{"id":1916,"title":"CENTRAL KYC REGISTRY | Know your Customer (KYC) Application Form | Legal Entity","purpose":"service","insurer":{"slug":"star-union-dai-ichi-life-insurance","name":"Star Union Dai-Ichi Life Insurance Company Limited"},"source_pdf":"https://dxwkpt4djlxwl.cloudfront.net/CKYC_Legal_Form_519e582339_e7e4cebbfa.pdf","sha256":"927dbc89e82cef7ee3bf755cf2c1fa55b040c6d2bd3d7dbc3ab0765c2d9fa335","pages":9,"collected":"2026-10-20","instructions":{"about":"This form is used for KYC (Know Your Customer) registration or update for legal entities. It is filled by the legal entity or its authorized representatives.","notes":["Fields marked with ‘*’ are mandatory.","Fill the form in English and in BLOCK letters.","Fill all dates in DD-MM-YYYY format.","Use two-digit codes for state/UT and country as per Indian Motor Vehicle Act, 1988 and ISO 3166 respectively.","KYC number is mandatory for update applications.","Submit certified copies of required documents.","Do not add leading zero in mobile number; use country code followed by 10 digit number.","For multiple correspondence/local addresses or related persons, use Annexure A2 and Annexure B2 respectively."],"title":"CENTRAL KYC REGISTRY | Know your Customer (KYC) Application Form | Legal Entity","submit":{"to":"","how":"","address":""},"purpose":"service","sections":[{"title":"Entity Details","fields":[{"help":"Select the applicable US reportable account holder type","type":"choice","label":"US Reportable Account Holder Type*","options":["F1 - Owner-Documented FI with specified US owner(s)","F2 - Passive Non-Financial Entity with substantial US owner(s)","F3 - Non-Participating FFI","F4 - Specified US Person","F5 - Direct Reporting NFFE","XX - Not Applicable"],"required":true,"pdf_field":""},{"help":"Select the entity constitution type","type":"choice","label":"Nature of Business / Entity Constitution Type*","options":["A - Sole Proprietorship","B - Partnership Firm","C - HUF","D - Private Limited Company","E - Public Limited Company","F - Society","G - Association of Persons (AOP) / Body of Individuals (BOI)","H - Trust","I - Liquidator","J - Limited Liability Partnership","K - Artificial Juridical Person","X - Not Categorised","Z - Others"],"required":true,"pdf_field":""},{"help":"Name of the legal entity as per official documents","type":"text","label":"Name*","options":[],"required":true,"pdf_field":""},{"help":"Date in DD-MM-YYYY format","type":"date","label":"Date of Incorporation*","options":[],"required":true,"pdf_field":""},{"help":"City or place where entity was incorporated","type":"text","label":"Place of Incorporation*","options":[],"required":true,"pdf_field":""},{"help":"Select country code from ISO 3166 list","type":"choice","label":"Country of Residence as per Tax laws*","options":[],"required":true,"pdf_field":""},{"help":"Select country code from ISO 3166 list","type":"choice","label":"Country of Incorporation*","options":[],"required":true,"pdf_field":""},{"help":"Country code issuing the TIN","type":"choice","label":"TIN Issuing Country","options":[],"required":null,"pdf_field":""},{"help":"Date in DD-MM-YYYY format","type":"date","label":"Date of Commencement of Business*","options":[],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Correspondence / Local Address Details","fields":[{"help":"Select the type of address","type":"choice","label":"Address Type*","options":["Residential","Registered Office","Unspecified","Business"],"required":true,"pdf_field":""},{"help":"Select the document submitted as proof of address","type":"choice","label":"Proof of Address*","options":["Certificate of Incorporation / Formation","Registration Certificate","Memorandum and Article of Association / Partnership Deed / Trust Deed","Others"],"required":true,"pdf_field":""},{"help":"Address line 1","type":"text","label":"Line 1*","options":[],"required":true,"pdf_field":""},{"help":"Address line 2 (optional)","type":"text","label":"Line 2","options":[],"required":false,"pdf_field":""},{"help":"Address line 3 (optional)","type":"text","label":"Line 3","options":[],"required":false,"pdf_field":""},{"help":"Select two-digit state or UT code","type":"choice","label":"State / U.T. Code*","options":["List of Indian state/UT codes as per Indian Motor Vehicle Act, 1988"],"required":true,"pdf_field":""},{"help":"Postal