1 Title: (Mr/Mrs/Ms/Others)
2 Name of client:
(as per KYC document)
3 Father's Name:
4 Mother's Name:
5 Correspondence /Local Address
PIN Code:
(mandatory)
6 Permanent address same as above:
Yes/No
7 Current/Permanent/ Overseas
(Address as per KYC document)
PIN Code: (mandatory)
8 Permanent Address Type:
(Residential/Business/Office)
9 Customer Category: (General/OBC/ST/SC/Staff/Others)
10 Date of Birth:
11 Place and Country of Birth:
12 Gender/Sex:
(Male/Female/Transgender)
13 Marital Status: (Single/Married – Spouse Name )
14 Religion: Hindu/Muslim/Christian/Sikh/Jain/
Buddhist/Zoroastrian/Parsee/Others;
15 Citizenship/Nationality: Indian/Others
16 Residential Status: Resident/Non-Resident*/
Person of Indian Origin*/Foreign National*
17 Educational Qualification: (Professional/Graduate/
SSC/literate/illiterate)
18 Disability, if Any:
19 *FATCA /CRS submitted:
Yes/Not applicable
20 Address Proof Type:
(attach) (Aadhaar/Voters ID/
Driving Licence/Passport/NREGA/NPR)
21 Mobile Number:
(with Country Code)
22 E-mail ID: (in block letters)
23 Occupation: (Service/Business/Agriculture/ Retired/
Professional/ Self-employed / /Housewife/ Student)
24 Annual Income slab:
(below Rs.1 lakh/ Rs.1 to 5 lakh/
Rs.5 to 10 lakh/ Rs.10 to 25 lakh/ Above Rs.25 lakh)
25 Source of Income (Salaried/ Business/ Pensioner/
Agriculture/ Others)
26 PAN / Form-60: (attach)
Apex ID: Base Branch: Selected Client ID:
Branch: CKYCR No:
II. Information to be Updated
I. Data Fields
Sl.
Customers declaration: I confirm that the accounts mentioned in your letter belong to me. I also hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I
undertake to inform you of any change therein, immediately. I hereby consent to receiving information from the Central KYC Registry to my SMS /Email. The Aadhaar number (if submitted), is with my explicit consent.
I am also aware that any change in my existing Mobile number and/or e-mail ID shall also be made effective for my Mobile or/and Net-Banking facilities (as applicable). I also hereby affirm and declare that my
correspondence address is as furnished under Item-5 above. I also understand that the address verification letter sent by the Bank to the said address, if returned undelivered may result in the Bank at its discretion,
stopping operations in my account, without further notice.
For Branch/Office use
KYC Details/Customer Signature
Verified and found correct
Signature of Customer
Name of Customer Paste Recent
Colour Photograph
Name, EMP Code and Signature
of BM/BOM/RO
Date:
CSB Bank Limited (formerly The Catholic Syrian Bank Ltd.) Registered Office: CSB Bhavan, St. Mary’s College Road, Thrissur, Kerala - 680 020 | www.csb.co.in | CIN: L65191KL1920PLC000175
Digital Banking - Value added Services
Now you can enable CSB Digital Banking service including Debit card, Net Banking, Mobile Banking, SMS alerts, e-Mail alerts/statements.
If you want to avail any of the said services please tick the below boxes to enable
Debit Card Internet Banking Mobile Banking SMS Alerts e-Mail Alerts e-Mail statement (Monthly)
