Passport Expiry Date C- PAN Card Driving Licence Expiry Date. Identification Number. Business. Business

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1 Kotak Seurities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Highway, Branh Inward Details Red. on KRA KY OMMON UPDATION FORM A - INDIVIDUAL Emp. Name Emp. ID Trading ode Demat Aount No. DP ID: IN D D / M M / KNOW YOUR LIENT (KY) NEW HANGE REQUEST Emp. Sign Aknowledgment No. Please fill this form in ENGLISH and in BLOK LETTERS.Please tik Branh Name the appropriate now where HANGE/ORRETION is required IDENTITY DETAILS MANDATORY *FATA Delaration: I/we onfirm that our ountry of Birth/Nationality/ itizenship/ Tax Resideny/ Address/ Telephone No./ Address of POA or Mandate holder is of India Yes No (if answer to your question is No, then please provide omplete FATA Delaration available on page 5 & 6) 1. PERSONAL DETAILS (Please refer instrution A) Name*(as per Aadhaar/UID) Maiden Name (if any*) Father/Spouse Name* 2. PROOF OF IDENTITY (PoI)* (Please refer instrution B) A-Passport No. B-Voter ID ard D-Driving Liene AKNOWLEDGEMENT *Request for Aadhaar updation - I/we wish to link the below mentioned Aadhaar and I/we have no objetion in authentiating with Aadhaar based authentiation system via OTP/Biometri/Demographi information. In ase of authentiation failure with UIDAI reords, I/we understand that my/our Aadhaar no. will not be updated in the KSL reords. onsent to share Aadhaar details: Y N. I hereby give my onsent to KSL to update and share my Aadhaar number and related details obtained from UIDAI through authentiation using OTP/Biometri/Demographi information on my behalf with any/all of Kotak Group ompanies as well as any third party entities like AM s, PMS, Mutual Funds, Insurer s or any other institution in ase of any investment or purhase of any produt/servies from suh entities made through KSL. Aadhaar Number Details: First Holder - - Gender* M-Male F-Female T- Transgender Marital Status* Married Unmarried Others Residential Status* E- UID (Aadhaar) F-NREGA Job ard Z- Others Identifiation Number (any doument notified by the entral government) S-Simplified Measures Aount - Doument Name Identifiation Number To be provided by Sikkim lients or by lients providing alternate ID Proofs. 3. PROOF OF ADDRESS (PoA)* (Please refer instrution ) Distrit* Distrit* Resident Individual Pin ode* 3.2 ORRESPONDENE/LOAL ADDRESS DETAILS* (Please see instrution D) Address Type* Residential/Business Pin ode* Foreign National Nationality* of Birth* D D / M M / Oupation Type* S-Servie ( Private Setor Publi Setor Government Setor) O-Others ( Professional Self Employed Retired Housewife Student) B-Business Agriulturist Forex Dealer Others Please Speify (ertified opy of any one of the following Proof of Identity [POI] needs to be submitted) This setion is Not Appliable for ustomers who are KRA omplied or have provided onsent for authentiating with UIDAI system. Landmark (If any) State/U.T* Landmark (If any) State/U.T* Non Resident Indian Passport Expiry - PAN ard Driving Liene Expiry Person of Indian Origin D D / M M / D D / M M / 3.1 URRENT / PERMANENT / OVERSEAS ADDRESS DETAILS Address Type* Residential/Business Residential Business Registered Offie Proof of Address* Passport Driving Liene UID ard (Aadhaar) Voter Identity ard NREGA Job ard Simplified Measures Aounts - Doument Abbreviation Please Speify Others Please Speify (Refer heklist) Doument No.: Expiry (If any) D D / M M / Address D D / M M / Mobile No./Phone No. Id Name of the Employee ountry* ountry* ity/town/village* Same as urrent/permanent/overseas Address details (In ase of multiple orrespondene/ loal addresses, please ask your RM to provide you Annexure A ) Business Registered Offie UID ard (Aadhaar) Voter Identity ard Please Speify Others Please Speify ity/town/village* Your request will be proessed within a tentative period of 7 days from the date of reeipt of omplete douments. In ase of queries regarding the status of the request, W/e request you to all on ustomer Servie No / / Demat related omplaints write at ks.demat@kotak.om for any other queries or omplaints write at servie.seurities@kotak.om. PHOTOGRAPH Residential Proof of Address* Passport Driving Liene NREGA Job ard Simplified Measures Aounts - Doument Abbreviation (Refer heklist) Doument No.: Expiry (If any) D D / M M / Yes No RM Query ID 1 Yes No RM Query ID 2 Yes No RM Query ID 3 Aadhar Yes No RM Query ID 4 Mother Name* Employee ode From having Trading ode lient Id For Kotak Seurities Ltd. (ompany Seal) Employee Signature Name 3rd Holder Name 2nd Holder Name 11st Holder

