· XLS file · Web viewAuthor: Santosh R. Kadam (Ext, Support Division, KMBL) [email protected] Last modified by: Shaiju Philips (Corporate, KMBL) Created Date

INSTRUCTIONS FOR FILLING THE FORM

1. Please follow the guideline comments for entering information, wherever provided.

2. Please enter ALL details in BLOCK letters, except for email address.

3. Please ensure all information being captured is correct.

4. Please use TAB to move from one field to the other, to go back use SHIFT+TAB

5. Certain details such as Name, Date of Birth, Marital Status, Nominee details etc. oncecaptured, will automatically reflect in the other sheets where required

6. Please fill family details correctly. If family details are not entered correctly,the nominee details wherever applicable, will not be captured properly.

7. If information provided / entered is incorrect, it will reflect in ORANGE color. Incorrectdetails must be rectified before printing and signing the form.

8. After filling the form, please sign wherever the numbers have been provided. For e.g 1

Employee Data Form

(This name will be used as short name in communications)

Date of Birth Gender

Nationality Category

PAN/GIR No. Passport No.

Marital Status Blood Group

Anniversary Date Religion

Domicile

Telephone Number PincodePersonal Email IDCell Phone Number Alternate Cell No.Permanent Address

Telephone Number Pincode1

Name(In Block Letters)

Preferred Name(In Block Letters)

Preferredofficial email id :

Father's Name(In Block Letters)

Residential Address (Welcome Kit from KMBL will be dispatched at this address)

Family DetailsSr No Name of Family Member Relationship Date Of Birth Occupation

1

2

3

4

5

6

7

8

Academic Details (Begin with last qualification)

Special Training, if any (Project Work, Course Assignments, On Job Training, Seminars Attended etc)

Intrests and co-curricular pursuits(Please provide details of particulars / membership & positions of leadership / offices held if any)

2

Month & Year of Passing

Degree / Diploma

Subject of Specialisation

School / College / Institute and

LocationUniversity /

Board% of

Marks

Experience Records (Begin with last employment)From To Organisation Name Position(s) held Reason for leaving

Employment Details of Last EmploymentLast Employment (Emp 1) Prior to Last Employment (Emp 2)

Office Landline Numbers

Dates Employed to to

Job Title / Designation

Gross Salary

Supervisor Name

Supervisor Mobile No.

Reason for Leaving

Employee Code

HR Contact Name

HR Contact Email

Reference Details for Professional Reference Checks

Reference 1 Reference 2

Reference Name

Reference Designation

Landline Number

Mobile Number

3

Employer Name and full address

Reference Organisation Name

Period for which he/she knows the candidate

Association with the candidate

Do you have any of your relatives working with Kotak Group companies or its subsidiaries ?

If yes, please provide the below details

Name of the person Position

Do you have any relatives working with any government organization (such as Income Tax or Provident Fundor Municipal Corporation or Police etc) ?

Name of the person Position Organisation

Languages known (Indicate proficiency as being "fluent" and "fair")Languages Speak Read Write

Contact Person (In case of Emergency)Sr No Name Address Tel . Number Cell Number

1

2

3

I, hereby declare that the information mentioned above is true to the best of my knowledge .I shall be solely responsible for any discrepancy / misleading statements and also it is upon me to communicate any additions / changes to the above informationto the HR in writing .

1 Signature :Date : 05-MAY-2023 Place

4

Relationship withthe person

Name of theCompany

Employee code(if available)

MonthJANFEBMARAPR

Joining Report MAYJUNJUL

Name AUGSEP

Date of Joining 2023 OCT(DD-MM-YYYY) NOV

DEC

Department

Grade

Designation

Location

Declaration

I confirm that Mr./Ms. has joined the bank on the abovementioned date.

Signature of the Dept. Head 2 Signature of the employee

Name of the Department Head Name of the employee

For HR's Use Only

Encl.: Salary Fitment Sheet

Signature of the Authorized HR Person

The above date of joining as mentioned in this report supercedes any earlier joining date mentioned in theAppointment letter or any other communication made to me in this regard.

