Customer Portal

FATCA / CRS - Declaration Form

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FATCA

PASSPORT

FATCA & PASSPORT

Customer ID

Account Number

Country Code*

Mobile Number*

Type the captcha shown

For any grievances please send mail to : nricell@ktkbank.com

Primary Applicant

Name *

Address *

PAN Number *

Nationality *

Country of Birth *

City of Birth *

Passport Number *

Passport Issued Country *

Passport Issued Place *

Passport Issue Date *

Passport Expiry Date *

Date of Birth *

File Number *

Upload PDF file(s) only*

#	File Name	Size	Status	Actions

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

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

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

#	Country	TIN Type	Tax Identification Number	Actions
1

Customer Declaration

I understand that the Bank is relying on this information for the purpose of determining the status of the applicant named above in compliance with FATCA. The Bank is not able to offer any tax advice on FATCA or its impact on the applicant. I shall seek advice from professional tax advisor for any tax questions.
I undertake to advice the bank promptly of any change in circumstances which causes the information contained herein to become incorrect and to provide bank with a suitably updated declaration within 30 days of such change in circumstances.
I agree that as may be required by domestic regulators/tax authorities the Bank 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 taxpayer identification number of the applicant.

I do hereby solemly declare that the information provided above is upto date and correct. I hereby submit the photocopy of the valid passport attested by the Indian Embassy or Consultate General in the country where the non-resident customer resided or Notary public abroad.

Date

Place