भारतीयअक्षयऊर्जाविकाससंस्थासीमित
INDIAN RENEWABLE ENERGY DEVELOPMENT AGENCY LTD
ISO 9001:2015, 27001:2013 CertifiedA Miniratna Category –I PSU
KNOW YOUR CUSTOMER (KYC)
FORM NO. KYC-A

KYC-A/Individuals21.02.2017

Profileof theCustomer:

(Recentphotographs)

KYC-A/Individuals21.02.2017

1. Legal name andanyothernames used
DateofBirth
Gender
TelephoneNo.
Mobile No.
Email
IncomeTaxID(PAN)
BankAccountNos.
2. DIN (issued byMCA)details,whereverapplicable
3.Mailingcurrentaddress(withfax,telephonenos.Pin Code) / Address:
State :
Pin Code: Phone No :Fax : Mobile:Email:
4. PermanentAddress(withtelephone nos.& Pin code) / Address:
State :
Pin Code: Phone No :

KYC-A/Individuals21.02.2017

5.Certifiedcopiesofthefollowing:

5.1Documentsinsupportofidentityproof(self-attested)copies/Verificationoforiginalsbyconcerned IREDA officer.

Nameof thedocument
a) For residentIndian nationals
(i)PANCard-mandatory
(ii)Anyoneofthefollowing:
a)Passport
b)Voter’sIdentityCard
c)DrivingLicense
d)UID/AdhaarCard
b) For foreignnationals/NRIs etc
(i)Passport–mandatory
(ii)DrivingLicense / Anyother document

5.2Documentsinsupportofproofofaddress(selfattested)/verificationoforiginals byconcernedIREDA’sOfficer) :

Nameof thedocument
(i)Passport
(ii)Voter’s Card
(iii)DrivingLicense(FrontBackcopy)
(iv)UID/AdhaarCard
(v)Letterissued by UIDofIndia containingdetailsofName,AddressandAdhaarNo. (E-Adhaar)
6.Detailsof MainBusiness/Otheractivities*
7. SourcesofFunds *
8.Networth*
9.Borrowingsfrom Banks/FIs*

*ForPromoterDirectors/Guarantors

KYC-A/Individuals21.02.2017

10. Declaration

a)Have you defaulted in payment of IREDA dues? / Yes/No
b)Are you classified as willful defaulter as defined by RBI, by any bank/FI? / Yes/No
c)Have you availed OTS from IREDA? / Yes/No
d)Were you convicted by court for criminal/economic offences under normal securities laws? / Yes/No

SignatureofDirector/Promoter/Guarantor

KYC-A/Individuals21.02.2017