Revised DOJ

Signature of the employee

5

DECLARATION AND AUTHORIZATION

I hereby authorize Kotak Mahindra Group of companies (or a third party agent by the Company) tocontact any former employers as indicated above and carry out all Background checks not restricted toeducation and employment deemed appropriate through this selection procedure. I authorize formeremployers, agencies, educational institution etc. to release any information pertaining to myemployment / education and I release them from any liablity in doing so.

I confirm that the above information is correct to the best of knowledge and I understand that anymisrepresentation of information on this application form may, in the event of my obtainingemployment, result in action based on the company policy.

Signature :3

Name :

Date : 05-MAY-2023

6

FORM 2 (REVISED)

NOMINATION AND DECLARATION FORM FOR For Office use onlyUNEXEMPTED / EXEMPTED ESTABLISHMENT Inward No:Declaration and Nomination Form under the Employee's Group No.:Provident Fund & Employee's Pension scheme Office At.:(Paragraph 33 & 61(1) of the Employees' Provident Fund Scheme,1952 & paragraph 18 of the Employees' Pension Scheme, 1995)

1 . Name (In Block Letters)

2 . Father's/ Husband's Name

3 . Date of Birth -- 4 . Sex

5 . Marital Status 6 . Account No(married / unmarried / widow / widower)

7 . AddressPermanent

Temporary

PART -A (EPF)I hereby nominate the person(s) / cancel the nomination made by me previously & nominate the person(s)mentioned below to receive the amount standing to my credit in Employees' Provident Fund, in the event of my death

Name of the Nominees Address Date of Birth

1 2 3 4 5 6

1 . * Certified that I have no family as denied in para2(g) of the Employee's Provident fund Scheme ,1952and should I acquire a family hereafter the above nomination should be deemed as cancalled.

2 . * Certified that my father / mother is / are dependent upon me.

* Strike out which ever is not applicable 4 Signature or thumb impression of the subscriber (P.T.O)

7

Nominee's relationship with

the member

Total amount or share of

accumula-tions in Provident

Fund to be paid to each nominee

If the nominee is a minor, name & relationship & address of the guardian

who may receive the amount during the

minority of nominee

PART-B (EPS)Para 18

I hereby furnish below particulars of the members of my family who would be eligible to receive widow/children pension in the event of my death

Sr . No.Name & Address of the family member

Date of Birth Relationship with memberName Address

1 2 3 4 5

1

2

3

4

* Certified that I have no family, as defined in para 2 (vii) of the Employees' Pension Scheme, 1995 & should I acquire a family hereafter I shall furnish particulars thereon in the above form.

I hereby nominate the following person for receiving the monthly widow pension (admissible under para16(2)(a)(i) & (ii) in the event of my death without leaving any eligible family member for receiving pension.

Name & Address of the nominee Date of Birth Relationship with the member

1 2 3

Date : 05-MAY-2023

* Strike out whichever is not applicable 5 Signature of thumb impression of the subscriber

CERTIFICATE BY EMPLOYERCertified that the above declaration & nomination has been signed/ thumb impressed before me by Shri/ Smt.Kum

employed in my establishment after he / she has read the entries / entries have been read over to him / her by me & got confirmed by him / her

PlaceSignature of the employer or other Authorised

Officer of the establishment

DesignationName & Address of the Factory/ Establishment or Rubber Stamp thereof .

8

FORM 'F' THE PAYMENT OF GRATUITY ACT 1972[See Sub-rule (1) of Rule 6]

NOMINATION

To,

(Give here name or description of the Establishment with full address)

1 . I, Shri / Shrimati / Kumari

Whose particulars are given in the statement below ,hereby nominate the person(s) mentioned elow to receive the gratuity

payable after my death as also the gratuity standing to my credit in the event of my death before the amount has become

payable, or having become payable has not been paid &direct that the said amount of gratuity shall be paid in proportion

indicate against the name (s) of the nominees (s)

2 . I hereby certify that the person (s) nominated is a/are members(s)of my family within the meaning of clause (h) of section 2

of the payment of Gratuity Act, 1972.

