Page 1 of 3

MHW1/181D/1-1/WBF-M/03-12

Your Base Branch:

MR.SEGARJI M.C.
46,BEERANGI KULAM STREET,
TRICHY-620008
TIRUCHIRAPALLY
TAMIL NADU - INDIA - 620008

NEW NO - 58, WEST BOULEWARD

ROAD,, SIVAPOORNA COMPLEX,, TRY,
TN, 620002

Visit www.icicibank.com
Dial your bank 09894478000

Did you know? It's mandatory to be KYC compliant as per RBI guidelines. If you have not submitted your KYC documents, please visit the nearest
branch or contact your Relationship Manager to complete the KYC details for your Account.

Summary of Accounts held under Cust ID: 70731198 as on December 31, 2013
ACCOUNT DETAILS - INR
ACCOUNT TYPE

A/c BALANCE (I)

FIXED DEPOSITS (LINKED) BAL. (II)

TOTAL BALANCE (I+II)

Savings A/c 613201198576

4,452.67

0.00

4,452.67

TOTAL

4,452.67

0.00

4,452.67

NOMINATION
Registered

Statement of Transactions in Savings Account Number : 613201198576 in INR for the period October 01, 2013 - December 31, 2013
DATE

MODE**

01-10-2013
03-10-2013

PARTICULARS

DEPOSITS

WITHDRAWALS

Balance Brought Forward

DEBIT CARD

08-10-2013

12,573.10

IPS/SPENCERS RE/20131002184620/0
By Cash

BALANCE

973.00
6,500.00

11,600.10
18,100.10

08-10-2013

ICICI ATM

ATM/CASH WDL/08-10-13/19:30:14/0

09-10-2013

CASH DEPOSIT

CAM/CASH DEPOSIT/09-10-13/13:37:03/0

09-10-2013

ICICI ATM

ATM/CASH WDL/09-10-13/20:52:15/0

15,000.00

29,900.10

09-10-2013

ICICI ATM

ATM/CASH WDL/09-10-13/20:53:22/0

15,000.00

14,900.10

11-10-2013

CREDIT CARD

ATD/4477460415272006/20131011122504

300.00

14,600.10

15.00

14,585.10

17-10-2013

SMSChgsJul13-Sep13+Stax1.65

23-10-2013

By Cash :6500 ANW-Chrgs :150.00 S-Tax :

24-10-2013

ICICI ATM

ATM/CASH WDL/24-10-13/10:56:26/0

25-10-2013

NON ICICI ATM

NFS/CASH WDL/25-10-13

28-10-2013

To:6143CNANWCHG,6143SL00STAX

08-11-2013

By Cash

11-11-2013

CREDIT CARD

12-11-2013

6,000.00
32,800.00

44,900.10

6,331.46

20,916.56
10,000.00

10,916.56

5,000.00

5,916.56

184.00
4,500.00

ATD/4477460415272006/20131111092309

12,100.10

5,732.56
10,232.56

300.00

9,932.56

By Cash :6500 ANW-Chrgs :150.00 S-Tax :

6,331.46

13-11-2013

CASH DEPOSIT

CAM/CASH DEPOSIT/13-11-13/12:59:12/0

39,350.00

13-11-2013

NON ICICI ATM

NFS/CASH WDL/13-11-13

10,000.00

45,614.02

13-11-2013

NON ICICI ATM

NFS/CASH WDL/13-11-13

10,000.00

35,614.02

13-11-2013

NON ICICI ATM

NFS/CASH WDL/13-11-13

10,000.00

25,614.02

13-11-2013

NON ICICI ATM

NFS/CASH WDL/13-11-13

10,000.00

15,614.02

221.00

15,393.02

20-11-2013

To:6143CNANWCHG,6143SL00STAX

21-11-2013

By Cash :32800 ANW-Chrgs :164.00 S-Tax :

23-11-2013

ICICI ATM

By Cash :6500 ANW-Chrgs :150.00 S-Tax :

