KRA Modification Form Individual
KRA Modification Form Individual
Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Branch Inward Details
Highway, Gen A. K. Vaidya Marg, Malad (E), Mumbai - 400097. Recd. on
Note:- �In case of multiple holders, please fill up separate forms Emp. Name
KRA KYC COMMON UPDATION FORM A - INDIVIDUAL �All holder(s) signature proof required for E-mail/Mobile updation
Emp. ID
Trading code Demat Account No. DP ID: IN300214 Emp. Sign
Date D D / M M / Y Y Y Y KNOW YOUR CLIENT (KYC) NEW CHANGE REQUEST Branch Name
Please fill this form in ENGLISH and in BLOCK [Link] tick the appropriate now where CHANGE/CORRECTION is required IDENTITY DETAILS MANDATORY
*FATCA Declaration: I/we confirm that our Country of Birth/Nationality/ Citizenship/ Tax Residency/ Address/ Telephone No./ Address of POA or Mandate holder
is of India Yes No (if answer to your question is ‘No’, then please provide complete FATCA Declaration available on page 5 & 6)
Name _______________________________
1. PERSONAL DETAILS (Please refer instruction A)
Name*(same ID prof.)
3rd Holder
Occupation Type* S-Service ( Private Sector Public Sector Government Sector)
O-Others ( Professional Self Employed Retired Housewife Student) Signature
B-Business Agriculturist Forex Dealer Others ________________________
Please Specify across photograph
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I. Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital
2. PROOF OF IDENTITY AND ADDRESS (Please refer instruction B) KYC process needs to be submitted (anyone of the following OVDs)
Name __________________________________
FB-Voter ID Card
FC-Driving Licence Driving Licence Expiry Date D D / M M / Y Y Y Y
FD-NREGA Job Card
FE-National Population Register Letter
FF-Proof of Possession of Aadhaar/ VID (Virtual ID) /
FE-KYC Authentication
FOffline verification of Aadhaar
Address: Line 1* _______________________________________________________________________________________________________
Line 2 ______________________________________________________________________________________________________________
2nd Holder
Line 3 ___________________________________________________ Landmark (If any) _____________________________________________
City /Town /Village*____________________________________________________________________ District*__________________________
Pin Code*_______________________________ State/U.T*____________________________________ Country*_________________________
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I. Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be
3. CURRENT ADDRESS DETAILS (Please refer instruction B) submitted (anyone of the following OVDs)
KRA
AADHAR NON KRA & NON AADHAR FSame as above mentioned address (In such cases address details as below need not be provided)
ACKNOWLEDGEMENT
Date D D / M M / Y Y Y Y
Address Yes No CRM Query ID 1 From __________________________
Yes No CRM Query ID 2 having Trading Code
Mobile No./Phone No.
Client Id
Email Id Yes No CRM Query ID 3
For Kotak Securities Ltd.
Name of the Employee __________________________________________ Employee Code _______________ (Company Seal) Employee Signature
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Your request will be processed within a tentative period of 7 days from the date of receipt of complete documents. In case of queries regarding the status of the request,
We request you to call on Customer Service No.1800 209 9191 / 1860 266 9191. Demat related complaints write at [Link]@[Link] for any other queries or complaints
write at [Link]@[Link]. 1
Kotak Securities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express
Highway, Gen A. K. Vaidya Marg, Malad (E), Mumbai - 400097.
4. CONTACT DETAILS (Please refer instruction C) (All communications will be sent on provided Mobile no. / Email-ID)
Tel.(Res.) 9 1 S T D - Mobile 9 1 -
Tel.(Off.) 9 1 S T D - Fax 9 1 S T D -
APPLICANT DECLARATION
• I 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 changes therein,
immediately. In case 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 consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address.
• I/We are aware that the information on provided herewith shall be updated in accounts maintained at Kotak Securities under intimation to me.