3 . I hereby declare that I have no family within the meaning of clause (h) of section 2 of the said Act.

4 . (a) My father / Mother / Parents is / are not dependent on me .

(b) My husband's father / Mother / Parents is / are not dependent on my husband .

5 . I have excluded my husband from my family by a notice dated the to the controlling

authority in terms of the proviso the clause (h) of section (2) of the said Act.

6 . Nomination made herein invalidates my previous nomination.

NOMINEE (S)

(1) (2) (3) (4)(1)

(2)

(3)

(4)

so on,

9

Name in full with full addressof Nominees(s)

Relationship withthe employee

Age ofnominee

Proportion bywhich the gratuity

will be shared

STATEMENT

1 . Name of the emploee in full

2 . Sex 3 . Religion

4 . Whether unmarried/married/widow/widower

5 . Department / Branch / Section where employed.

6 . Post held with Ticket No . or Serial No., if any 7 . Date of appointment --

Vilage Thana Subdivision

Post Office District State

Place

Date 05-MAY-2023 6 Signature / Thumb-Impression of the Employee

DECLARATION BY WITNESSES

Nomination signed / thumb impressed before me .

Name in full and address of witness Signature of witnesses

1 . 1 .2 . 2 .

Place : Date : 05-MAY-2023

CERTIFICATE BY THE EMPLOYER

Certified that the particulars of the above nomination have been verified and recorded in this establishment.Employer's Reference No., If Any

Name and address of the establishment or rubber stamp thereof

Signature of the employer/office authorised .

Date: 05-MAY-2023 Designation:

ACKNOWLEDGEMENT BY THE EMPLOYEEReceived the duplicate copy of nomination in Form 'F' filed by me and duly certified by the employer.

Date : 7 Signature of the Employee

10

NOTE : Strike out the words and paragraphs not applicable.

ENROLMENT FORM FOR MEDICLAIM INSURANCE POLICYEmployee Name : Employee Number :

Grade : Designation :

Department : Location :

PARTICULARS OF THE PERSONS PROPOSED FOR COVERAGE UNDER MEDICLAIM SCHEME

Sr No . NAME RELATIONSHIP

1 - -

2 - -

3 - -

4 - -

5 - -

PLACE :

8 DATE : 05-MAY-2023

EMPLOYEE'S SIGNATURE

Note :

This form is essential for enrolment of coverage under group mediclaim , thus all the above details need to be furnished correctly and completely at the earliest. Without the submission of this formneither the employee nor nominated dependents will be covered.

The employee is entitled to nominate parents or in-laws, spouse and 2 children. Siblings and grand parents are not covered.

11

DATE OF BIRTH(DD-MM-YYYY)

n

n

Beneficiary Nomination Form

EMPLOYEE NUMBER : ………………

BENEFICIARY DETAILS

Bank Details ***

If minor, the details of the guardian with proof of identity requiredOriginal certified copy required .

*** Bank Details required are :n Bank Namen Bank Branch Name/Coden Account No n Account Type

EMPLOYEE SIGNATURE :

(1) NAME SIGNATURE DATE 05-MAY-2023

9

For HR use only Date of receipt of Form:

Received By:

Signature:

PLAN NAME : Kotak Term GrouplanPOLICY NUMBER :Employee Number :

12

Name ofBeneficiary *

Proof ofIdentity **

Relationshipto the policy

holder% Share of

Benefit

***

APPLICATION FOR IDENTITY CARD

PLEASE ENTER THE DETAILS IN CAPITALS

NAME

EMP CODE

BLOOD GROUP

13

Format for Medical Certificate (on Letter head with Registration No .)

