UTI - KYC Application Form (For Non-Individuals Only)

1. Gross Annual Income Details Please tick () Below 1 Lac 1-5 Lacs 5-10 Lacs 10-25 Lacs >25 Lacs-1 Crore >1 Crore
2. Net-worth in v as on (date)
Know Your Client (KYC)
Application Form (For Non-Individuals Only) Application No. :
Ver. 02-2012
1. Name of Applicant (Please write complete name as per Certifi cate of Incorporation/Registration; leaving one box blank between 2 words. Please do not abbreviate the Name).
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. I / We hereby authorise sharing of the information furnished on this form with all SEBI registered KYC
Registration Agencies.
Place : Date :
A. Identity Details (please see guidelines overleaf)
N
2a. Date of Incorporation 2b. Place of Incorporation
5. Permanent Account Number (PAN) (MANDATORY)
3. Registration No. (e.g. CIN)
Date of commencement of business
D D / M M / Y Y Y Y
D D / M M / Y Y Y Y
D D / M M / Y Y Y Y
B. Address Details (please see guidelines overleaf)
2. Contact Details
4. Registered Office Address (If different from above)
1. Address for Correspondence
City / Town / Village Postal Code
State Country
E-Mail Id.
Tel. (Off.) (ISD) (STD) Tel. (Res.) (ISD) (STD)
Mobile (ISD) (STD) Fax (ISD) (STD)
City / Town / Village Postal Code
State Country
3. Name, PAN, DIN/UID, residential address and photographs of Promoters/Partners/Karta/Trustees/whole time directors
(Please use the Annexure to fi ll in the details)
4. Is the entity involved in/providing any of the following services
– Foreign Exchange / Money Changer Services YES NO
– Gaming / Gambling / Lottery Services (e.g. casinos, betting syndicates) YES NO
– Money Lending / Pawning YES NO
5. Any other information:
C. Other Details (please see guidelines overleaf)
3. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick () against the document attached.
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *Latest Bank Account Statement Registered Lease / Sale Agreement of Offi ce Premises
Any other proof of address document (as listed overleaf) Please specify *Not more than 3 Months old.
5. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick () against the document attached.
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *Latest Bank Account Statement Registered Lease / Sale Agreement of Offi ce Premises
Any other proof of address document (as listed overleaf) Please specify *Not more than 3 Months old.
(* Net worth should not be older than 1 year)
PHOTOGRAPH
Please affix
recent Passport
size photograph of
Authorised Signatory.
Signatory to also sign
across the Photograph.
4. Status Private Ltd. Co. Public Ltd. Co. Body Corporate Partnership Trust / Charities / NGOs
Please tick () FI FII HUF AOP Bank Government Body Non-Government Organisation
Defence Establishment Body of Individuals Society LLP Others Please specify
Please enclose a duly attested copy of your PAN Card.
NAME &
SIGNATURE(S)
OF
AUTHORISED
PERSON(S)
Seal/Stamp of the intermediary should contain
Staff Name
Designation
Name of the Organization
Signature
Date
Documents Attestation
AMC/Intermediary name OR code
(Originals Verifi ed) Self Certifi ed Document copies received
(Attested) True copies of documents received
FOR OFFICE USE ONLY
Please fill this form in ENGLISH and in BLOCK LETTERS.
A. IMPORTANT POINTS:
1. Self attested copy of PAN card is mandatory for all clients, including Promoters/
Partners/Karta/Trustees and whole time directors and persons authorized to deal in
securities on behalf of company/fi rm/others.
2. Copies of all the documents submitted by the applicant should be self-attested
and accompanied by originals for verifi cation. In case the original of any document
is not produced for verifi cation, then the copies should be certifi ed true by Karta/
Partner/Trustee/Authorized Offi cial/Director/Company Secretary (Name, Designation &
Seal should be affi xed on the copy) and properly attested by entities authorized for
attesting the documents, as per the list mentioned under [E].
3. If any proof of identity or address is in a foreign language, then translation into
English is required.
4. Name & address of the applicant mentioned on the KYC form,should match with
the documentary proof submitted.
5. If correspondence & registered offi ce addresses are different, then proofs for both
have to be submitted.
6. Sole proprietor must make the application in his individual name & capacity. If you
are a sole proprietor, please use the KYC Application Form for Individuals.
7. For foreign entities, CIN is optional; and in the absence of DIN for the directors,their
passport copy should be given.
8. Politically Exposed Persons (PEP) are defi ned as individuals who are or have been
entrusted with prominent public functions in a foreign country, e.g., Heads of States
or of Governments, senior politicians, senior Government/judicial/military offi cers,
senior executives of state owned corporations, important political party offi cials,etc.
B. Permanent Account Number (PAN):
PAN is a mandatory requirement for all applicants except those who are specifi cally exempt
from obtaining PAN (listed in Section D).
In case of institutional clients, namely, FIIs, MFs, VCFs, FVCIs, Scheduled Commercial Banks,
Multilateral and Bilateral Development Financial Institutions, State Industrial Development
Corporations, Insurance Companies registered with IRDA and Public Financial Institution
as defi ned under section 4A of the Companies Act, 1956, Custodians shall verify the PAN
card details with the original PAN card and provide duly certifi ed copies of such verifi ed
PAN details to the intermediary.