Date ___________________________ Place ___________________________
Check list to be verified by acquiring sales staff Certified Copies Details Applicable for All Holders
Details Documents verified with original / Client Interviewed By / In-Person Verification done by
Date
Place of verification
Signature
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Kotak Securities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express Branch Inward Details
Highway, Gen A. K. Vaidya Marg, Malad (E), Mumbai - 400097. Recd. on
Note:- In case of multiple holders, please fill up separate Emp. Name
KRA KYC COMMON UPDATION FORM B - INDIVIDUAL forms for FATCA Emp. ID
Emp. Sign
Trading code Demat Account No. DP ID: IN300214 Branch Name
Date D D / M M / Y Y Y Y
Please fill this form in ENGLISH and in BLOCK [Link] tick the appropriate now where CHANGE/CORRECTION is required IDENTITY DETAILS MANDATORY
*FATCA Declaration: I/we confirm that our Country of Birth/Nationality/ Citizenship/ Tax Residency/ Address/ Telephone No./ Address of POA or Mandate holder
is of India Yes No (if answer to your question is ‘No’, then please provide complete FATCA Declaration available on page 5 & 6)
Name _______________________________________________________________________________________________________________________________________
1. REQUEST FOR BANK DETAILS UPDATION/RTGS FACILITY Change Addition (Only for trading) CRM Query ID 5
I want to avail RTGS/NEFT Facility: Yes No Default mapping Yes No
Bank Name __________________________________________________________________________________________________________________________________
Branch Address____________________________________________________________________________City ___________________ Pin Code
IFSC Code of beneficiary bank MICR Code :
Bank A/c No. ________________________________________________________________________________________________Bank A/c Type : Saving Current
Full name of First Holder in the Bank _____________________________________________________________________________________________________________
Full name of Second Holder in the Bank ___________________________________________________________________________________________________________
Full name of Third Holder in the Bank _____________________________________________________________________________________________________________
I am enclosing the following documents as proof that the aforesaid account belongs to me:
1. Cancelled personalized cheque leaf of the above mentioned Bank Account and 2. Bank statement/Bank Passbook copy of the same.
3. In case Bank Account in Joint Name NOC from Account holder is required. A/c Type : Online Offline Bank Name: KMBL Other Bank
In case Existing Bank a/c is being replaced with KMBL A/c then read the Point # “E” given in “Instruction / Check List for Filling KYC Form”
2. Mode of Receiving Statement of Account [Tick any one] Please refer instruction D CRM Query ID 6
Physical Form Electronic Form (Read the point #‘D’ and ensure that email id is provided in KYC application form)
[Link] Form for Accepting Contract Notes and other Communication through Electronic mode and on Mobile Phone: (Only for trading)
Email ID: _______________________________________________________________ Mobile 9 1 - CRM Query ID 7
I/We hereby agree to receive: (Please tick any one) Contract notes and other communication on Email and mobile
Contract notes and other communication through physical mode*
Please send all communication at my/our email id and mobile number as mentioned in the client registration form. I/ We agree that all information sent to the
abovementioned email id shall be binding upon me/us. Further, I /We understand that nonreceipt of bounced mail notification by Kotak Securities Limited (KSL) shall
amount to delivery of the contact note or such other information at my /our email id. I/We agree that KSL shall not be responsible for the non-receipt of the contract
note/confirmation note/other correspondence by me/us due to any change in the address/email id/mobile number if not intimated by me/us. I/We am/are aware that for any
change in the address/email id/mobile number, I/we am/are required to update the same to KSL in writing through a physical letter. If I/we avail online trading services
provided by KSL, the said updation can also be made through a secured access to the website.
* Nominal charges may be debited to my account as per the prevalent policy of the company towards the physical delivery of various communication
The mobile number mentioned here belongs to Name of relative _______________________________________________
Self Spouse Dependent parent Dependent children PAN of relative Client Signature
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The email ID mentioned here belongsto Name of relative _____________________________________________________
Self Spouse Dependent parent Dependent children PAN of relative
DECLARATION
I / We hereby declare that the details furnished above are true & correct to the best of my knowledge and undertake to inform you of any changes 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 accounts maintained at Kotak Securities under intimation to me.
1st Holder 2nd Holder 3rd Holder
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ACKNOWLEDGEMENT
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Kotak Securities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express
Highway, Gen A. K. Vaidya Marg, Malad (E), Mumbai - 400097.
IMPORTANT POINTS :
1. Self attested copy of PAN card and all other documents are mandatory all clients and persons authorized to deal in securities onbehalf of for company / firm / others.
2. Copies of all documents submitted by the client should be verified with original by Kotak Securities employee / Registered Authorised Person. In case the original of
any document is not produced for verification, then the copies should be properly attested by entities authorized for attesting the documents, as per the below
mentioned list. List of people authorized to attest the documents: Notary Public, Gazetted Officer, Manager of a Scheduled Commercial / Co-operative Bank or
Multinational Foreign Banks (Name, Designation & Seal should be affixed on the copy). In case of NRIs, authorized officials of overseas branches of Scheduled
Commercial Banks registered in India, Notary Public, Court Magistrate, Judge, Indian Embassy /Consulate General in the country where the client resides are
permitted to attest the documents.
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 & permanent address are different, then proofs for both have to be submitted.
6. Sole proprietor must make the application in his individual name & capacity.
7. For non-residents and foreign nationals, (allowed to trade subject to RBI and FEMA guidelines), copy of passport / PIOCard / OCI Card and over seas address proof
Is mandatory.
