CLIENT PROFILE

*USE BLOCK LETTERS ONLY

Please type " P " on the box if " P " required

for EXISTING CUSTOMERS

Open a/c with

Provide Customer Code

DATE:

Business Name
Account Opening Requested for

Registered Office

Branch Office

Address
Address Location
City/District
State
Pin Code / Country
Landline Number
Mobile Number
Fax No./Telex No.
Email
Home Page

Proposed Business Items

Air Tickets

Tour Packages

Visa & Documentation

Air India Express

Car Rentals

Travel Insurance

Foreign Exchange

Riya Connect

Reference (if any)

Name

Contact Number

Address

1
2

LEGAL INFORMATION
PAN No
Name Printed on PAN
Date of Incorporation/Registration
Registration no./CIN
Place of Incorporation
Date of Commencement of Business
TAN
Service TAX Registration No
VAT

Type of Customer

IATA

Non-IATA

Corporate

Freelancer

Rent

Owned

IATA Code
Premises

Others

Specify

Proprietor's/Director's/Partner's Name
Contact No.

Customer Contact Persons

Domestic Counter

Name

Contact No.

1
2

International Counter

1
2

Accounts

1
2

Bank Details
**

No

Bank Name

Bank Account Number

Type

Address

** "R" for Registered Office, "B" for Branch Office.

Documents Submitted

Expected International Business/Monthly

Expected Domestic Business/Monthly
Applied Credit
TDS Exemption % and Certificate No.
Exemption Period
Exemption Amount
Additional Information's (if any)

Agent CRS

I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief an
undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or
misleading or misrepresenting, I am/we are aware that I/we may be held liable for it.
Authorized Signatory
Place

Name

Date

Designation

Stamp/S

Riya Contacts
Department

Name

Designation

Contact No.

E-mail ID

FOR OFFICE USE

Branch Name & Region
Applied Credit Limit & Date of Joining
Approved Credit Limit & Approved by

Name

Credit Approval Valid Up to

Payment Terms
Services Offered

Period

Date of Settlement

1st Week
2nd Week

Air

3rd Week
4th Week

Other Services
Other Services
Other Services

Service Charges
Air

Visa

Insurance

Commission offered:

Remarks (if any):

Department

Name

Designation

Contact No.

E-mail ID

Mirror ID

CRS Provided by Riya

Sign
Name
Sales Officer

Acc Handling Person Code

Sales Person Code

Sales Manager

Accounts Manager

Branch Mana

Customer Code

Verified by

CVendor Code

Date

Branch Office

Others

rue and correct to the best of my/our knowledge and belief and I/we
n case any of the above information is found to be false or untrue or
ay be held liable for it.

Stamp/Seal

Date of Settlement

Branch Manager/Director