2 Kotak Seurities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Highway, 4. ONTAT DETAILS (Please refer instrution E) (All ommuniations will be sent on provided Mobile no. / -ID) Tel.(Res.) S T D Mobile Tel.(Off.) 9 1 S T D - Fax S T D ID. The mobile number mentioned here belongs to Name of relative Self Spouse Dependent parent Dependent hildren PAN of relative The ID mentioned here belongs to Name of relative Self Spouse Dependent parent Dependent hildren PAN of relative SMS Flag Yes No APPLIANT DELARATION I hereby delare that the details furnished above are true and orret to the best of my knowledge and belief and I undertake to inform you of any hanges therein, immediately. In ase any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby onsent to reeiving information from entral KY Registry through SMS/ on the above registered number/ address. I/We are aware that the information on provided herewith shall be updated in aounts maintained at Kotak Seurities under intimation to me. 1st Holder 2nd Holder 3rd Holder Name Name Name hek list to be verified by aquiring sales staff ertified opies Details Appliable for All Holders Details Douments verified with original / lient Interviewed By / In-Person Verifiation done by Name of the Employee / Sub-Broker /AP Employee ode / SEBI Reg. No. / AP Reg. No. Name & Address of Branh/Franhisee/ Servie enter Designation of the Employee Plae of verifiation Signature Name of Institution Kotak Seurities Ltd. ode of Institution NSE ode BSE ode MSEI ode Stamp of Institution For Offie Use Only Ver. 1 (Jan 2017) Address RM Query ID 1 Mobile No./Phone No. RM Query ID 2 Id RM Query ID 3 Aadhar RM Query ID 4 Appliation Type* Update KY Number (To be filled by (Mandatory for KY update request) finanial institution) Aount Type* Normal Simplified (for low risk ustomers) 2

3 Trading ode Kotak Seurities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Highway, KRA KY OMMON UPDATION FORM B - INDIVIDUAL Name D D / M M / DP ID: IN Branh Inward Details Red. on Emp. Name Emp. ID Emp. Sign Branh Name Please fill this form in ENGLISH and in BLOK LETTERS.Please tik the appropriate now where HANGE/ORRETION is required IDENTITY DETAILS MANDATORY *FATA Delaration: I/we onfirm that our ountry of Birth/Nationality/ itizenship/ Tax Resideny/ Address/ Telephone No./ Address of POA or Mandate holder is of India Yes No (if answer to your question is No, then please provide omplete FATA Delaration available on page 5 & 6) *Request for Aadhaar updation - I/we wish to link the below mentioned Aadhaar and I/we have no objetion in authentiating with Aadhaar based authentiation system via OTP/Biometri/Demographi information. In ase of authentiation failure with UIDAI reords, I/we understand that my/our Aadhaar no. will not be updated in the KSL reords. onsent to share Aadhaar details: Y N. I hereby give my onsent to KSL to update and share my Aadhaar number and related details obtained from UIDAI through authentiation using OTP/Biometri/Demographi information on my behalf with any/all of Kotak Group ompanies as well as any third party entities like AM s, PMS, Mutual Funds, Insurer s or any other institution in ase of any investment or purhase of any produt/servies from suh entities made through KSL. 1. REQUEST FOR BANK DETAILS UPDATION/RTGS FAILITY hange Addition (Only for trading) RM Query ID 5 Aadhaar Number Details: Demat Aount No. First Holder - - Gender* M-Male F-Female T- Transgender of Birth* D D / M M / I want to avail RTGS/NEFT Faility: Yes No Default mapping Yes No Bank Name Branh Address ity Pin ode IFS ode of benefiiary bank MIR ode : Bank A/ No. Bank A/ Type : Saving urrent Full name of First Holder in the Bank Full name of Seond Holder in the Bank Full name of Third Holder in the Bank I am enlosing the following douments as proof that the aforesaid aount belongs to me: 1. anelled