DECLARATION OF MEDICAL FITNESS

I, the undersigned Mr. /Ms have

checked Mr./ Ms and certified that he / she is

medically fit and that he / she does not suffer from any serious illness of infection or any other terminal or

communicable illness .

Signed :

Dated :

Note : Doctor has to be atleast MBBS

14

SAMPLE

ACKNOWLEDGEMENT FORM FOR EMPLOYEE SHARE DEALING CODE

Declaration

I acknowledge the receipt of Kotak Mahindra Bank Limited Employee Share Dealing Code and proceduresmade thereunder ("the code.") .I have read the code & hereby confirm my understanding & acceptance of the code .

I am aware that the Bank reserves to itself the right to check with brokerage firms / relevent agencies andauthorities and obtain details of any securities transaction done by me or my affected relative/s. I am alsoaware that in such circumstance, if the Bank after checking with brokerage firms / relevent agencies andauthorities finds that securities transaction has been done by me in violation of the Code, the Bank has theright to take any action against me.

I hereby authorise the Bank or any of its Directors or Officers or seek such information as they deem necessary from any brokerage firm, stock exchange, clearing house, depository, bank or any other authority or agency that may be in possession of information relating to any trading activity carried on by me or by any of my affected relatives. I agree and confirm that any information provided by an organisationpursuant to the authority hereby granted would not be a breach of confidentiality obligations contained inany agreement / arrangement between me and such organisation.

Signature : 10

Name of Director/ Employee :

Employee Code :

Employee's Designation :

Branch / Department :

Date : 05-MAY-2023

15

Corporate Policy Manual on Conflict of Interest,Confidential and Proprietary Information

MEMORANDUM

This acknowledgement must be Signed and returned to the Human Resources Function, Kotak Mahindra Bank Ltd., within 10 days.

I have received the Kotak Mahindra Bank policies & procedures regarding conflict of interest, confidentialand proprietary information. I have read and agreed to comply with these policies & procedures. I understand and agree that failure to observe these policies and procedures and such other policies andprocedures as may be in the force from time to time & may subject me to disciplinary action .

11Signature : Date : 05-MAY-2023

Name :

(in block capitals)

Department : Employee No :

For Human Resources Use Only :

Data Entered :

(Signature ,Name,Designation & Date)

Sent to compliance for review :

16

Date : 05-MAY-2023

To,The Human Resoures,Kotak Mahindra Bank LimitedMumbai

Subject : Request for opening staff Bank A/c with Kotak Mahindra Bank Limited / updating Exsiting A/c

Dear Sir ,

I, have joined / am joining Kotak Mahindra Bank Limited / Kotak Group Company on --

I request you to open my Bank Staff A/c and Reimbursement A/c with Kotak Mahindra Bank / update myexisting Kotak Mahindra Bank A/c for salary processing and open Reimbursement A/c.

For New Staff A/c and Reimbursement A/c Opening

A/c Type (Please tick the appropriate A/c):Staff Edge A/c (Scheme Code : LSTEDG) Staff Ace A/c (Scheme Code : LSTACE)

Name of the Branch Branch CodeOR

Branch Code Name of the Branch

For Updating Existing Bank A/c and Opening Reimbursement A/c

I am having a Savings A/c with Kotak Mahindra Bank with following details:

CRN: A/c No:

I authorize Kotak Mahindra Bank to change the Scheme Code of my existing Savings A/c and open anew Reimbursement A/c on the same CRN.

Scheme Code (Please tick the appropriate A/c)LSTEDG (Staff Edge A/c)LSTACE (Staff Ace A/c)

I have read / obtained and understood the GSFC of the A/c I have opted for. I will ensure to submit therequired documents in the branch to activate the same.

Thanking you.

Yours faithfully

1217

AGREEMENT TO COMPLY WITH INFORMATION SECURITY GUIDELINES

Each one of us is responsible for ensuring compliance with Kotak’s Information Security Guidelines.

