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GEIMS (KYC) APPLICATION

IDENTITY DETAILS

Gender

Male

Female

Marital Status

Single

Married

Specify the proof of Identity submitted

ADDRESS DETAILS

Residence Address

Contact Details

Specify the proof of address submitted for residence address

Permanent Address
Is same as Residence Address?

BANK DETAILS

Upload Photo & Signature

Applicant Photo

Photo should be below 100kb

Applicant Signature

Signature should be below 30kb

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 of misleading of misrepresenting, I am aware that I may be held liable for it.

GEIMS (KYC) APPLICATION

GEIMS (KYC) APPLICATION

IDENTITY DETAILS

ADDRESS DETAILS

Residence Address

Contact Details

Permanent Address Is same as Residence Address?

BANK DETAILS

Upload Photo & Signature

DECLARATION

Permanent Address
Is same as Residence Address?