8. In case you submit deemed Officially Valid Document (OVD) for proof of address as your Officially Valid Document (OVD) does not contain updated address then
you are required to submit OVD or their equivalent E-document within a period of three months, failing which we may suspend your account.
General Instructions:
A) Fields marked with ‘*’ are mandatory fields.
B) Tick ‘√ ’ wherever applicable.
C) Please fill the form in English and in BLOCK letters.
D) Please fill the date in [Link] format.
E) For particular section update tick ( √ ) in the box section number and strike off the sections not required to be updated.
F) Please read section wise detailed guideliness/ instruction at the end.
G) KYC number of applicant is mandatory for update application.
H) The ‘OTP based E-KYC’ check box is to be checked for accounts opened using OTP based E-KYC in non-face to face mode.
7. Regulated Entity (RE) shall redact (first 8 digits) of the Aadhaar number from Aadhaar related data and documents such as proof of possession of Aadhaar, while
uploading on CKYCR.
8. “Equivalent e-document” means an electronic equivalent of a document, issued by the issuing authority of such document with its valid digital signature including
documents issued to the digital locker account of the client as per rule 9 of the Information Technology (Preservation and retention of Information by Intermediaries
Providing Digital Locker Facilities) Rules, 2016.
9. ‘Digital KYC process’ has to be carried out as stipulated in the PML Rules, 2005.
1st Holder - Section I (All fields are mandatory) (Please fill in BLOCK LETTERS)
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It is mandatory to supply a TIN or functional equivalent (in case TIN not available )if the country in which you are tax resident issues such identifiers. If no TIN /functional equivalent is yet available or
has not yet been issued, please provide an explanation below.
2nd Holder - Section I (All fields are mandatory) (Please fill in BLOCK LETTERS)
Details of Account Holder
1 Trading code: Client ID (To be provided only if demat account is with KSL):
Country of Tax residency Tax identification no Tax identification document (TIN or functional equivalent)
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It is mandatory to supply a TIN or functional equivalent (in case TIN not available )if the country in which you are tax resident issues such identifiers. If no TIN /functional equivalent is yet available or
has not yet been issued, please provide an explanation below.
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Kotak Securities Ltd. Kotak Infinity, 8th floor, Building No 21, Infinity Park, Off Western Express
Highway, Gen A. K. Vaidya Marg, Malad (E), Mumbai - 400097.
3rd Holder - Section I (All fields are mandatory) (Please fill in BLOCK LETTERS)
4 Address Type (Tick whichever applicable) (a) Residential (b) Business (c) Registered Office
(d) Residential/ Business (e) Unspecified
5 Do you satisfy any of the criteria mentioned below? Yes No
a. Citizen of any country other than India (dual / multiple) [including Green card]
b. Country of birth is any country other than India
c. Tax resident of ANY country / 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 Section II of the form, else go to declaration & acknowledgment
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It is mandatory to supply a TIN or functional equivalent (in case TIN not available )if the country in which you are tax resident issues such identifiers. If no TIN /functional equivalent is yet available or
has not yet been issued, please provide an explanation below.
Declaration & Acknowledgment
I/We being the beneficial owner of the account opened / to be opened with Kotak Securities Limited(KSL) and the income credited therein, declare that the above
information and information in the submitted documents to be true, correct and updated, and the submitted documents are genuine and duly executed. I/We acknowledge
that towards compliance with tax information sharing laws, such as FATCA/CRS, the KSL may be required to seek additional personal, tax and beneficial owner information
and certain certifications and documentation from the account holder. Such information may be sought either at the time of account opening or any time subsequently. In
certain circumstances (including if the KSL does not receive a valid self- certification from me) KSL may be obliged to share information on my account with relevant tax
authorities. Should there be any change in any information provided by me I/We ensure that I/We will advise KSL promptly, i.e., within 30 days. Towards compliance with
such laws, the KSL may also be required to provide information to any institutions such as withholding agents for the purpose of ensuring appropriate withholding from the
account or any proceeds in relation thereto. As may be required by domestic or overseas regulators/ tax authorities, the KSL may also be constrained to withhold and pay
out any sums from my account or close or suspend my account(s). I/We further agree that the information provided above will be updated in all my trading/demat accounts,
if any at PAN level.I/We also understand that the account will be reported if any one of the aforesaid FATCA / CRS criteria for any of the account holders i.e. primary or joint (in
case of demat account) are met.
Client Signature (1st Holder) Client Signature (2nd Holder) Client Signature (3rd Holder)
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1 1 1