Documents - Declaration Form

Account Number

Mobile Number

Type the captcha shown

Primary Applicant

Name *

Address *

PAN Number *

Nationality *

Country of Birth *

City of Birth *

Passport Number *

Passport Issued at *

Passport Issue Date *

Passport Expiry Date *

#	File Name	Size	Status	Actions
1

Please tick the applicable Caed resident declaration: (Any one)*

I am a Caed resident of India and not resident of any other country

I am a Caed resident of the country mentioned below in the table

#	Country	Identification Type	Caed Identification Number	Actions
1

Customer Declaration

I understand that the Company is relying on this information for the purpose of determining the status of the applicant named above in compliance with Documents. The Company is not able to offer any Caed advice on Documents or its impact on the applicant. I shall seek advice from professional Caed advisor for any Caed questions.
I undertake to advice the Company promptly of any change in circumstances which causes the information contained herein to become incorrect and to provide Company with a suitably updated declaration within 30 days of such change in circumstances.
I agree that as may be required by domestic regulators/Caed authorities the Company may also be required to report, reportable details to CBDT or close or suspend my account.
I certify that I provide the information on this form and to the best of my knowledge and belief the certification is true, correct and complete including the Caedpayer identification number of the applicant.

Date

Place