personalized heque leaf of the above mentioned Bank Aount and 2. Bank statement/bank Passbook opy of the same. 3. In ase Bank Aount in Joint Name NO from Aount holder is required. A/ Type : Online Offline Bank Name: KMBL Other Bank In ase Existing Bank a/ is being replaed with KMBL A/ then read the Point # G given in Instrution / hek List for Filling KY Form 2. onsent to Reeive Transation Statement on (Only for DP) RM Query ID 6 Please refer instrution F I/We understand from you that a faility is being granted wherein I/We an get aess to the transation statements in respet of my/our above demat aount in the Website of the Depository Partiipant or in the address provided by me/us to the Depository Partiipant. I/We are also aware that the said faility is available subjet to me/us omplying with ertain terms and onditions as presribed by National Seurities Depositories Ltd (NSDL). I/We have requested Kotak Seurities Ltd to provide me the faility of aessing the transation statements in the aount provided by me below/in the enlosed KY form and Kotak Seurities Ltd has agreed to the said request. In onsideration of Kotak Seurities Ltd agreeing to allow me/us to avail the said faility I/We agree that I/We have read and understood the Terms and ondition as mentioned in (F) Point Please note the ID : 3. Request Form for Aepting ontrat Notes and other ommuniation through Eletroni mode and on Mobile Phone: (Only for trading) ID: Mobile RM Query ID 7 I/We hereby agree to reeive: (Please tik any one) ontrat notes and other ommuniation on and mobile ontrat notes and other ommuniation through physial & digital mode* ontrat notes and other ommuniation through physial mode* Please send all ommuniation at my/our id and mobile number as mentioned in the lient registration form. I/ We agree that all information sent to the abovementioned id shall be binding upon me/us. Further, I /We understand that nonreeipt of bouned mail notifiation by Kotak Seurities Limited (KSL) shall amount to delivery of the ontat note or suh other information at my /our id. I/We agree that KSL shall not be responsible for the non-reeipt of the ontrat note/onfirmation note/other orrespondene by me/us due to any hange in the address/ id/mobile number if not intimated by me/us. I/We am/are aware that for any hange in the address/ id/mobile number, I/we am/are required to update the same to KSL in writing through a physial letter. If I/we avail online trading servies provided by KSL, the said updation an also be made through a seured aess to the website. * Nominal harges may be debited to my aount as per the prevalent poliy of the ompany towards the physial delivery of various ommuniation The mobile number mentioned here belongs to Name of relative Self Spouse Dependent parent Dependent hildren PAN of relative lient Signature The ID mentioned here belongsto Name of relative Self Spouse Dependent parent Dependent hildren PAN of relative * I/We agree to ativate my aount from dormant status to ative status DELARATION I / We hereby delare that the details furnished above are true & orret to the best of my knowledge and undertake to inform you of any hanges therein immediately, and I/we may be held liable for any information is found to be false/misreading /misrepresenting. I/We are aware that the information provided herewith shall be updated in aounts maintained at Kotak Seurities under intimation to me. 1st Holder 2nd Holder 3rd Holder Name AKNOWLEDGEMENT Name Name D D / M M / Bank Updation/RTGS Faility Yes No RM Query ID 5 onsent for Transation Yes No RM Query ID 6 Statement (Only for DP) ontrat Note/ommuniation Preferene (Only for Trading) Yes No RM Query ID 7 Aadhar Yes No RM Query ID 8 From having Trading ode lient Id Name of the Employee Employee ode Your request will be proessed within a tentative period of 7 days from the date of reeipt of omplete douments. In ase of queries regarding the status of the request, We request you to all on ustomer Servie No / / Demat related omplaints write at ks.demat@kotak.om for any other queries or omplaints write at servie.seurities@kotak.om. For Kotak Seurities Ltd. (ompany Seal) Employee Signature 3

