PART I - KNOW YOUR CLIENT (KYC) APPLICATION FORM (For Non-Individuals)
ABHIK FINANCE PVT. LTD.
UPPAL’S PLAZA M6, 5G 5TH FLOOR, JASOLA DISTRICT CENTRE, NEW DELHI – 110 025
Please fill this form in ENGLISH and in BLOCK LETTERS
- IDENTITY DETAILS
1 / Name of the Applicant
2 / Date of incorporation / Place of incorporation
3 / Date of commencement of business
4 / a)PAN / b) Registration No. (e.g. CIN)
5 / Status (please tick any one):
Private Limited Co.
Public Ltd. Co.
Body Corporate
Trust
Charities
NGO’s
Others (please specify) / Bank
Government Body
Non Government Organization
Defense Establishment
Society
LLP / Partnership
FI
FII
HUF
AOP
BOI
- ADDRESS DETAILS
1 / Correspondence Address / ______
______
City/town/village / PIN Code
State / Country
2 / Specify the proof of address submitted for correspondence address
3 / Contact Details / Tel. (Off.) / Tel. (Res.)
Fax No. / Mobile No.
Email ID
4 / Registered Address (if different from above): / ______
______
City/town/village / PIN Code
State / Country
5 / Specify the proof of address submitted for registered address
- OTHER DETAILS
1 / Gross Annual Income Details (please specify): Income Range perannum
Below ` 1 lac
` 1- 5 lac
` 5- 10 lac / ` 10- 25 lac
` 25 lac- 1 crore
More than ` 1 crore
2 / Networth
Amount (`) ______
As on (date)
D / D / M / M / Y / Y / Y / Y
(Networth should not be older than 1 year)
3 / Name, PAN, residential address and photographs of Promoters/Partners/Karta/Trustees and whole time directors: / If space is insufficient, enclose these details separately[Illustrative format enclosed]
4 / DIN/UID of Promoters/Partners/Karta and whole time directors:
5 / Please tick, if applicable, for any of your authorized signatories/Promoters/Partners/Karta/Trustees/whole time directors: / Politically Exposed Person (PEP)
Related to a Politically Exposed Person (PEP)
6 / Any other information
- DECLARATION
I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am/we are aware that I/we may be held liable for it.
Name & Signature of the Authorised Signatory(ies) / ______/ Date / D / D / M / M / Y / Y / Y / Y
TRADING ACCOUNT RELATED DETIALS
- BANK ACCOUNT(S) DETAILS (through which transactions generally be routed)
Bank Name / Branch Address / Account Number / Account Type / MICR Number / IFSC Code
Saving
Current
Others – in case of NRI / NRE / NRO
Saving
Current
Others – in case of NRI / NRE / NRO
- DEPOSITORY ACCOUNT(S) DETAILS (through which transactions generally be routed)
Depository Participant Name / Name of Depository / Beneficiary Name / DP ID / Beneficiary ID (BO ID)
NSDL
CDSL
NSDL
CDSL
- TRADING REFERENCES (please sign in the relevant boxes where you wish to trade)
NSE /
Cash F & O
Currency
Derivatives
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FOR OFFICE USE ONLY(Originals verified) True copies of documents received
(Self-Attested) Self Certified Document copies received
Signature of the Authorised Signatory / ______/ Seal/Stamp of the intermediary
Date / D / D / M / M / Y / Y / Y / Y
Annexure (A)
Details of Promoters/ Partners/ Karta / Trustees and whole time directors forming a part of Know Your Client (KYC) Application Form for Non-Individuals
Sr. No. / Name / Relationship with Applicant (i.e. promoters, whole time directors etc.) / PAN / Residential / Registered Address / DIN/UID / Photograph1
2
3
4
5
Name & Signature of the Authorised Signatory(ies)
Date / D / D / M / M / Y / Y / Y / Y
Annexure (B)
- Name of Authorised Signatory(ies) of the Company
S. No. / Name / Relationship with Applicant Company (i.e.) promoters, whole time directors etc) / Proof of Address as per Annexure “D” / DIN (if Applicable) / Photograph (Signed across) not applicable if photo affixed in form)
1.
2.
3.
4.
5.
Name & Signature of the Authorised Signatory(ies)
Date / D / D / M / M / Y / Y / Y / Y
Annexure (C)
- Latest share holding pattern inclurding list of all those holding control, either directly of indirectly, in the company in terms SEBI takeover Regulations, duly certified by the company secretary / whole time director / MD (to be submitted every year)
S. No. / Name of Share Holder / Address of Holder / No. of Shares
1
2
3
4
5
Name & Signature of the Authorised Signatory(ies) Date
INSTRUCTIONS/CHECK LIST FORFILLING KYC FORM
IncaseofNon-Individuals,additionaldocumentstobeobtainedfromnon-individuals,overabove the POIPOA,asmentionedbelow:
Typesof entity / DocumentaryrequirementsCorporate /
- Copyofthebalancesheetsfor thelast 2financial years(tobesubmittedeveryyear).
- Copyoflatestshareholdingpatternincludinglistofallthoseholdingcontrol,either directlyorindirectly,inthecompanyintermsofSEBItakeoverRegulations, dulycertified by thecompany secretary/Wholetimedirector/MD(tobe submittedeveryyear).
- Photograph,POI,POA,PANandDINnumbersofwholetimedirectors/twodirectorsin chargeofdaytodayoperations.
- Photograph,POI,POA,PANofindividualpromotersholdingcontrol-eitherdirectlyor indirectly.
- Copies oftheMemorandumandArticles of Associationandcertificateofincorporation.
- Copy ofthe BoardResolutionfor investmentinsecurities market.
- Authorisedsignatories list withspecimensignatures.
Partnership firm /
- Copyofthebalance sheetsfor thelast 2financial years(tobesubmittedeveryyear).
- Certificateofregistration (forregisteredpartnership firmsonly).
- Copy ofpartnershipdeed.
- Authorisedsignatories list withspecimensignatures.
- Photograph, POI, POA,PANof Partners.
Trust /
- Copyof thebalance sheetsfor thelast 2financial years(tobesubmittedeveryyear).
- Certificateofregistration (forregisteredtrust only).
- Copy ofTrustdeed.
- List of trustees certifiedbymanagingtrustees/CA.
- Photograph, POI, POA,PANofTrustees.
HUF /
- PANof HUF.
- Deedofdeclarationof HUF/List of coparceners.
- Bankpass-book/bank statement in thenameofHUF.
- Photograph, POI, POA,PANof Karta.
Unincorporated
associationora bodyof individuals /
- Proofof Existence/Constitutiondocument.
- Resolutionofthe managingbody & Power of Attorney grantedtotransact businessonits behalf.
- Authorizedsignatories list withspecimensignatures.
Banks/Institutional
Investors /
- Copyoftheconstitution/registrationorannualreport/balancesheetforthelast2financial years.
- Authorizedsignatories list withspecimensignatures.
Foreign
Institutional
Investors (FII) /
- Copy ofSEBIregistrationcertificate.
- Authorizedsignatories list withspecimenignatures.
Army/Government
Bodies /
- Self-certificationonletterhead.
- Authorizedsignatories list withspecimensignatures.
RegisteredSociety /
- Copy ofRegistration Certificateunder Societies Registration Act.
- List of ManagingCommitteemembers.
- Committee resolution for persons authorised to act as authorised signatories with specimensignatures.
- Truecopy ofSocietyRules and ByeLaws certifiedbytheChairman/Secretary.