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HDFC-Beneficial Owner Declaration

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Yatin Wahi
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368 views

HDFC-Beneficial Owner Declaration

Uploaded by

Yatin Wahi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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BENEFICIAL OWNER DECLARATION FOR EXISTING CUSTOMERS

FOR Company/Partnership/LLP/AOP/BOI/Trust/Societies
(To be obtained on the Letterhead)

Name of Entity- AAV MINERAL & CHEMICALS IND. PVT. LTD. Customer ID- 32700533

Whether Company is listed OR subsidiary of listed company*  No Yes

If yes, Name of Stock Exchange: BSE NSE Others ___________________________


(In case of listed Companies, no further details of beneficial owners given in Section A or B to be obtained. Please
sign the declaration at the end.)

A. Details of Non Individual Entity Holding more than prescribed threshold limit in above captioned entity
I/We the undersigned hereby declare the below details of beneficial owners holding **Controlling ownership in the
captioned Company/LLP/Firm/AoP/BoI above the prescribed threshold limit
Sr. Name of Company Date of Country of CIN/Regn. Address % of
No. Incorporation Incorporation No. Ownership/
Capital/
Profits
U74999DL
1 01/09/1997 INDIA 1997PTC0
89359

B. Details of Natural Person having Controlling Ownership or Senior Managing Official


We declare that no individual person holds directly **Controlling ownership in the captioned Company/Firm/
LLP/AoP/BoI/Trust above the prescribed threshold limit. Below are the details of Natural Person who holds the
position of Senior Managing Official- Designation: _____________________
If there is/are non-individual Beneficial owner(s) holding Controlling** ownership as declared in SectionA. The
following individual person(s), directly or indirectly holds **Controlling ownership in the above captioned
Company/Firm/LLP/AoP/BoI/Trust.
(*if you have ticked any of the above, please complete the Table below before signing the decleration)
1 Name of the controlling person (mandatory) 1) 2)
Customer ID (if available)
Pub/Pvt. Co. LLP Partnership Trust Association

2 Entity type (mandatory) Society Club HUF Bank Insurance SHG

Foreign Bodies NGO Mutual Fund Government


3 Controlling person type code (mandatory)
4 Date of Birth (mandatory)
5 Percentage of ownership/capital/profits
(mandatory)
6 Place/City of Birth (mandatory
7 Country of Birth (mandatory)
8 Gender (mandatory) Male Female Male Female
Third Gender Third Gender
1
9 Marital Status (mandatory) Married Unmarried Married Unmarried
Others Others
10 Father’s Name (mandatory)
11 Nationality (Please specify country) (mandatory)
12 Country of tax residence* (Mention only if it is
other than India)
13 Tax identification number (or functional
equivalent of country other than India) %
14 Tax identification number type (for country other
than India)
15 Address (mandatory)
Address – City (mandatory)
Address – State (mandatory)
Address – Country (mandatory)
Address – Pin Code (mandatory)
Residential / Business Residential / Business
16 Address Type for above (mandatory) Residential Business Residential Business
Registered Office Registered Office
17 Mobile Number (mandatory)
S - Service Provider S - Service Provider
18 Occupation Type (mandatory) O - Others B - Business O - Others B - Business
X - Not Categorized X - Not Categorized
Passport No. Passport No.
Voter ID No. Voter ID No.
Driving License No. Driving License No.
Proof of Identity (mandatory) Aadhaar No. Aadhaar No.
19 NREGA Job Card No. NREGA Job Card No.
(Tick Relevant and mention the details) Letter from National Letter from National
Population Register Population Register
Any other Government Any other Government
Issued Doc____________ Issued Doc____________
Mention ID no_________ Mention ID no_________
Expiry Date / / Expiry Date / /
Passport No. Passport No.
Voter ID No. Voter ID No.
Driving License No. Driving License No.
20 Proof of Address (mandatory) Aadhaar No. Aadhaar No.
(attached self-attested proof) (any one) NREGA Job Card No. NREGA Job Card No.
(Please select any one Address proof) Letter from National Letter from National
Population Register Population Register
Any other Government Any other Government
Issued Doc____________ Issued Doc____________
Mention ID no_________ Mention ID no_________
Expiry Date / / Expiry Date / /

21 Recent Photograph
Name of Director/Partner/Member/Trustee

____________________________________________________
(Signature & Seal of any of the Director/Partner/Member/Trustee

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