4 Kotak Seurities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Highway, A. IMPORTANT POINTS : 1. Self attested opy of PAN ard and all other douments are mandatory for all lients and persons authorized to deal in seurities onbehalf of ompany /firm/others. 2. opies of all douments submitted by the lient should be verified with original by Kotak Seurities employee/registered Sub-broker/ Registered Authorised Person. In ase the original of any doument is not produed for verifiation, then the opies should be properly attested by entities authorized for attesting the douments, as per the below mentioned list. List of people authorized to attest the douments: Notary Publi, Gazetted Offier, Manager of a Sheduled ommerial/o-operative Bank or Multinational Foreign Banks (Name, Designation & Seal should be affixed on the opy). In ase of NRIs, authorized offiials of overseas branhes of Sheduled ommerial Banks registered in India, Notary Publi, ourt Magistrate, Judge, Indian Embassy /onsulate General in the ountry where the lient resides are permitted to attest the douments 3. If any proof of identity or address is in a foreign language, then translation into English is required. 4. Name & address of the appliant mentioned on the KY form, should math with the doumentary proof submitted. 5. If orrespondene & permanent address are different, then proofs for both have to be submitted. 6. Sole proprietor must make the appliation in his individual name & apaity. 7. For non-residents and foreign nationals, (allowed to trade subjet to RBI and FEMA guidelines), opy of passport / PIOard / OI ard and over seas address proof Is mandatory. 8. In ase of high risk lients like PEP (Politial Exposed Person) douments speified as proof of identity and address for opening simplified measure aount are not appliable. General Instrutions: 1. Fields marked with * are mandatory fields. 2. Tik wherever appliable. 3. Please fill all dates in DD-MM-YYYY format. 4. For partiular setion update, please tik in the box available before the setion number and strike off the setions not required tobe updated. B A larifiation / Guidelines on filling Personal Details setion 1. Name: Please state the name with Prefix (Mr/Mrs/Ms/Dr/et.). The name should math the name as mentioned in the Proof of Identity submitted failing whih the appliation is liable to be rejeted.. 2. Either father s name or spouse s name is to be mandatorily furnished. In ase PAN is not available father s name is mandatory. larifiation / Guidelines on filling Proof of Identity [PoI] setion 1. If driving liense number or passport is provided as proof of identity then expiry date is to be mandatorily furnished. 2. Mention identifiation / referene number if Z- Others (any doument notified by the entral government) is tiked. Sr. No. Desription 1. Identity ard with appliant s photograph issued by entral/ State Government Departments, Statutory/Regulatory Authorities, Publi Setor Undertakings, Sheduled ommerial Banks, and Publi Finanial Institutions. 2. Letter issued by a gazetted offier, with a duly attested photograph of the person. larifiation/guidelines on filling Proof of Address [PoA] - urrent / Permanent / Overseas Address details setion 1. PoA to be submitted only if the submitted PoI does not have an address or address as per PoI is invalid or not in fore. 2. State / U.T ode and Pin / Post ode will not be mandatory for Overseas addresses. 3. In ase of Simplified Measures Aounts for verifying the address of the appliant, any one of the following douments an also be submitted D larifiation / Guidelines on filling Proof of Address [PoA] - orrespondene / Loal Address details setion 1 To be filled only in ase the PoA is not the loal address or address where the ustomer is urrently residing. 2 In ase of multiple orrespondene/loal addresses, Please ask for Annexure A1 from your Relationship Manager and submit the same. E larifiation / Guidelines on filling ontat details setion 1 In ase of mobile no. please mention ountry ode and 10 digit mobile number (e.g. for Indian mobile number mention ). 2 Do not add 0 in the beginning of Mobile number. 