Addendum to Individual Account opening form 7 December 2015
Annexure to Account opening Form for Individuals containing information for
reporting requirement under Section 285BA of the Income-tax Act, 1961 and KYC.
Background:
1. India has joined the Multilateral Competent Authority Agreement (MCAA) on Automatic Exchange of
Financial Account Information (AEOI) on June 3, 2015 and has agreed to certain global standards on
automatic exchange of information, known as Common Reporting Standards (CRS). Further, the Government
of India (GoI) signed an Inter-Governmental Agreement (IGA) with United States of America (USA) on July
9, 2015 to improve international tax compliance and to implement Foreign Account Tax Compliance Act
(FATCA) in India.
2. To implement the CRS on AEOI and also the IGA with USA, the GoI has made necessary amendments in
Section 285BA of the Income-tax Act, 1961 and notified Rules 114F to 114H in the Income-tax Rules, 1962
vide amendment dated August 7, 2015 . These Rules are available on: http://www.incometaxindia.gov.in.
3. SEBI has issued a circular dated August 26, 2015 advising all registered intermediaries to implement FATCA
and CRS as per above mentioned Rules.
We do understand that the information mentioned above is technical in nature and hence we advise you to
consult your financial or tax advisor for more details.
Applicant’s Name :
Client Id / Form No : Father's name :
PAN : Place of Birth(City) : Country of Birth :
Gender : M – Male
Nationality : Indian
F – Female
Other (Please specify the name of country) :
O – Others
Occupation Type: Service Business Others Not Categorized
Address Type : Residential Or Business Residential Business
Registered Office Unspecified
City/ Town : State :
Country : Postal Code:
1. Declaration of Tax Residency / Citizenship Country of tax residence India - Yes / No.
2. Tax resident of Multiple Countries – Yes / No
If tax resident of multiple countries, kindly provide information of tax residence of all countries.
If Point 1 is Yes and Point 2 is No, no further information required to be provided.
If Point 1 is No OR if both Point 1 and 2 are Yes, then the following should be provided alongwith with
documentary evidence:
Country/countries of Tax TIN / Documents provided Date upto which the
tax residency Identification functional (copy of certificate of documentary evidence
Number (TIN)/ equivalent tax residence or copy is valid
functional Issuing of TIN or others)
equivalent Country
number
Signature of the Applicant
Addendum to Individual Account opening form
7 December 2015
Remarks if any :
Declaration and Undertakings
The Customer/account holder certifies that:
a. The information provided in the Form is in accordance with Section 285BA of the Income Tax Act, 1961 read
with Rules 114F to 114H of the Income-tax Rules, 1962.
b. the information provided by me/us in the Form, its supporting Annexures as well as in the documentary
evidence provided by me/us are, to the best of our knowledge and belief, true, correct and complete and that
I/we have not withheld any material information that may affect the assessment/categorization of the account
as a Reportable account or otherwise.
c. I/We permit/authorise the Company to collect, store, communicate and process information relating to the
Account and all transactions therein, by the Company and any of its affiliates wherever situated including
sharing, transfer and disclosure between them and to the authorities in and/or outside India of any confidential
information for compliance with any law or regulation whether domestic or foreign.
d. I / We undertake the responsibility to declare and disclose within 30 days from the date of change, any
changes that may take place in the information provided in the Form, its supporting Annexures as well as in
the documentary evidence provided by us or if any certification becomes incorrect and to provide fresh self
certification alongwith documentary evidence.
e. I / We also agree that our failure to disclose any material fact known to us, now or in future, may invalidate
our application and the Company would be within its right to put restrictions in the operations of my/our
account or close it or report to any regulator and/or any authority designated by the Government of India
(GOI) /Reserve Bank of India for the purpose or take any other action as may be deemed appropriate by the
Company if the deficiency is not remedied by us within the stipulated period.
f. I / We hereby accept and acknowledge that the Company shall have the right and authority to carry out
investigations from the information available in public domain for confirming the information provided by me
/ us to the Company.
g. It shall be my responsibility / our responsibilities to educate myself / ourselves and to comply at all times with
all relevant laws relating to reporting under Section 285BA of the Act read with the Rules thereunder.
h. I/We also agree to furnish such information and/or documents as the Company may require from time to time
on account of any change in law either in India or abroad in the subject matter herein.
i. I/We shall indemnify the Company for any loss that may arise to the Company on account of providing
incorrect or incomplete information.
Date : ___________________________
Place:___________________________
Signature of the Applicant