The undersigned confirms that he/she

p has read the relevant Information Security Acceptable Usage Guidelines and understands theprocedures described therein.

p agrees to abide by the guidelines described therein as a condition of continued employment /contract.

p will attend the Information Security Induction training which is part of corporate inductionprogramme for all new joiners.

p understands that violators of these guidelines are subject to disciplinary measures includingtermination of employement / contract.

p understands that access to the information systems of the company is a privilege which maybe changed or revoked at the sole discretion of the company.

p will promptly report all violations of the information security policies and security incidentsof to [email protected]

05-MAY-2023

13 User's signature Date Location

User's name in block capital letter Department

05-MAY-2023Witness name and signature Date

18

KOTAK MAHINDRA GROUP OF COMPANIESINCOME TAX DECLARATION FORM

(To be used to declare investment for income Tax that will be made during the period)

Company Name Ticket No (Emp no)Employee Name MR. / MS. Reporting Location

Date Of Joining --

Address

ITEMS PARTICULARS MAXIMUM LIMIT DECLARED AMOUNTDEDUCTION U/S 10

HOUSE RENT METROX months) & the

Max Limit Declared Amount

15,000.00

40,000.00Sec 80U - Handicapped 50,000.00Any other Deduction (Please specify)

Max Limit Declared AmountSec 80CCC - Contribution to Pension Fund (Jeevan Suraksha)

100,000.00

100,000.00Deferred Annuity 100,000.00

70,000.00

100,000.00

100,000.00

100,000.00Notified scheme of ELSS of Mutual Fund 100,000.00Investment in Notified Infrastructure Bonds 100,000.00

100,000.00Deposit in home loan account scheme of NHB/HDFC 100,000.00

100,000.00

100,000.00Investment in 5 year Fixed Deposit Scheme 100,000.00

NOTES:

1. The maximum amount of investmentS qualifying for deduction u/s 80C & 80CCC together is Rs.1,00,000/-.

2. Premiums on LIC paid in excess of 20% of the actual sum assured will not qualify for deduction & hence excess

premia paid should be excluded from the above details.

3. The LIC premium paid should not include the amount of which deduction is claimed u/s 80ccc & also the late

fees is not included.

19

No. of Documentsattached

PAN(Compulsary -plsattached a copy of yourPANcard/Form 49A)

I'm staying in a rented house & I agree to submit rent receipt when required. The rent paid is (Rs.

house is located in a METRO / NON METRO (Tick whichever is applicable)

DEDUCTION UNDER

CHAPTER - VI A

Sec 80D - Medical Insurance Premium (if the policy covers a senior citizen then exemption is Rs.20000/-)

Sec 80E - Repayment of loan for higher education (only interest for loan taken prior to employement)

DEDUCTIONU/S 80C

Life Insurance Premium on life of self or spouse & child only

Public Provident Fund in own name or spouse & child only

ULIP of UTI/LIC in own name or spouse & child onlyPrinciple Loan (Housing Loan) Repayment for fully constructed property

Contribution to Pension Fund or UTI or Notified Mutual Fund

Children Tuition Fee: Restricted to a max 2 children

Investment in NSC- Only Fresh Invsts made in current year

Interest Accrued on NSC VIII Isuue (Calculation table is provided separately)

Declared Amount

PROFESSIONAL TAX deducted by the Previous Employer

PROVIDENT FUND deducted by the Previous Employer

INCOME TAX deducted by the Previous Employer

Note : The above mentioned amounts will be considered based on actual proof given

Max Limit Declared Amount

150,000.00

30,000.00

DECLARATIONS:

1. I hereby declare that the information given above is correct & true in all respects. I am also aware that the

company will be considering the above details in utmost good faith based on the details provided by me

and that I am & personally lible for any

2. I am also aware that any person making a false statement /declaration in the above form shall be liable to

be fined and prosecution u/s 277 of the income Tax Act,1961

3. The proof of payment / Supportings for claim, will be provided post December 2009 latest by February 10th,2010.

4. The following members of my family are financially dependent on me.

RELATIONSHIP NAME OF THE DEPENDANT AGE

Statement showing details of Interest Accrued on NSC -VIII IssueCertificate Amount Accrued int.rate Interest Accrued

First Year 1 8.16%

Second Year 2 8.83%

Third Year 3 9.55%

Fourth Year 4 10.33%

Fifth Year 5 11.17%

Sixth Year 6 12.08%

Date : 05-MAY-2023

Place : 14 SIGNATURE OF THE EMPLOYEE

20

Previous Employement salary (salary earned from till date of joining)

If yes,Form 16 from previous employer or Form 12B with tax compution to be attachedSALARY paid by the Previous Employer after Sec 10 Exemption

Non Employement Declaration for employees joined post

I hereby declare that this being my first job, I do no have any salary income prior to joining this company.

DEDUCTIONU/S 24

Interest on Housing Loan on fully constructed accomodation only

Interest if the loan is taken before 01/04/99 on fully constructed accomodation only and for repairs

The year for which interest accrues

No. of years completed(Rs.)

Form No. 60[See third proviso to rule 114B]

Form of declaration to be filed by a person who does not have either a permanentaccount number or General Index Register Number and who makes payment in

cash in respect of transaction specified in clauses (a) to (h) of rule 11B

1. Full name and address of the declarant

2. Particulars of transaction

3. Amount of the transaction

4. Are you assessed to tax?

5. If yes,

(i) Details of Ward/Circle/Range where the last return of income was filed?

(ii) Reasons for not having permanent account number/General Index Register Number?

6. Details of the document being produced in support of address in column (1)

Verification

I, do hereby declare that what is stated above istrue to the best of my knowledge and belief.

Verify today, the 5TH day of JAN 2023

Date: 05-MAY-2023

Place:

11 Signature of the declarant

(a) Ration Card(b) Passport(c) Driving licence(d) Identity Card issued by an institution(e) Copy of the electricity bill or telephone bill whoing residential address(f) Any document or communication issued by an authority of Central Government, State Governmentor local bodies showing residential address.(g) Any other documentary evidence in support of his address given in the declaration.

14

Instructions: Documents which can be produced in support of the address are :-

DOCUMENTS CHECK - LIST

Emp Name

Sr No. Documents

1 Acceptance copy of Appointment letter ( HR-RM Sign & Employee Sign - 2 each)

2 Salary Breakup sheet ( HR-RM Sign & Employee Sign)

3 Employee Data Form (1 Sign)

4 Joining confirmation / Joining Report (1 Sign)

5 Declaration & Authorization (1 Sign)

6 PF Nomination Form (2 Signs)

7 Gratuity Nomination Form (2 Signs)

8 Mediclaim Enrolment form (1 Sign)

9 Life Cover Beneficiary Form (1 Sign)

10 ID- Card Application Form (1 Photo)

11 Doctors Certificate (As per Format, in original) / (MBBS & Registration No )

12 Acknowledgment of Share dealing Code (1 Sign)

13 Acknowledgment of Corporate code of conduct (1 Sign)

14 Account opening request Letter (Branch code)(1 Sign)

15 IT Security Agreement (1 Sign & Witness Sign)

16 Relieving / Experience / Acceptance of Resignation Letter (Wherever applicable)

17 Qualification marksheets & certificates (Graduation / Post Graduation)(OSV)

18 DOB Proof (Birth Certificate / School Leaving Certificate / Pan card)(OSV)

19 PAN Card Copy / Copy of Form (49A / 60)(OSV)

20 3 Passport Size Photographs

21 Address Proof (OSV)

22 Proof of Bank account details for beneficiary form

05-MAY-2023

15 Employee Signature Date21

Name of HRRM

ChecklistYes/No