3. In ase of landline number please mention STD ode & ISD ode F. onsent to reeive Transation Statement on Notes: For reeiving Statement of Aount in eletroni form: 1) I/We are aware that the on availing this faility transation statements will not be reeived in paper form. 2) I/we will take all neessary steps to ensure onfidentiality and serey of the login name and password of the internet/ aount. 3) I/we am/are aware that the transation statement may be aessed by other entities in ase the onfidentiality/serey of the login name and password is 4) I/We shall not hold kotak seurities ltd liable if any problem arises with my/our omputer network beause of me/us reeiving statements. 5) I/We are authorized by the other holders to reeive the statements on their behalf in IDs provided to kotak seurities ltd 6) I/we shall immediately inform Kotak Seurities Ltd regarding any hange of address provided by me/us for reeiving the transation statements. 7) I/We shall not hold responsible kotak seurities ltd, if we do not reeive statement due to inorret ids and / tehnial reasons. 8) I/We are aware that both the parties have the right to terminate the said faility on providing a 10 days advane written notie to the other party. I. lient must ensure the onfidentiality of the password of the aount. II. lient must promptly inform the Partiipant if the address has hanged. III. lient may opt to terminate this faility by giving 10 days prior notie. Similarly, Partiipant may also terminate this faility by giving 10 days prior notie. G. In ase you wish to have diret Aess Faility with the new Bank Aount and Power Of attorney has not been registered against this Aount, please submit a opy of the Linking Letter to your Bank for linking the same. Please note that in absene of the same, you will be unable to transfer funds to your Trading Aount. Sr.No. Desription Abbreviation 1. Utility bill whih is not more than two months old of any servie provider (eletriity, telephone, post- paid mobile phone, piped gas, water bill). UB 2. Property or Muniipal Tax reeipt. PRT Bank aount or Post Offie savings bank aount statement. 3. BAS Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Publi Setor Undertakings, if they 4. ontain the address. PPOs Letter of allotment of aommodation from employer issued by State or entral Government departments, statutory or regulatory bodies, 5. publi setor undertakings, sheduled ommerial banks, LOA Douments issued by Government departments of foreign jurisditions and letter issued by Foreign Embassy or Mission in India. 6. DIG 4

5 Kotak Infinity, 8 th Floor, Bldg; No.21,Infinity Park, Off Western Express Highway, Goregaon Mulund Link Road, Malad ( E), Mumbai (022) FATA / RS Delaration for Individual Aounts The information in this setion is being olleted beause of enhanements to o s new aount on-boarding proedures in order to fully omply with Foreign Aount Tax ompliane At (FATA) requirements and the ommon Reporting Standards (RS) requirements pursuant to amendments made to Inome-tax At,1961 read with Inome-tax Rules, For more information refer: & (We are unable to provide advie about your tax resideny. If you have any questions about your tax resideny, please ontat your tax advisor) 1st Holder - Setion I (All fields are mandatory) (Please fill in BLOK LETTERS) 1 Trading ode: lient ID (To be provided only if demat aount is with KSL) 2 Name of Aount Holder 3 a. Address for Tax Residene ity State ountry Pin ode (Please use this spae in ase you are Tax Resident of more than one ountry) b. Address for Tax Residene ity State ountry Pin ode 4 Address Type (Tik whihever appliable) Residential Business Registered Offie Residential/ Business 5 Do you satisfy any of the riteria mentioned below? Yes No a. itizen of any ountry other than India (dual/multiple) [inluding Green ard] b. ountry of birth is any ountry other than India. Tax resident of ANY ountry / ies other than India d. POA or a mandate holder who has an address outside India e. Address or telephone number outside India If your answer to any of the above questions is a YES, please fill Setion II of the form,else go to delaration & aknowledgment 1st Holder - Setion II (All fields are mandatory) Father s name (If PAN not availabe, then mandatory) ountry of Birth Plae within the ountry of birth `(If USA, however nationality and/or ountry of tax resideny is not USA, Please provide doumentary evidene as mentioned in instrution 