KYC Form CUSTOMER/SUPPLIER NAME REGISTERED ADDRESS *Office Number: *Building Number: *Street : *Floor Number: *Building Name: Area: *Pin Code: *Country: *City: State: P.O. Box: CONATCT DETAILS & BUSINESS REGISTERED NUMBER *Work 1: Work 2: Fax Number: Website: *PAN Number: *VAT TIN Number: *CST TIN Number: *With Effect From Date: BANK DETAILS *Bank Name: Branch: Acoount Name: *Account Number: COMPANY DETAILS Nature Of Organisation: Business Type: MemberShip Of Industry Association: COMPANY IDENTITY PROOF *PAN Card Copy: Yes No *VAT & CST TIN No: Yes No *Reg. Certificate: Yes No Proprioter / Partner's / Director's / Manager's / Shareholder's Proprioter 1 *Name: *Designation : *Mobile Number: *Primary Email: *Photo ID Proof: Yes No AUTHORISED BUYER'S *Name: Designation : Contact Number: *Primary Email: *Photo ID Proof: Yes No *Name: Designation : Contact Number: *Primary Email: *Photo ID Proof: Yes No ACCOUNT'S DEPARTMENT Name: Contact Number: Primary Email: Encloser Req. Photo ID Proof : (Aadhar Card as .jpg file) NOTE : * to be filled COMPULSORY TRADE REFERENCES Trade Reference 1 *Company Name: *Person Name: *Office Number: *Primary Email: *Address: *Designation: *Mobile Number: Yes No Are you conforming to your Conuntry's anti-money laundering requirements. If any ? Yes No Cancel
