Addendum to Entity Account opening form

07 December 2015
Annexure to Account opening Form for Non-Individuals containing information for reporting
requirement under Section 285BA of the Income-tax Act, 1961 and KYC.
Background:

1. India has joined the Multilateral Competent Authority Agreement (MCAA) on Automatic Exchange of Financial
Account Information (AEOI) on June 3, 2015 and has agreed to certain global standards on automatic exchange of
information, known as Common Reporting Standards (CRS). Further, the Government of India (GoI) signed an Inter-
Governmental Agreement (IGA) with United States of America (USA) on July 9, 2015 to improve international tax
compliance and to implement Foreign Account Tax Compliance Act (FATCA) in India.

2. To implement the CRS on AEOI and also the IGA with USA, the GoI has made necessary amendments in Section
285BA of the Income-tax Act, 1961 and notified Rules 114F to 114H in the Income-tax Rules, 1962 vide amendment
dated August 7, 2015 . These Rules are available on: http://www.incometaxindia.gov.in

3. SEBI has issued a circular dated August 26, 2015 advising all registered intermediaries to implement FATCA and CRS
as per above mentioned Rules.

We do understand that the information mentioned above is technical in nature and hence we advise you to consult your
financial or tax advisor for more details.

Entity Constitution Type : (Please tick one of the following) :

Sole Proprietorship Partnership Firm HUF Private Limited Company
Public Limited
Society AOP/BOI Trust
Company
Limited Liability Artificial Juridical
Liquidator Not Categorised.
Partnership Person
Others
Name of the Entity :

Permanent Account Number (PAN):

Client Id: Place of incorporation:

Country of Incorporation : India

Other ( Please specify the name of the country) -----------------------
Address Type : Residential Or Business Residential Business
Registered Office Unspecified
City/ Town : State :
Country : Postal Code:
Nature of Business (kindly fill details as per Annexure 5) :

Identification Type (tick as applicable)

Company identification Number Trust registration Number

TIN/Tax deduction Account Number (TAN) Global Entity Identification Number (EIN)
US GIIN Other
 Addendum to Entity Account opening form
07 December 2015

Identification Number :

Identification issuing Country:

Declaration of Tax Residency

Please indicate the Entity’s place of tax residence (if resident in more than one country please detail all
countries and associated tax identification number (TIN) and TIN issuing country).

Country/cou Tax Identification TIN/ functional Document Date upto which

ntries of tax number (TIN)/ Equivalent type attached the documentary
residency Functional Issuing Country (tax residence evidence is valid
Equivalent number certificate or
TIN card or
others)

(Documentary evidence to be provided for foreign country of tax residence and TIN)

If tax resident of Country outside India, kindly provide confirmation as under:

(1) If US tax resident, kindly confirm whether the Entity is a US Specified Person. – Yes / No
If No, Kindly indicate exclusion number from Annexure 1

(2) If tax resident of country other than USA, kindly tick if any of the following is applicable:

(i) orporation, the stock of which is regularly traded on one or more established securities markets;

(ii)

(iii)

(iv)

(v) or

(vi)
 Addendum to Entity Account opening form
07 December 2015

Entity Classification
A. Financial Institution
1. Reporting Financial Institution – Yes/ No
If Yes, please tick atleast one of the below categories, and provide your FATCA Global Intermediary Identification
Number (GIIN):

Depository Institution stitution

Investment Entity mpany

GIIN__________________________________________________________

2. Non–reporting financial institution - Yes/ No

If Yes, please provide category from Annexure 2:------------

3. Sponsored Investment Entity and has not yet obtained a GIIN but is sponsored by another entity that has
registered as a Sponsoring Entity. Please provide the Sponsoring Entity’s name and GIIN.
Sponsoring Entity’s Name: ________________________
Sponsoring Entity’s GIIN: ________________________

4. Trustee Documented Trust and has not yet obtained a GIIN. Please provide the Trustee’s name and the GIIN
Name of the Trustee of the Trust: ______________________________
GIIN of the Trustee: _________________________
5. Owner documented Financial Institution - Yes/ No. If Yes, each controlling person should fill details as per
Annexure A

6. Non-Participating Foreign Financial Institution - Yes/ No

B. Non -Financial Entity (NFE):

1. Active NFE – Yes/ No
If Yes, provide category from Annexure 3
If category is Sl No 2, please provide the following details, as applicable:
(a) If listed company, provide name of the Stock Exchange on which listed------------
(b) If related entity of listed company, please provide
(i) Name of the company

(ii) Stock Exchange on which listed

2. Passive NFE – Yes/ No.

If Yes, provide category from Annexure 4
Each Controlling Person of the Passive NFE should fill Controlling Persons from Annexure A.