1) Soure of Wealth Nationality Please list below the details, onfirming ALL ountries of tax resideny/ permanent resideny/ itizenship and ALL Tax Identifiation Numbers ountry of Tax resideny Tax identifiation no s Tax identifiation doument (TIN or funtional equivalent) It is mandatory to supply a TIN or funtional equivalent (in ase TIN not available )if the ountry in whih you are tax resident issues suh identifiers. If no TIN /funtional equivalent is yet available or has not yet been issued, please provide an explanation 2nd Holder - Setion I (All fields are mandatory) (Please fill in BLOK LETTERS) 1 Trading ode: lient ID (To be provided only if demat aount is with KSL) 2 Name of Aount Holder 3 a. Address for Tax Residene ity State ountry Pin ode (Please use this spae in ase you are Tax Resident of more than one ountry) b. Address for Tax Residene ity State ountry Pin ode 4 Address Type (Tik whihever appliable) Residential Business Registered Offie Residential/ Business 5 Do you satisfy any of the riteria mentioned below? Yes No a. itizen of any ountry other than India (dual/multiple) [inluding Green ard] b. ountry of birth is any ountry other than India. Tax resident of ANY ountry / ies other than India d. POA or a mandate holder who has an address outside India e. Address or telephone number outside India If your answer to any of the above questions is a YES, please fill Setion II of the form,else go to delaration & aknowledgment 5

6 2nd Holder - Setion II (All fields are mandatory) Father s name (If PAN not availabe, then mandatory) ountry of Birth Plae within the ountry of birth `(If USA, however nationality and/or ountry of tax resideny is not USA, Please provide doumentary evidene as mentioned in instrution 1) Soure of Wealth Nationality Please list below the details, onfirming ALL ountries of tax resideny/ permanent resideny/ itizenship and ALL Tax Identifiation Numbers ountry of Tax resideny Tax identifiation no s Tax identifiation doument (TIN or funtional equivalent) It is mandatory to supply a TIN or funtional equivalent (in ase TIN not available) if the ountry in whih you are tax resident issues suh identifiers. If no TIN /funtional equivalent is yet available or has not yet been issued, please provide an explanation 3rd Holder - Setion I (All fields are mandatory) (Please fill in BLOK LETTERS) 1 Trading ode: lient ID (To be provided only if demat aount is with KSL) 2 Name of Aount Holder 3 a. Address for Tax Residene ity State ountry Pin ode (Please use this spae in ase you are Tax Resident of more than one ountry) b. Address for Tax Residene ity State ountry Pin ode 4 Address Type (Tik whihever appliable) Residential Business Registered Offie Residential/ Business 5 Do you satisfy any of the riteria mentioned below? Yes No a. itizen of any ountry other than India (dual/multiple) [inluding Green ard] b. ountry of birth is any ountry other than India. Tax resident of ANY ountry / ies other than India d. POA or a mandate holder who has an address outside India e. Address or telephone number outside India If your answer to any of the above questions is a YES, please fill Setion II of the form,else go to delaration & aknowledgment 3rd Holder - Setion II (All fields are mandatory) Father s name (If PAN not availabe, then mandatory) ountry of Birth Plae within the ountry of birth `(If USA, however nationality and/or ountry of tax resideny is not USA, Please provide doumentary evidene as mentioned in instrution 1) Soure of Wealth Nationality Please list below the details, onfirming ALL ountries of tax resideny/ permanent resideny/ itizenship and ALL Tax Identifiation Numbers ountry of Tax resideny Tax identifiation no s Tax identifiation doument (TIN or funtional equivalent) It is mandatory to supply a TIN or funtional equivalent (in ase TIN not available )if the ountry in whih you are tax resident issues suh identifiers. If no TIN /funtional equivalent is yet available or has not yet been issued, please provide an explanation Delaration & Aknowledgment I/We being the benefiial owner of the aount opened / to be opened with Kotak Seurities Limited(KSL) and the inome redited therein, delare that the above information and information in the submitted douments to be