code","type":"text","label":"Pin / Post Code*","options":[],"required":true,"pdf_field":""},{"help":"Name of city, town or village","type":"text","label":"City / Town / Village*","options":[],"required":true,"pdf_field":""},{"help":"Select country code from ISO 3166 list","type":"choice","label":"ISO 3166 Country Code*","options":["List of two-digit ISO 3166 country codes"],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Proof of Identity (PoI)","fields":[{"help":"Submit certified copy of any one PoI document","type":"choice","label":"Proof of Identity (PoI)*","options":["PAN Card","Passport","Voter ID Card","Driving Licence","NREGA Job Card","Others (any document notified by the central government)"],"required":true,"pdf_field":""},{"help":"Mandatory if Passport is submitted as PoI","type":"date","label":"Passport Expiry Date","options":[],"required":false,"pdf_field":""},{"help":"Mandatory if Driving Licence is submitted as PoI","type":"date","label":"Driving Licence Expiry Date","options":[],"required":false,"pdf_field":""}],"filled_by":""},{"title":"Proof of Address (PoA)","fields":[{"help":"Submit certified copy of any one PoA document if required","type":"choice","label":"Proof of Address (PoA)*","options":["Certificate of Incorporation / Formation","Registration Certificate","Memorandum and Article of Association / Partnership Deed / Trust Deed","Others"],"required":true,"pdf_field":""},{"help":"Select the type of address","type":"choice","label":"Address Type*","options":["Residential","Registered Office","Unspecified","Business"],"required":true,"pdf_field":""},{"help":"Address line 1","type":"text","label":"Line 1*","options":[],"required":true,"pdf_field":""},{"help":"Address line 2 (optional)","type":"text","label":"Line 2","options":[],"required":false,"pdf_field":""},{"help":"Address line 3 (optional)","type":"text","label":"Line 3","options":[],"required":false,"pdf_field":""},{"help":"Select two-digit state or UT code","type":"choice","label":"State / U.T Code*","options":["List of Indian state/UT codes as per Indian Motor Vehicle Act, 1988"],"required":true,"pdf_field":""},{"help":"Postal code","type":"text","label":"Pin / Post Code*","options":[],"required":true,"pdf_field":""},{"help":"Name of city, town or village","type":"text","label":"City / Town / Village*","options":[],"required":true,"pdf_field":""},{"help":"Select country code from ISO 3166 list","type":"choice","label":"ISO 3166 Country Code*","options":["List of two-digit ISO 3166 country codes"],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Contact Details","fields":[{"help":"Office telephone number with country code","type":"phone","label":"Tel. (Off)","options":[],"required":false,"pdf_field":""},{"help":"Fax number with country code","type":"phone","label":"FAX","options":[],"required":false,"pdf_field":""},{"help":"Residential telephone number with country code","type":"phone","label":"Tel. (Res)","options":[],"required":false,"pdf_field":""},{"help":"Email address for communication","type":"email","label":"Email ID","options":[],"required":false,"pdf_field":""},{"help":"Mobile number with country code, do not add leading zero","type":"phone","label":"Mobile","options":[],"required":false,"pdf_field":""}],"filled_by":""},{"title":"Details of Related Person","fields":[{"help":"Tick if adding a related person","type":"checkbox","label":"Addition of Related Person","options":[],"required":null,"pdf_field":""},{"help":"Tick if deleting a related person","type":"checkbox","label":"Deletion of Related Person","options":[],"required":null,"pdf_field":""},{"help":"Provide KYC number if available","type":"text","label":"KYC Number of Related Person (if available*)","options":[],"required":false,"pdf_field":""},{"help":"Select the type of related person","type":"choice","label":"Related Person Type*","options":["Director","Promoter","Karta","Trustee","Partner","Authorised Signatory","Court Appointed Official","Beneficiary"],"required":true,"pdf_field":""},{"help":"Name of related person matching ID proof","type":"text","label":"Name* (Same as ID proof)","options":[],"required":true,"pdf_field":""},{"help":"Maiden name if applicable","type":"text","label":"Maiden Name (If any*)","options":[],"required":false,"pdf_field":""},{"help":"Either