Place fr Know Your Client (KY) Application Form (For Non-Individuals Only) Please fill in ENGLISH and in BLOCK LETTERS cvL D [A Mentity Details (please see quidelinesovereaM {Name of Aplant Pease wit comple ame asp: Ceticate of crpratn Regan; ag one tox Hank betwen 2 wads Plese do nt abr oe Nan 2 date of corporation © | fon 1s |) |v | ace af ncorpration | | | LEE LI aRegivaionne. (5.0m) | | | | | | | | | | |) patecteammencenen of buines | fel f bi fy ly 4, Sats ese cc) Pate Lid Co. CIPabic Le. Co. Body Copote Parmestip Cost /Chartes (NGOs WWF OR Chem category | C1 Category CLF category ih C]A0P fark Gonenment Body] Nor GoverreentOxgaiaton i befenceésabshment C1Body of indians Clsecity CUP ChOthes Vine wy Intermediary Logo 5. remanent count amber ao manowworn ||| | | | | | | || Rese ene yest ny ui a [B Address Details Glease see guidelines vee — SY 1. Ades for Carespondence TTI cy wn i | sat) | 2. Contact Details eo) (s0)_| (S70) ‘Mebie | (180) | (STO) EMalla| | 3. Poof of address tobe provided by Applicant. Please submit AN tates eproe ail fon Land ie) Fate cy Be i Any othe prot of adie document sited overeat Pees "Not rare tan 3 aso aya date of roto dees submited 4. Registered Address (f diferent from above) (ly | Peal ode soe TLL [eur LI 5, Proof of address to be provided by Appliant. Please submit ANY ONE ofthe following vad documents & tick () aginst the document attached. atest leone Bl ony Land Ue) Cates lccty 8 Citatest Bank Account Statement iRegsteed Lease ae Agreement of Ofc Premises Any other proof of acess document (as Istedoveea Plesesech ‘tot mare tan 3 Wort ld. api date of proof of adress nimited 2/7 INP [ylyly)SOSOC~C~S~S~S ‘1.Name, PAN, DIN/Aadhaar Number, residential address and photographs of Promoters/Partners/Karta/Trustees/whole time directors (Please use the Annexure to fil in the deals) 2. Any other information: pp ie eceby declare that the dete furished above are te and correct tothe best of myfour knowledge and belief and Ve undertake to inform you of any changes therein, immecately In case any ofthe above information s found to be false or untrue or misleading or ristepresenting, lame are aware hat we maybe hed liane fort, Pace: pate | ANCletemedary rane OR cde Sealstamp ofthe termed shoud contain se Stat Nae (ong Veet se Cerifed Docent copies ected Designation Nare of the Organization Signature ate 1 dates) Tue copies of documents eedIwPonran rons: 1. Slated sen cardmanany alles 2 Copies ef alte decens sma by te apart shoud be sal ated nd “comptes orga fr een. hate arg ay coer ‘eared ‘or wenn, then te pies shoud be popely aise y eas Sitesnleatetngttecocmen arb been ay eden abs alg gang he tasaton Els srauea, Name aes fh alan etn an he KY em, ld mae wn he ocean a bid crepenatce& pemanet aes teen, un cl fr bah hae be sie Salepratrmasaiateaplaoninhs idiualrane pty Fer moves an a9 rare t ta sgn RL and FEA etn), cy of pespeePOceatCCe ard owests ess pol ont Far foe ees, Cs epana adn the abso of DIN rhe dees thereupon cn sodden br xe of Maran Ny Ns, anes ccaen at rtd coy of COC {Comin DiehrgeCret) abe vamie Fer cain 2 zc wth estoy parent ot Muna Fr, fer amino proccny of he Stal Leng Ceihattak she sued by Higher Secday SeardPaspocitaarithcarae mse poi rail xed Poses (PP) ae cnd a niin who ae et hae bee feted wo perianpuni ners a Heh cue, He Sates orf Corres, er pln, se! Canvass aa, Seict sess of sae owned penn, Import glial ary eae Proof otentiy{ POH Uscdonmas sense ashesot ety: TP ead ath ooyagh Tes 2 mite mgutenenl Sel ‘plat exe toa spec eng ontario, Unguetenfxionhinoe (U0) facaa Paseo crdrveg eve ety car deceit spats Pho, sued by ay of the (lev: Ceroaate Covenmes df Oeptness. Saayagdoy homes, Pbie Seer Uaeeangs SheieaConmeca™ Bars Rule Fran Pecos Caages ali te Unvestie, Parson Ses su af ICA VOWS Bar Curl ete, ote Darbar re cients sed by sank Proof of Address (POR): Uist of cocmens aire as Pot of Ads (MOscamensheingaapyatestoudbevaignthedeedsibmision) 1. 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