C. Proof of Address (POA):
List of documents admissible as Proof of Address:
(*Documents having an expiry date should be valid on the date of submission)
1. Latest Land Line Telephone Bill
2. Latest Electricity Bill
3. Latest Bank Passbook / Bank Account Statement
4. Registered Lease / Sale Agreement of offi ce premises
5. Proof of address issued by any of the following: Bank Managers of Scheduled
Commercial Banks/Scheduled Co-operative Bank/Multinational Foreign Banks/Gazetted
Offi cer/Notary public/Elected representatives to the Legislative Assembly or Parliament/
Documents issued by any Govt. or Statutory Authority.
6. For FII/sub account, Power of Attorney given by FII/sub-account to the Custodians
(which are duly notarized and/or apostiled or consularised) that gives the registered
address should be taken.
7. Registration Certifi cate issued under Shops and Establishments Act
Documents having an expiry date should not be more than three months old as on the
date of submission of this form.
D. Exemptions/clarifications to PAN (*Sufficient documentary evidence in support
of such claims to be collected.)
1. In case of transactions undertaken on behalf of Central Government and/or State
Government and by offi cials appointed by Courts e.g. Offi cial liquidator,Court receiver
etc.
2. UN entities/multilateral agencies exempt from paying taxes/fi ling tax returns in India.
3. Investors residing in the state of Sikkim.
E. List of people authorized to attest the documents after verification with the
originals:
1. Authorised offi cials of Asset Management Companies (AMC).
2. Authorised offi cials of Registrar & Transfer Agent (R&T) acting on behalf of the AMC.
3. KYD compliant mutual fund distributors.
4. Notary Public, Gazetted Offi cer, Manager of a Scheduled Commercial/Co-operative
Bank or Multinational Foreign Banks.
5. Government authorised offi cials who are empowered to issue Apostille Certifi cates.
INSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM
alok
graphics
Please Submit the KYC Documents on A4 Size Paper Only.
F. Incase of Non-Individuals, additional documents to be obtained from non-individuals, over & above the POI & POA, as mentioned below:
Type of entity Documentary requirements
Corporate • Copy of the balance sheets for the last 2 fi nancial years (to be submitted every year)
• Copy of latest share holding pattern including list of all those holding control, either directly or indirectly, in the company in terms of SEBI
takeover Regulations, duly certifi ed by the company secretary/Whole time director/MD(to be submitted every year)
• Photograph, POI, POA, PAN and DIN numbers of whole time directors/two directors in charge of day to day operations
• Photograph, POI, POA, PAN of individual promoters holding control – either directly or indirectly
• Copies of the Memorandum and Articles of Association and certifi cate of incorporation
• Copy of the Board Resolution for investment in securities market
• Authorised signatories list with specimen signatures
Partnership firm • Copy of the balance sheets for the last 2 fi nancial years (to be submitted every year)
• Certifi cate of registration (for registered partnership fi rms only)
• Copy of partnership deed
• Authorised signatories list with specimen signatures
• Photograph, POI, POA, PAN of Partners
Trust • Copy of the balance sheets for the last 2 fi nancial years (to be submitted every year)
• Certifi cate of registration (for registered trust only). Copy of Trust deed
• List of trustees certifi ed by managing trustees/CA
• Photograph, POI, POA, PAN of Trustees
HUF • PAN of HUF
• Deed of declaration of HUF/List of coparceners
• Bank pass-book/bank statement in the name of HUF
• Photograph, POI, POA, PAN of Karta
Unincorporated Association or a
body of individuals
• Proof of Existence/Constitution document
• Resolution of the managing body & Power of Attorney granted to transact business on its behalf
• Authorized signatories list with specimen signatures
Banks/Institutional Investors • Copy of the constitution/registration or annual report/balance sheet for the last 2 fi nancial years
• Authorized signatories list with specimen signatures
Foreign Institutional Investors (FII) • Copy of SEBI registration certifi cate
• Authorized signatories list with specimen signatures
Army/Government Bodies • Self-certifi cation on letterhead
• Authorized signatories list with specimen signatures
Registered Society • Copy of Registration Certifi cate under Societies Registration Act
• List of Managing Committee members
• Committee resolution for persons authorised to act as authorised signatories with specimen signatures
• True copy of Society Rules and Bye Laws certifi ed by the Chairman/Secretary
Details of Promoters/Partners/Karta/Trustees and whole time directors forming a part of
Know Your Client (KYC) Application Form for Non-Individuals
Name of Applicant
PAN of the Applicant
Sr.
No.
PAN Name DIN (For
Directors)/
UID (For
others if
available)
Residential Address Relationship
with Applicant
(i.e. promoters,
whole time
directors etc.)
Whether
Politically
Exposed*
Photograph
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
*PEP: Politically Exposed Person
*RPEP: Related to Politically Exposed Person
Sr.
No.
PAN Name DIN (For
Directors)/
UID (For
others if
available)
Residential Address Relationship
with Applicant
(i.e. promoters,
whole time
directors etc.)
Whether
Politically
Exposed*
Photograph
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
(Please attach
a copy of
your PAN
Card)
(Please attach proof
of your residential
address)
PEP
RPEP
NO
*PEP: Politically Exposed Person
Name & Signature of the Authorised Signatory(ies) Date D D / M M / Y Y Y Y *RPEP: Related to Politically Exposed Person
Details of Promoters/Partners/Karta/Trustees and whole time directors forming a part of
Know Your Client (KYC) Application Form for Non-Individuals (contd.)