3. Direct reporting NFE - Yes/ No

If Yes, provide the GIIN ____________________

 Addendum to Entity Account opening form
07 December 2015
Declaration and Undertakings
The Customer/account holder certifies that:

a) the information provided in the Form is in accordance with Section 285BA of the Income- tax Act, 1961 read with
Rules 114F to 114H of the Income tax Rules, 1962.

b) the information provided by me/us in the Form, its supporting Annexures as well as in the documentary evidence
provided by me/us are, to the best of our knowledge and belief, true, correct and complete and that I/we have not
withheld any material information that may affect the assessment/categorization of the account as a Reportable
account or otherwise.

c) I/We permit/authorise the Company to collect, store, communicate and process information relating to the Account
and all transactions therein, by the Company and any of its affiliates wherever situated including sharing, transfer and
disclosure between them and to the authorities in and/or outside India of any confidential information for compliance
with any law or regulation whether domestic or foreign.

d) I / We undertake the responsibility to declare and disclose within 30 days from the date of change, any changes that
may take place in the information provided in the Form, its supporting Annexures as well as in the documentary
evidence provided by us or if any certification becomes incorrect and to provide fresh self-certification along with
documentary evidence.

e) I / We also agree that our failure to disclose any material fact known to us, now or in future, may invalidate our
application and the company would be within its right to put restrictions in the operations of my/our account or close
it or report to any regulator and/or any authority designated by the Government of India (GOI) /Reserve Bank of India
for the purpose or take any other action as may be deemed appropriate by the company if the deficiency is not
remedied by us within the stipulated period.

f) I / We hereby accept and acknowledge that the company shall have the right and authority to carry out investigations
from the information available in public domain for confirming the information provided by me / us to the company.

g) It shall be my responsibility / our responsibilities to educate myself / ourselves and to comply at all times with all
relevant laws relating to reporting under Section 285BA of the Act read with the Rules thereunder.

h) I/We also agree to furnish such information and/or documents as the company may require from time to time on
account of any change in law either in India or abroad in the subject matter herein.

i) I/We shall indemnify the company for any loss that may arise to the company on account of providing incorrect or
incomplete information.

j) I / We certify that I/we have the capacity to sign for the entity as per CBDT rules/SEBI guidelines.

Authorised Signatures

Name: ______________________

Position/Title: _____________________

Date: (DD/MM/YYYY) ________________

Stamp & Signature of the Applicant

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07 December 2015

Annexure A – Controlling Person Self certification

Controlling Person Type:

Legal Persons

Legal
Arrangement Trust:

Others:
beneficiary equivalent
Unknown

Name of Controlling Person :

Father's name :
PAN : Aadhar Number :
Identification
Type (tick and
Driving License
provide as
Not categorised
proof of
identity):

Identification
Number
(mentioned in
the
Identification
Document):
Occupation Service Business Others Not Categorised
Type
Gender : M – Male F – Female O - Others Status : Resident Individual
Non Resident Individual
Foreign National
Nationality : Indian
Other (Please specify the name of country) :
Date of Birth : Place of Birth(City) :
Country of Residence as per tax laws:
Country of Birth :

Phone No(s) : Mobile No(s) :

Email Id(s) :
Other Contact Number :
 Addendum to Entity Account opening form
07 December 2015
Address Type : Residential Or Business Residential Business
Registered Office Unspecified
Complete Address :

City/ Town : State :

Country : Postal Code:

Declaration of Tax Residency

Please indicate the Country of tax residence (if resident in more than one country please detail
all countries and associated tax identification number and TIN issuing country).