27-11-2013

SMSChgsOct13-Dec13+Stax1.65

55,614.02

32,615.73

ATM/CASH WDL/23-11-13/11:18:05/0

26-11-2013

16,264.02

48,008.75
3,000.00

6,331.46

45,008.75
51,340.21

15.00

51,325.21

500.00

50,825.21

02-12-2013

NET BANKING

BIL/000518640498/OXIGENPMR/9940870972

02-12-2013

NET BANKING

BIL/000518643498/OXIGENPMR/9443529651

700.00

50,125.21

09-12-2013

ICICI ATM

ATM/CASH WDL/08-12-13/19:33:40/0

15,000.00

35,125.21

09-12-2013

ICICI ATM

ATM/CASH WDL/08-12-13/19:34:25/0

15,000.00

20,125.21

11-12-2013

CREDIT CARD

ATD/4477460415272006/20131211115403

290.00

19,835.21

19-12-2013
23-12-2013

By Cash
ICICI ATM

ATM/CASH WDL/22-12-13/10:12:29/0

6,500.00

26,335.21
15,000.00

11,335.21

Page 2 of 3

MR.SEGARJI M.C.
Statement of Transactions in Savings Account Number : 613201198576 in INR for the period October 01, 2013 - December 31, 2013
DATE

MODE**

PARTICULARS

23-12-2013

CASH DEPOSIT

CAM/CASH DEPOSIT/23-12-13/13:14:00/0

32,200.00

43,535.21

By Cash :20000 ANW-Chrgs :150.00 S-Tax :

19,831.46

63,366.67

24-12-2013

DEPOSITS

WITHDRAWALS

BALANCE

26-12-2013

OTHER ATMS

NFS/CASH WDL/25-12-13

4,000.00

59,366.67

26-12-2013

ICICI ATM

ATM/CASH WDL/26-12-13/10:13:02/0

20,000.00

39,366.67

26-12-2013

ICICI ATM

ATM/CASH WDL/26-12-13/10:13:53/0

20,000.00

19,366.67

26-12-2013

ICICI ATM

ATM/CASH WDL/26-12-13/10:14:51/0

9,000.00

10,366.67

30-12-2013
30-12-2013

613201198576:Int.Pd:01-09-2013 to 29-12-2013
OTHER ATMS

267.00

NFS/CASH WDL/30-12-13

30-12-2013

To:6143CNANWCHG,6143SL00STAX
TOTAL

1,93,558.57

10,633.67
6,000.00

4,633.67

181.00

4,452.67

2,01,679.00

4,452.67

REWARD POINTS SUMMARY

Points earned for the month of November 2013

SAVINGS ACCOUNT
NUMBER

LINKED PAYBACK
NUMBER

MySavings REWARDS

DEBIT CARD

613201198576

9401152668055903

POINTS BALANCE*

To get current reward points balance and for other queries visit www.icicibank.com

54

or call ICICI Bank Customer Care

*As on December 20, 2013, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the total point balance

Account Related Other Information

ACCOUNT TYPE

ACCOUNT NUMBER

MICR CODE

IFSC CODE

NAME OF NOMINEE

Savings

613201198576

620229005

ICIC0006132

Nominee name is displayed only on specific consent of customer.

For ICICI Bank Limited

Authorised Signatory

Page 3 of 3

MR.SEGARJI M.C.

Legends for transactions in your account statement

VAT/MAT/NFS - Cash withdrawal at other banks ATMs
EBA - Transaction at ICICIDirect
VPS/IPS - Debit card transaction
RTGS - Real Time Gross Settlement (Instant Transfer of Rs 2 Lakh and up to Rs 10 Lakh)

INF - Internet funds transfer in linked accounts

BIL - Internet bill payment or funds transfer to third party
TOP - Mobile recharge
NEFT - National Electronic Fund Transfer (Up to Rs 10 Lakh)

** Mode is available only for transaction done after August 6, 2013.

As per prevailing guidelines of the Income tax Act, 1961 if a valid PAN is not provided by the
Customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher.
As per guidelines issued by CBDT on May 13, 2011, Form 16A (TDS Certificates) will be generated
through the Income tax website for which the PAN of the customer needs to be necessarily updated
in Bank's record.

REGD ADDRESS: LANDMARK, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA
This is an authenticated intimation/statement.
Customers are requested to immediately notify the Bank of any discrepancy in the statement
MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1

In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
In case your PAN is not updated in our record, please visit the nearest branch and provide a
copy of the PAN card along with the original PAN card for verification.
The address of the customer in Form 16A will be the last updated address in the data base of
the Income tax department.

www.icicibank.com
Category of service: Banking & Financial Services.
Registration No. MIV/ST/Bank & Finc/4.
PAN Based STC No. AAACI1195HSST001.