true, orret and updated, and the submitted douments are genuine and duly exeuted. I/We aknowledge that towards ompliane with tax information sharing laws, suh as FATA/RS, the KSL may be required to seek additional personal, tax and benefiial owner information and ertain ertifiations and doumentation from the aount holder. Suh information may be sought either at the time of aount opening or any time subsequently. In ertain irumstanes (inluding if the KSL does not reeive a valid selfertifiation from me) KSL may be obliged to share information on my aount with relevant tax authorities. Should there be any hange in any information provided by me I/We ensure that I/We will advise KSL promptly, i.e., within 30 days. Towards ompliane with suh laws, the KSL may also be required to provide information to any institutions suh as withholding agents for the purpose of ensuring appropriate withholding from the aount or any proeeds in relation thereto. As may be required by domesti or overseas regulators/ tax authorities, the KSL may also be onstrained to withhold and pay out any sums from my aount or lose or suspend my aount(s). I/We further agree that the information provided above will be updated in all my trading/demat aounts, if any at PAN level.i/we also understand that the aount will be reported if any one of the aforesaid FATA / RS riteria for any of the aount holders i.e. primary or joint (in ase of demat aount) are met. lient Signature (1st Holder) lient Signature (2nd Holder) lient Signature (3rd Holder)

7 Instrutions to the Form In ase ustomer has the following Indiia pertaining to a foreign ountry and yet delares self to be non-tax resident in the respetive ountry, ustomer to provide relevant uring Douments as mentioned below: FATA/ RS Indiia observed (tiked) U.S. plae of birth Residene/mailing address in a ountry other than India or Telephone number in a ountry other than India Standing instrutions to transfer funds to an aount maintained in a ountry other than India (other than depository aounts) Doumentation required for ure of FATA/ RS indiia Self-ertifiation that the aount holder is neither a itizen of United States of Ameria nor a resident for tax purposes; Non-US passport or any non-us government issued doument evidening nationality or itizenship (refer list below);and Any one of the following douments: ertified opy of ertifiate of Loss of Nationality or Reasonable explanation of why the ustomer does not have suh a ertifiate despite renouning US itizenship; or Reason the ustomer did not obtain U.S. itizenship at birth 1. Self-ertifiation that the aount holder is neither a itizen of United States of Ameria nor a tax resident of any ountry other than India; and 2. Doumentary evidene (refer list below) 1. Self-ertifiation that the aount holder is neither a itizen of United States of Ameria nor a tax resident of any ountry other than India; and 2. Doumentary evidene (refer list below) POA granted to a person with an address in a ountry outside India 1. Self-ertifiation that the aount holder is neither a itizen of United States of Ameria nor a tax resident for tax purposesof any ountry other than India; OR 2. Doumentary evidene (refer list below) A. List of aeptable doumentary evidene needed to establish the residene(s) for tax purposes: 1. ertifiate of residene issued by an authorized government body* 2. Valid identifiation issued by an authorized government body* (e.g. Passport, National Identity ard, et.) * Government or ageny thereof or a muniipality of the ountry or territory in whih the payee laims to be a resident. B. larifiation / Guidelines on filling details if appliant residene for tax purposes in jurisdition(s) outside India 1 Tax identifiation Number (TIN): TIN need not be reported if it has not been issued by the jurisdition. However, if the said jurisdition has issued a high integrity number with an equivalent level of identifiation (a Funtional equivalent ), the same may be reported. Examples of that type of number for individual inlude, a soial seurity/insurane number, itizen/personal identifiation/servies ode/number, and resident registration number) Offie Use Setion: Name of the Employee Employee ode Designation of Employee Plae Signature Verified 7