KYC FORM — INDIVIDUAL / PROPRIETOR =================================== QUICK SILVER SHIPPING INDIA PVT. LTD. Section 1: Applicant Information --------------------------------- Full Name: ___________________________________ Father's Name: ___________________________________ Date of Birth: _____ / _____ / _________ Nationality: ___________________________________ Section 2: Identity Verification --------------------------------- PAN Number: ___________________________________ Aadhaar Number: ___________________________________ Passport Number: ___________________________________ Section 3: Address (As on Aadhaar) --------------------------------- Address Line 1: ___________________________________ Address Line 2: ___________________________________ City: ___________________________________ State: ___________________________________ PIN Code: ___________________________________ Section 4: Business Details --------------------------------- Business Name: ___________________________________ IEC Number: ___________________________________ GSTIN: ___________________________________ Nature of Business: ___________________________________ Section 5: Bank Details --------------------------------- Bank Name: ___________________________________ Branch: ___________________________________ Account Number: ___________________________________ IFSC Code: ___________________________________ Section 6: Declaration --------------------------------- I hereby declare that the information provided above is true and correct to the best of my knowledge. I authorize Quick Silver Shipping India Pvt. Ltd. to verify the details furnished above. Signature: ___________________________________ Date: _____ / _____ / _________ Place: ___________________________________ --- Document: QS-KYC-IND-v3.0 Effective: January 2024 Quick Silver Shipping India Pvt. Ltd.