USA)
- Second account holder: □ (To tick, especially in cases where the individual is a citizen/green card holder of USA)
If yes, please indicate all countries in which you are resident for tax purposes and the relevant details in below section:
Account
holder
details
Country/(ies) of
Tax residency #
Tax Identication
Number (TIN)%
Identication Type
(TIN or Other%,
please specify)
Please tick if your Ad-
dress for Tax purpose is
other than your Mailing
Address
Please tick if Address Type
for tax purpose is other than
Residential
First
□ Same as permanent
address
□ Residential and Business
□ Business
□ Registered Oce
Second
□ Same as permanent
address
□ Residential and Business
□ Business
□ Registered Oce
#
To also include USA, where the individual is a citizen/ green card holder of USA,
%
In case Tax Identication Number is not available, kindly
provide functional equivalent
$
92856/26.05.2023_M019
Below details required if tax resident outside
India / Nationality is other than India
First Account Holder Second Account Holder
Please mention if your “Country of Birth” is
other than India
City of Birth
Certication: I/We have understood the information requirements of this Form as per the CBDT notied Rules 114F to 114H and hereby conrm
that the information provided by me/us on this Form is true, correct, and complete. I/We also conrm that I/We have read and understood the
Terms and Conditions below and hereby accept the same. I/We understand that my personal details as provided /available in the bank records will
be used for CBDT reporting / Central KYC Registry. I hereby consent to receiving information from Central KYC Registry through SMS / Email.
Signature of rst holder Signature of second holder
Date: ___ / ____ / ______ Place: _____________________________
CBDT Terms and Conditions - The Central Board of Direct Taxes (CBDT) has notied Rules 114F to 114H, as part of the Income-tax Rules, 1962, which Rules
require Indian nancial institutions such as the Bank to seek additional personal, tax and benecial owner information and certain certications and documentation
from all our account holders. In relevant cases, information will have to be reported to tax authorities/ appointed agencies. Towards compliance, we may also be
required to provide information to any institutions such as withholding agents for the purpose of ensuring appropriate withholding from the account or any proceeds
in relation thereto. Should there be any change in any information provided by you, please ensure you advise us promptly, i.e., within 30 days. Please note that
you may receive more than one request for information if you have multiple relationships with HDFC Bank or its group entities. Therefore, it is important that you
respond to our request, even if you believe you have already supplied any previously requested information.
CBDT Instructions - If you have any questions about your tax residency, please contact your tax advisor. If you are a US citizen or resident or green card holder,
please include United States in the foreign country information eld along with your US Tax Identication Number.
$ It is mandatory to supply a TIN or functional equivalent if the country in which you are tax resident issues such identiers. If no TIN is yet available or has not yet
been issued, please provide an explanation and attach this to the form. In case customer has the following Indicia pertaining to a foreign country and yet declares self
to be non-tax resident in the respective country, customer to provide relevant Curing Documents as mentioned below:
FATCA/ CRS Indicia observed (ticked) Documentation required for Cure of FATCA/ CRS indicia
If customer does not agree to be Specied U.S. person/ reportable
person status
1 U.S. place of birth 1. Self-certication (in attached format) that the account holder is
neither a citizen of United States of America nor a US resident for tax
purposes;
2. Non-US passport or any non-US government issued document
evidencing nationality or citizenship (refer list below); AND
3. Any one of the following documents:
a. Certied Copy of “Certicate of Loss of Nationality or
b. Reasonable explanation of why the customer does not have such a
certicate despite renouncing US citizenship; or Reason the customer
did not obtain U.S. citizenship at birth
2 Residence/mailing address in a country other than India 1. Self-certication (in attached format) that the account holder is not
resident for tax purposes in that country; and
2. Documentary evidence (refer list below)
3 Telephone number in a country other than India (and no
telephone number in India provided)
1. Self-certication (in attached format) that the account holder is not
resident for tax purposes in that country; and
2. Documentary evidence (refer list below)
List of acceptable documentary evidence needed to establish the residence(s) for tax purposes:
1. Certicate of residence issued by an authorized government body*
2. Valid identication issued by an authorized government body* (e.g. Passport, National Identity card, etc.)
* Government or agency thereof or a municipality
For Bank use only :
Documents Received : □ Self Certied □ True Copies □ Notary
Employee Name : _______________________________________ Employee Code :_________________________________
Employee designation :_____________________________
Sourcing Employee Branch Name : ____________________Branch Code :□□□□ Signature veried and form approved by :
BDA / BM employee Code : ________________ Signature & Date : _____________________________