Page 1 of 3 MHW1/181D/1-1/WBF-M/03-12 Your Base Branch: MR.ASHISH SHRIVASTAVA NEW GANDHI COLONY DIST MORENA MORENA MADHYAPRADESH - INDIA - 476001 2/1, KRISHNA TOWER, OPP. CUREWELL HOSPITAL,, NEW PALASIA, JANZIRWALA SQUARE,, IND, MP, 452001 Visit www.icicibank.com Dial your bank 09893208000 Did you know? It's mandatory to be KYC compliant as per RBI guidelines. If you have not submitted your KYC documents, please visit the nearest branch or contact your Relationship Manager to complete the KYC details for your Account. Summary of Accounts held under Cust ID: 530010361 as on July 15, 2014 ACCOUNT DETAILS - INR ACCOUNT TYPE A/c BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) Savings A/c 144101504523 19,169.50 0.00 19,169.50 TOTAL 19,169.50 0.00 19,169.50 NOMINATION Registered Statement of Transactions in Savings Account Number : 144101504523 in INR for the period April 16, 2014 - July 15, 2014 DATE MODE** PARTICULARS 15-05-2014 OTHER ATMS Balance Brought Forward NEFT-CITIN14432659477-GLOBAL REMITTANCEOTHERS-Source NRE Funds NEFT-CITIN14432659476-GLOBAL REMITTANCEOTHERS-Source NRE Funds NEFT-000015137046-SYSCRAFT INFORMATION SYSTEM PVTLTNFS/CASH WDL/15-05-14 5,000.00 16,498.83 16-05-2014 ICICI ATM ATM/CASH WDL/16-05-14/19:50:29/0 5,500.00 10,998.83 19-05-2014 OTHER ATMS NFS/CASH WDL/18-05-14 1,500.00 9,498.83 21-05-2014 OTHER ATMS NFS/CASH WDL/21-05-14 500.00 8,998.83 23-05-2014 OTHER ATMS NFS/CASH WDL/23-05-14 2,000.00 6,998.83 02-06-2014 DEBIT CARD VPS/SUNIL SERVI/20140602195226/0 200.00 6,798.83 16-04-2014 02-05-2014 02-05-2014 15-05-2014 06-06-2014 DEPOSITS WITHDRAWALS BALANCE 5,347.28 1.26 5,348.54 1.29 5,349.83 16,149.00 21,498.83 11.24 6,787.59 06-06-2014 DEBIT CARD Dt:02/06/14 SUNIL SERVICE STAT VPS/SAMRAT REST/20140606205459/0 448.00 6,339.59 09-06-2014 ICICI ATM 500.00 5,839.59 11-06-2014 ICICI ATM ATM/CASH WDL/08-06-14/17:46:39/0 NEFT-000016070861-SYSCRAFT INFORMATION SYSTEM PVTLTATM/CASH WDL/11-06-14/21:14:51/0 12-06-2014 DEBIT CARD VPS/WOODLAND /20140612193503/0 12-06-2014 OTHER ATMS NFS/CASH WDL/12-06-14 13-06-2014 OTHER ATMS NFS/CASH WDL/13-06-14 16-06-2014 ICICI ATM ATM/CASH WDL/15-06-14/22:31:25/0 17-06-2014 DEBIT CARD 19-06-2014 ICICI ATM 19-06-2014 DEBIT CARD 11-06-2014 20-06-2014 21,454.00 27,293.59 2,000.00 25,293.59 2,095.00 23,198.59 500.00 22,698.59 500.00 22,198.59 7,000.00 15,198.59 VPS/SAMRAT REST/20140617212140/0 660.00 14,538.59 ATM/CASH WDL/19-06-14/10:55:59/0 500.00 14,038.59 IPS/BIG BAZAAR /20140619184501/0 481.00 13,557.59 POSDEC CHG/01-05-14/5385/25ST3 28.09 13,529.50 3,000.00 10,529.50 159.00 10,370.50 21-06-2014 OTHER ATMS 23-06-2014 NET BANKING 25-06-2014 OTHER ATMS NFS/CASH WDL/21-06-14 BIL/000607891221/Mobile net recharge/365306861_PAY NFS/CASH WDL/25-06-14 1,000.00 9,370.50 27-06-2014 DEBIT CARD VPS/HOTEL SAMRA/20140627220411/0 748.00 8,622.50 30-06-2014 DEBIT CARD VPS/BATA INDIA./20140629192909/0 250.00 8,372.50 30-06-2014 30-06-2014 144101504523:Int.Pd:30-12-2013 to 29-06-2014 DEBIT CARD VPS/HOTEL CHAND/20140630210305/0 120.00 8,492.50 367.00 8,125.50 Page 2 of 3 MR.ASHISH SHRIVASTAVA Statement of Transactions in Savings Account