KYC Form - Construction Finance

Sale Model (Form No. 1)

KYC Form Annexure 11

Information about Directors / Partners / Major Shareholders (Individuals holding 20% or more Shares) /
Authorised Representatives / Proprietor :- (Please use Copies of the Sheet in case of more than 2 Persons)

Recent Passport-size Recent Passport-size

Photograph of the Photograph of the
1st Director / Partner 1st Director / Partner
/ Major Shareholder / Major Shareholder
/Representative / /Representative /
Proprietor with Proprietor with
Signature across Signature across

1st PERSON 2nd PERSON

Full Name
Surname First Name Middle Name Surname First Name Middle Name
Fathers Name
Date of Birth DD MM YYY DD MM YYYY

Income Tax PAN

(attach Photo Copy)
Residence Address
_______________________________________ _______________________________________

_______________________________________ _______________________________________

Nearest Landmark _______________________ Nearest Landmark _______________________

Dist. BANGALORE State KARNATAKA Dist. BANGALORE State KARNATAKA

PIN STD Code _________ PIN STD Code _________

Ph.#_______________ Mob Ph. #_______________ Mob.

E-mail
E-mail _________________________________

Address Proof
(attach Photo Copy) Passport Driving Licence Passport Driving Licence

Bank Pass Book Bank Pass Book

Ration Card Ration Card