Country/countr Tax Identification TIN / Documentary Date upto

ies of tax number (TIN)/ Functional Evidence which the
residency functional Equivalent enclosed for documentary
equivalent number Issuing country of tax evidence is
Country residence or valid
TIN or others

Declaration and Undertakings

I / We certify that:
a) the information provided in the Form is in accordance with Section 285BA of the Income Tax Act, 1961
read with Rules 114F to 114H of the Income-tax Rules, 1962.
b) the information provided by me/us in the Form, its supporting Annexures as well as in the documentary
evidence provided by me/us are, to the best of our knowledge and belief, true, correct and complete and that
I/we have not withheld any material information that may affect the assessment/categorization of the
account as a Reportable account or otherwise.
c) I/We permit/authorise the Company to collect, store, communicate and process information relating to the
Account and all transactions therein, by the Company and any of its affiliates wherever situated including
 Addendum to Entity Account opening form
07 December 2015
sharing, transfer and disclosure between them and to the authorities in and/or outside India of any
confidential information for compliance with any law or regulation whether domestic or foreign.
d) I / We undertake the responsibility to declare and disclose within 30 days from the date of change, any
changes that may take place in the information provided in the Form, its supporting Annexures as well as in
the documentary evidence provided by us or if any certification becomes incorrect and to provide fresh self-
certification alongwith documentary evidence.
e) I / We also agree that our failure to disclose any material fact known to us, now or in future, may invalidate
our application and the Company would be within its right to put restrictions in the operations of my/our
account or close it or report to any regulator and/or any authority designated by the Government of India
(GOI) /Reserve Bank of India for the purpose or take any other action as may be deemed appropriate by the
Company if the deficiency is not remedied by us within the stipulated period.
f) I / We hereby accept and acknowledge that the Company shall have the right and authority to carry out
investigations from the information available in public domain for confirming the information provided by
me / us to the Company.
g) It shall be my / our responsibilities to educate myself /ourselves and to comply at all times with all relevant
laws relating to reporting under Section 285BA of the Act read with the Rules thereunder.
h) I/We also agree to furnish such information and/or documents as the Company may require from time to
time on account of any change in law either in India or abroad in the subject matter herein.
i) I/We shall indemnify the Company for any loss that may arise to the Bank on account of providing incorrect
or incomplete information.

Authorised Signatures

Name: ______________________

Position/Title: _____________________

Date: (DD/MM/YYYY) ________________

Stamp & Signature of the Applicant

Instructions:
1. All the information mentioned above have to be mandatorily provided.

Annexure A should be filled separately by each Controlling Person for all Accounts

Information on the terms used in the Annexure to the Account opening form:

Terms in the Annexure:

 Reporting financial institution means a custodial institution, a depository institution, an investment
entity, or a specified insurance company which is registered with US IRS and obtained a Global
Intermediary Identification Number (GIIN).
 “custodial institution” means any entity that holds, as a substantial portion of its business, financial
assets for the account of others
 “depository institution” means any entity that accepts deposits in the ordinary course of a banking or
similar business;
 “investment entity” means any entity,-
 Addendum to Entity Account opening form
07 December 2015
(A) that primarily conducts as a business one or more of the following activities or operations for or on
behalf of a customer, namely:-
(i) trading in money market instruments (cheques, bills, certificates of deposit, derivatives, etc.); foreign
exchange; exchange, interest rate and index instruments; transferable securities; or commodity futures
trading; or
(ii) individual and collective portfolio management; or
(iii) otherwise investing, administering, or managing financial assets or money on behalf of other
persons; or
(B) the gross income of which is primarily attributable to investing, reinvesting, or trading in financial
assets, if the entity is managed by another entity that is a financial institution.
 “specified insurance company” means any entity that is an insurance company (or the holding company
of an insurance company) that issues, or is obligated to make payments with respect to, a Cash Value
Insurance Contract or an Annuity Contract;
 Owner Documented Financial institution: It is an Financial Institution which does not report to the US
IRS. Owner documented FI are generally small investment entities.
 Direct Reporting Non-financial Entity – It is a Passive NFE but will not share the details of the
controlling persons with the financial institution it maintains accounts with but will report directly to US
IRS and so its GIIN should be taken
 Controlling persons means natural persons who exercise control over an entity who includes a beneficial
owner as defined in Explanation to sub-rule (3) of rule 9 Prevention of Money-laundering (Maintenance
of Records) Rules, 2005. In determining the beneficial owner the procedure specified in the
RBI/SEBI/IRDA circulars shall be applied. In the case of Trust, the controlling persons mean the settlor,
the trustees, the protector, the beneficiaries or class of beneficiaries and any other natural person
exercising ultimate effective control over the trust, and in the case of a legal arrangement other than a
trust, the said expression means the person in equivalent position.