Number : 144101504523 in INR for the period April 16, 2014 - July 15, 2014 DATE MODE** PARTICULARS 03-07-2014 NET BANKING BIL/000613082295/smart/RELIANCECOMM_MI 03-07-2014 OTHER ATMS NFS/CASH WDL/03-07-14 07-07-2014 OTHER ATMS NFS/CASH WDL/06-07-14 09-07-2014 ICICI ATM ATM/CASH WDL/09-07-14/09:17:50/0 11-07-2014 OTHER ATMS NFS/CASH WDL/11-07-14 NEFT-000017149048-SYSCRAFT INFORMATION SYSTEM PVTLTATM/CASH WDL/12-07-14/16:33:04/0 300.00 5,786.50 12-07-2014 12-07-2014 ICICI ATM DEPOSITS WITHDRAWALS BALANCE 39.00 8,086.50 500.00 7,586.50 500.00 7,086.50 1,000.00 6,086.50 21,383.00 TOTAL 59,108.55 SAVINGS ACCOUNT NUMBER LINKED PAYBACK NUMBER Points earned for the month of June 2014 MySavings REWARDS DEBIT CARD 144101504523 9401157532314808 0 0 27,169.50 8,000.00 19,169.50 45,286.33 19,169.50 REWARD POINTS SUMMARY POINTS BALANCE* To get current reward points balance and for other queries visit www.icicibank.com 359 or call ICICI Bank Customer Care *As on July 20, 2014, includes points earned through other PAYBACK partners Points earned for the month will reflect with a lag of upto 50 days in the total point balance Account Related Other Information ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFSC CODE NAME OF NOMINEE Savings 144101504523 452229007 ICIC0001441 - Nominee name is displayed only on specific consent of customer. For ICICI Bank Limited Authorised Signatory Page 3 of 3 MR.ASHISH SHRIVASTAVA Legends for transactions in your account statement VAT/MAT/NFS - Cash withdrawal at other bank’s ATMs EBA - Transaction at ICICIDirect VPS/IPS - Debit card transaction RTGS - Real Time Gross Settlement (Instant Transfer of Rs 2 Lakh and up to Rs 10 Lakh) INF - Internet funds transfer in linked accounts BIL - Internet bill payment or funds transfer to third party TOP - Mobile recharge NEFT - National Electronic Fund Transfer (Up to Rs 10 Lakh) ** Mode is available only for transaction done after August 6, 2013. • As per prevailing guidelines of the Income tax Act, 1961 if a valid PAN is not provided by the Customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher. • As per guidelines issued by CBDT on May 13, 2011, Form 16A (TDS Certificates) will be generated through the Income tax website for which the PAN of the customer needs to be necessarily updated in Bank's record. REGD ADDRESS: LANDMARK, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA This is an authenticated intimation/statement. Customers are requested to immediately notify the Bank of any discrepancy in the statement MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1 • In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted. • In case your PAN is not updated in our record, please visit the nearest branch and provide a copy of the PAN card along with the original PAN card for verification. • The address of the customer in Form 16A will be the last updated address in the data base of the Income tax department. www.icicibank.com Category of service: Banking & Financial Services. Registration No. MIV/ST/Bank & Finc/4. PAN Based STC No. AAACI1195HSST001.
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