father's or spouse's name is mandatory","type":"text","label":"Father / Spouse Name*","options":[],"required":true,"pdf_field":""},{"help":"Mother's name","type":"text","label":"Mother Name*","options":[],"required":true,"pdf_field":""},{"help":"Date in DD-MM-YYYY format","type":"date","label":"Date of Birth*","options":[],"required":true,"pdf_field":""},{"help":"Select marital status","type":"choice","label":"Marital Status*","options":["Married","Unmarried"],"required":true,"pdf_field":""},{"help":"Select gender","type":"choice","label":"Gender*","options":["M-Male","F-Female","T-Transgender"],"required":true,"pdf_field":""},{"help":"Select nationality","type":"choice","label":"Nationality*","options":["IN- Indian","Others (ISO 3166 Country Code)"],"required":true,"pdf_field":""},{"help":"Tick if applicable","type":"checkbox","label":"Person of Indian Origin","options":[],"required":null,"pdf_field":""},{"help":"Select country code","type":"choice","label":"ISO 3166 Country Code of Jurisdiction of Residence*","options":["List of two-digit ISO 3166 country codes"],"required":true,"pdf_field":""},{"help":"Place or city of birth","type":"text","label":"Place / City of Birth*","options":[],"required":true,"pdf_field":""},{"help":"Select country code of birth","type":"choice","label":"ISO 3166 Country Code of Birth*","options":["List of two-digit ISO 3166 country codes"],"required":true,"pdf_field":""},{"help":"Select occupation type","type":"choice","label":"Occupation Type*","options":["Professional","Self Employed","Retired","Housewife","Student"],"required":true,"pdf_field":""},{"help":"Select residential status","type":"choice","label":"Residential Status*","options":["Resident Individual","Foreign National","Non Resident Indian"],"required":true,"pdf_field":""},{"help":"Submit certified copy of any one PoI document","type":"choice","label":"Proof of Identity (PoI)*","options":["Passport","Voter ID Card","PAN Card","Driving Licence","NREGA Job Card","Others (any document notified by the central government)"],"required":true,"pdf_field":""},{"help":"Mandatory if Passport is submitted as PoI","type":"date","label":"Passport Expiry Date","options":[],"required":false,"pdf_field":""},{"help":"Mandatory if Driving Licence is submitted as PoI","type":"date","label":"Driving Licence Expiry Date","options":[],"required":false,"pdf_field":""},{"help":"Submit certified copy of any one PoA document if required","type":"choice","label":"Proof of Address (PoA)*","options":["Passport","Address","Driving Licence","Voter Identity Card","NREGA Job Card","Others"],"required":true,"pdf_field":""},{"help":"Select the type of address","type":"choice","label":"Address Type*","options":["Residential","Registered Office","Unspecified","Business"],"required":true,"pdf_field":""},{"help":"Address line 1","type":"text","label":"Line 1*","options":[],"required":true,"pdf_field":""},{"help":"Address line 2 (optional)","type":"text","label":"Line 2","options":[],"required":false,"pdf_field":""},{"help":"Address line 3 (optional)","type":"text","label":"Line 3","options":[],"required":false,"pdf_field":""},{"help":"Select two-digit state or UT code","type":"choice","label":"State / U.T Code*","options":["List of Indian state/UT codes as per Indian Motor Vehicle Act, 1988"],"required":true,"pdf_field":""},{"help":"Postal code","type":"text","label":"Pin / Post Code*","options":[],"required":true,"pdf_field":""},{"help":"Name of city, town or village","type":"text","label":"City / Town / Village*","options":[],"required":true,"pdf_field":""},{"help":"Select country code from ISO 3166 list","type":"choice","label":"ISO 3166 Country Code*","options":["List of two-digit ISO 3166 country codes"],"required":true,"pdf_field":""}],"filled_by":""},{"title":"Applicant Declaration","fields":[{"help":"Sign or provide thumb impression","type":"signature","label":"Signature / Thumb Impression of Applicant","options":[],"required":true,"pdf_field":""},{"help":"Date of signing in DD-MM-YYYY format","type":"date","label":"Date","options":[],"required":true,"pdf_field":""},{"help":"Place of signing","type":"text","label":"Place","options":[],"required":true,"pdf_field":""}],"filled_by":"applicant"}],"deadlines":[],"applies_to":"Legal entities applying for KYC registration or