Annexure 1: Exclusions from being treated as Specified US Persons

Sr. Type of entity

No.
1 a corporation the stock of which is regularly traded on one or more established securities
markets;
2 a member of the same expanded affiliated group of the listed company,
3 the United States or any wholly owned agency or instrumentality thereof
4 US State or Territory, any political subdivision, or any wholly owned agency or
instrumentality
5 501(a) Entity or 7701(a)(37) individual retirement plan
6 bank as defined in section 581 of the U.S. Internal Revenue Code;
7 real estate investment trust as defined in section 856 of the U.S. Internal Revenue Code
8 regulated investment company or entity under the Investment Company Act of 1940
9 any common trust fund as defined in section 584(a) of the U.S. Internal Revenue Code;
10 any tax exempt trust
11 a registered dealer in securities, commodities, or derivative financial instruments
12 a broker as defined in section 6045(c) of the U.S. Internal Revenue Code;
13 any tax-exempt trust under a plan that is described in section 403(b) or section 457(g)
 Addendum to Entity Account opening form
07 December 2015

Annexure 2:“Non-reporting financial institution”

Sl Category
No
1 a Governmental entity, International Organisation or Central Bank, other than wih
respect to a payment that is derived from an obligation held in connection with a
commercial financial activity of a type engaged in by reporting financial institution
2 Treaty Qualified Retirement Fund; a Broad Participation Retirement Fund; a Narrow
Participation Retirement Fund; or a Pension Fund of a Governmental entity, International
Organization or Central Bank;
3 a non-public fund of the armed forces, Employees’ State Insurance Fund, a gratuity fund
or a provident fund;
4 An Indian investment entity held only by (1) to (3) above
5 a qualified credit card issuer;
6 Specified Investment advisor or investment manager or executing broker
7 Specified exempt collective investment vehicle
8 a financial institution with a local client base
9 a local bank*
10 a financial institution with only low-value accounts
11 sponsored investment entity and controlled foreign corporation
12 Trustee documented trust
13 sponsored closely held investment vehicle, in case of any U.S. reportable account

*Regional Rural Banks constituted under the Regional Rural Bank Act 1976 (21 of 1976), Urban Cooperative Banks
constituted under respective State Cooperative Societies Acts or Multi State Cooperative Societies Act, State Cooperative
Banks or District Central Cooperative Banks constituted under respective State Cooperative Societies Act and Local Area
Banks licensed under the Banking Regulations Act, 1949 (10 of 1949) and regulated and registered as public limited
companies under the Companies Act, 1956 (1 of 1956) or Companies Act, 2013 (18 of 2013), that satisfy the requirement
under sub-clause (iv) shall be treated as local bank for the purpose of this clause.
Annexure 3: Active Non-Financial Entity (NFE)

Sr no. Category of Active NFFE

(i) Less than 50 per cent of the entity’s gross income for the preceding financial year is passive
income and less than 50 per cent of the assets held by the entity during the preceding financial
year are assets that produce or are held for the production of passive income; or

(ii) The stock of the entity is regularly traded on an established securities market

or

the non-financial entity is a related entity of an entity the stock of which is regularly traded on
an established securities market; or

Explanation.- For the purpose of this sub-clause, an established securities market means an
exchange that is officially recognised and supervised by a governmental authority in which the
securities market is located and that has a meaningful annual value of shares traded on the
 Addendum to Entity Account opening form
07 December 2015
exchange.

(iii) the entity is a Governmental Entity, an International Organization, a Central Bank , or an entity
wholly owned by one or more of the foregoing;

(iv) substantially all of the activities of the entity consist of holding (in whole or in part) the
outstanding stock of, or providing financing and services to, one or more subsidiaries that
engage in trades or businesses other than the business of a financial institution, except that an
entity does not qualify for this status if it functions (or holds itself out) as an investment fund,
such as a private equity fund, venture capital fund, leveraged buyout fund, or any investment
vehicle whose purpose is to acquire or fund companies and then hold interests in those
companies as capital assets for investment purposes;

(v) the entity is not yet operating a business and has no prior operating history, but is investing
capital into assets with the intent to operate a business other than that of a financial institution,
provided that the entity does not qualify for this exception after the date that is 24 months after
the date of the initial organization of the entity;

(vi) the entity was not a financial institution in the past five years, and is in the process of
liquidating its assets or is reorganizing with the intent to continue or recommence operations in
a business other than that of a financial Institution;

