Customer Information Form
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1
2For Office Use Only
CUSTOMER ACKNOWLEDGMENT
(Customer Information - Non Individual Form)
Please staple
Please quote this reference no.
the relevant
for any future communication
Instructions
documents
1. Please fill the form in BLOCK LETTERS and in BLACK INK only
Date:
in this box
2. All fields marked * are mandatory
D
D M M Y
Y
Y
Y
3. This is a MACHINE READABLE form and will pass through a SCANNER
Branch official :
4. Account facility shall be at sole descretion of Deutsche Bank AG, India
CUSTOMER INFORMATION FORM
For Non-Individual Entities
(To be filled by applicant only)
Date:
Customer ID No.
Branch
For Bank use Only
D
D M M Y
Y
Y
Y
*Entity Details
Name
Constitution
Sole Proprietorship
Partnership Firm
Public/ Private Limited Company
Trusts
Clubs
Society
Associations
Others
Nature of
Manufacturer
Trader/ Stockist
Service Provider
Consultant/ Professional
Exporter/ Importer
Retailer
Business
Others
Date of Incorporation
No. of years in Business
D
D M M Y
Y
Y
Y
Nature of Industry to which the Business belongs
A
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T
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n r
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R (
. s
L
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) s
PAN/ GIR No.
Form 60/61 attached
IT Circle/ Ward/ District No.
Contact Details
*Mailing Address
Address Line - 1
Address Line - 2
City
PIN Code
S
a t
e t
C
o
u
t n
y r
Landline No.
Mobile No.
STD Code
E-mail
Registered Address
(Only if it is different from the mailing address)
Address Line - 1
Address Line - 2
City
PIN Code
S
a t
e t
C
o
u
t n
y r
Landline No.
STD Code
*Details of Partners/ Directors/ Trustees/ Management Committee/ Karta
(valid proofs mandatory to verify identification and addressess of the following persons)
N
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D
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A
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C
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N
. o
Telephone
Cellular
Contact Person
N
a
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(
) 1
D
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n
M
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N
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(
) 2
D
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NOTE: THIS FACILITY/ SERVICE IS NOT AVAILABLE FOR RESIDENTS OF CERTAIN COUNTRIES.
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