update with the Central KYC Registry","attachments":["Certified copy of any one Proof of Identity (PoI) document","Certified copy of any one Proof of Address (PoA) document","Certificate of Incorporation / Formation","Registration Certificate","Resolution of Board / Managing Committee","Memorandum and Article of Association / Partnership Deed / Trust Deed"],"declarations":["I/We declare that the details furnished are true and correct to the best of my/our knowledge and belief and undertake to inform any changes immediately.","I/We understand that if any information is found false or misleading, I/we may be held liable.","I/We consent to sharing personal KYC details with Central KYC Registry.","I/We consent to receiving information from Central KYC Registry through SMS/Email on the registered contact details."],"dropped_labels":5},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"phone","value":"18002668833","label":"Toll Free No","level":null,"hours":null,"applies_to":"all","source_url":"https://irdai.gov.in/documents/37343/563751/Saral+Jeevan+Bima+PD+V_1_5+%28final%29_2020-21.pdf/dc4af66a-d7ca-94d8-62a4-432805c9f5ed?version=1.1&t=1667460523120&download=true","quote":"PAID.\nFor any assistance relating to your Policy or claim related query, you may get in touch with us via Toll Free No: 18002668833 or Land line No: 022 71966300 (charges apply) or email Us at: customercare@sudlife.in.\nThanking you once again for your","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"022 71966300","label":"Land line No","level":null,"hours":"charges apply","applies_to":"all","source_url":"https://irdai.gov.in/documents/37343/563751/Saral+Jeevan+Bima+PD+V_1_5+%28final%29_2020-21.pdf/dc4af66a-d7ca-94d8-62a4-432805c9f5ed?version=1.1&t=1667460523120&download=true","quote":"ting to your Policy or claim related query, you may get in touch with us via Toll Free No: 18002668833 or Land line No: 022 71966300 (charges apply) or email Us at: customercare@sudlife.in.\nThanking you once again for your patronage and looking forward","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"022 39546300","label":"Land line No","level":null,"hours":"charges apply","applies_to":"all","source_url":"https://irdai.gov.in/documents/37343/563751/142N056V01_2017-18.pdf/53e63035-8872-7f44-0263-63016740a6c8?version=1.1&t=1667469582333&download=true","quote":"ting to your Policy or claim related query, you may get in touch with us via Toll Free No: 18002668833 or Land line No: 022 39546300 (charges apply) or email Us at: customercare@sudlife.in.\nThanking you once again for your patronage and looking forward","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"Grievance Redressal Officer, Star Union Dai-ichi Life Insurance Company Ltd., 11th Floor, Vishwaroop IT Park, Plot No. 34, 35 & 38, Sector 30A of IIP, Vashi, Navi Mumbai – 400 703","label":"Grievance Redressal Officer","level":1,"hours":null,"applies_to":"all","source_url":"https://irdai.gov.in/documents/37343/563751/GEBP+Master+Pol+doc_2020-21.pdf/a5b92dec-159b-de50-83f9-52e6f268a1fc?version=1.1&t=1667460674786&download=true","quote":"our website\nIf You are not satisfied with the response provided by any of the above touch points, You may write to the Grievance Redressal Officer at grievanceredressal@sudlife.in or send a communication at Grievance Redressal Officer, Star Union Dai-ichi Life Insurance Company Ltd., 11th Floor, Vishwaroop IT Park, Plot No. 34, 35 & 38, Sector 30A of IIP, Vashi, Navi Mumbai – 400 703.\nTo further escalate the matter","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"grievanceredressal@sudlife.in","label":"Grievance Redressal Officer","level":1,"hours":null,"applies_to":"all","source_url":"https://irdai.gov.in/documents/37343/563751/GEBP+Master+Pol+doc_2020-21.pdf/a5b92dec-159b-de50-83f9-52e6f268a1fc?version=1.1&t=1667460674786&download=true","quote":"isfied with the response provided by any of the above touch points, You may write to the Grievance Redressal Officer at grievanceredressal@sudlife.in or send a communication at Grievance Redressal Officer, Star Union Dai-ichi Life Insurance Company Ltd., 11th Floor, Vi","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/star-union-dai-ichi-life-insurance/1916-central-kyc-registry-know-your-customer-kyc-application-form-legal-entity"}