(vii) the entity primarily engages in financing and hedging transactions with, or for, related entities
that are not financial institutions, and does not provide financing or hedging services to any
entity that is not a related entity, provided that the group of any such related entities is
primarily engaged in a business other than that of a financial institution;

(viii) the entity meets all of the following requirements, namely:-

(a) It is established and operated in India exclusively for religious, charitable, scientific, artistic,
cultural, athletic, or educational purposes; or it is established and operated in India and it is a
professional organization, business league, chamber of commerce, labour organization,
agricultural or horticultural organization, civic league or an organization operated exclusively
for the promotion of social welfare;
(b) It is exempt from income-tax in India;
(c) It has no shareholders or members who have a proprietary or beneficial interest in its
income or assets;
(d) The applicable laws of the entity’s jurisdiction of residence or the entity’s formation
documents do not permit any income or assets of the entity to be distributed to, or applied
for the benefit of, a private person or non-charitable entity other than pursuant to the
conduct of the entity’s charitable activities, or as payment of reasonable compensation for
services rendered, or as payment representing the fair market value of property which the
entity has purchased; and
(e) The applicable laws of the entity’s jurisdiction of residence or the entity’s formation
documents require that, upon the entity’s liquidation or dissolution, all of its assets be
distributed to a Governmental Entity or other non-profit organization, or escheat to the
government of the entity’s jurisdiction of residence or any political subdivision thereof.
 Addendum to Entity Account opening form
07 December 2015

Explanation.- For the purpose of this sub-clause, the following shall be treated as fulfilling
the criteria provided in the said sub-clause, namely:-
(I) an Investor Protection Fund referred to in clause (23EA);
(II) a Credit Guarantee Fund Trust for Small Industries referred to in clause 23EB; and
(III) an Investor Protection Fund referred to in clause (23EC),
of section 10 of the Act

Annexure 4 - Passive Non-Financial Entity (NFE)

Sr no. Category of Passive NFFE

1 Any non-financial entity which is not an active non-financial entity
2 An investment entity described in sub-clause (B) of clause (c) of the Explanation to
clause (3)
3 A withholding foreign partnership or withholding foreign trust

Annexure 5: Business codes as per income-tax return form ITR 6

Sr. No. Sector Sub-sector Code

1 Manufacturing Industry Agro-based industries 0101
Automobile and Auto parts 0102
Cement 0103
Diamond cutting 0104
Drugs and Pharmaceuticals 0105
Electronics including Computer Hardware 0106
Engineering goods 0107
Fertilizers, Chemicals, Paints 0108
Flour & Rice Mills 0109
Food Processing units 0110
Marble & Granite 0111
Paper 0112
Petroleum and Petrochemicals 0113
Power and energy 0114
Printing & Publishing 0115
Rubber 0116
Steel 0117
Sugar 0118
Tea, Coffee 0119
Textiles, handloom, Power looms 0120
Tobacco 0121
Tyre 0122
Vanaspati & Edible Oils 0123
Others 0124
2 Trading Chain Stores 0201
Retailers 0202
Wholesalers 0203
Others 0204

3 Commission Agents General Commission Agents 0301

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07 December 2015
4 Builders Builders 0401
Estate Agents 0402
Property Developers 0403
Others 0404

5 Contractors Civil Contractors 0501

Excise Contractors 0502
Forest Contractors 0503
Mining Contractors 0504
Others 0505

6 Professionals Chartered Accountants, Companies Secretaries, etc 0601

Fashion designers 0602
Legal professionals 0603
Medical professionals 0604
Nursing Homes 0605
Specialty hospitals 0606
Others 0607

7 Service Sector Advertisement agencies 0701

Beauty Parlours 0702
Consultancy services 0703
Courier Agencies 0704
Computer training/educational and coaching institutes 0705
Forex Dealers 0706
Hospitality services 0707
Hotels 0708
I.T. enabled services, BPO service providers 0709
Security agencies 0710
Software development agencies 0711
Transporters 0712
Travel agents, tour operators 0713
Others 0714
8 Financial Service Sector Banking Companies 0801
Chit Funds 0802
Financial Institutions 0803
Financial service providers 0804
Leasing Companies 0805
Money Lenders 0806
Non-Banking Finance Companies 0807
Share Brokers, Sub-brokers, etc. 0808
Others 0809
9 Entertainment Industry Cable T.V. productions 0901
Film distribution 0902
Film laboratories 0903
Motion Picture Producers 0904
Television Channels 0905
Others 0906