KYC - UD - TPL Insurance

Know Your Customer (KYC) Form

Individual Customer Information

Identity Document Number*

Full Name (as per identify document)*

Father/Spouse Name (as per identity document)*

Mother Maiden Name

Policy/Proposal No.

Nationality*

Date of Birth*

Date of Issuance*

Date of Expiry*

Existing Residential Address (if different from CNIC)

Place of Birth*

Marital status*

Religion*

Phone Number*

Customer Email*

Sales Agent Email

Source of Income*

Salary

Business

Inheritance

Saving/Investments

Remittance

Others

Monthly Income*

Under Rs 100,000

Under Rs 500,000

Under Rs 1,000,000

Over Rs 1,000,000

KYC Questions

Are you a resident/national of any country other than Pakistan?*

Yes

Do you have any business relationship or transactions in from offshore Tax Haven countries?*

Yes

Has any Financial Institution ever refused to open your account?*

Yes

Do you hold a high profile position i.e. Sports or Media Personality?*

Yes

Are you a domestic or foreign “Politically Exposed Person” (PEP)?*

Yes

Are you a family member or close associate of a domestic or foreign “Politically Exposed Person” (PEP)?*

Yes

Documents to be Attached

CNIC Front side*

CNIC Back side*

Business Visiting CardProof of Income*

Import documents (if the vehicle is imported)

I/We hereby acknowledge that the information provided on this form is correct to the best of my/our knowledge and I/We shall immediately update TPL Insurance Limited if there is any change in the information provided I/We authorize that TPL Insurance Limited may verify any or all information provided in/with this KYC Form.

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KYC – UD

Know Your Customer (KYC) Form

Individual Customer Information

KYC Questions

Documents to be Attached

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