Know your customer (KYC)
Individual customer
DateTime
Contact Information
Full Name (as per identify document)
*
Father/Spouse Name (as per identity document)
*
Mother Maiden Name
Policy/Proposal No.
Nationality
*
Date of Birth
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Identity Document Number
*
Date of Issuance
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date of Expiry
Life Time
Expiry Date
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Existing Residential Address (if different from CNIC)
Place of Birth
*
Marital status
*
Married
Single
Religion
*
Phone Number
*
Format: 0000-0000000.
Customer Email
*
Sales Agent Email
Source of income
*
Salary
Business
Inheritance
Saving/Investments
Remittance
Others
Please specify Source of income
*
Occupation
*
Please Select
Accountant
Actor
Analyst
Architect
Artist
Banker
Chef
Dentist
Designer
Director
Doctor
Economist
Engineer
Firefighter
Flight Attendant
IT Professional
Journalist
Judge
Lawyer
Manager
Military Personnel
Pharmacist
Physician
Pilot
Police Officer
Real Estate Agent
Salesperson
Social Worker
Teacher
Other
Please specify your Occupation
*
Residential Status (Kindly provide FATCA/ CRS Declaration, whichever is applicable)
*
Resident
Non-Resident
Monthly income
*
Under Rs. 100,000
Under Rs. 500,000
Under Rs. 1,000,000
Over Rs. 1,000,000
KYC Questions
1) Are you a resident/ national of any country other than Pakistan?
*
YES
NO
a) Do you belong to a country that is not part of FATF (Financial Action Task Force") FATCA Complied Country?
*
YES
NO
2) Do you have any business relationship or transactions in from offshore Tax Haven countries?
*
YES
NO
3) Has any Financial Institution ever refused to open your account?
*
YES
NO
4) Do you hold a high profile position i.e. Sports or Media Personality?
*
YES
NO
5) Are you a domestic or foreign "Politically Exposed Person" (PEP)?
*
Foreign
Domestic
Neither
6) Are you a family member or close associate of a domestic or foreign "Politically Exposed Person" PEP?
*
Foreign
Domestic
Neither
List of documents to be attached
CNIC / NICOP / Passport/ POC
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CNIC Front side
*
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CNIC Back side
*
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Business visiting card or any proof of source of income
*
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Business Visiting CardProof of Income
*
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If the vehicle is imported Import documents required ( Leave check box if not applicable)
*
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Import documents(if the vehicle is imported)
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of
Please read and agree
*
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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