Page 1 of 2 M-791980

029416/791980/1-2/RESGB/05-11
Your Base Branch : SUVAS COMPLEX, GROUND
FLOOR, OPP. RAJASTHAN HOSPITAL,
SHAHIBAUG, 380004
MR.SUMEET ARVINDBHAI CHAUHAN
D 190 SUN RESIDENCY NR VEDANT RESIDENCY B/H
BHARAT PETROLIUM WAGHODIYA DABHOI RING ROAD : Visit www.icicibank.com
VADODARA
GUJARAT - INDIA - 390019 Dial your Bank 33667777

NEVER SHARE your Card number, CVV, PIN, OTP, Internet Banking User ID, Password or URN with anyone, even if the caller claims
to be a bank employee. Sharing these details can lead to unauthorised access to your account.

Summary of Accounts held under Cust ID : 529267796 as on April 30, 2017

ACCOUNT DETAILS - INR

ACCOUNT TYPE A/C. BALANCE (I) FIXED DEPOSITS (LINKED) BAL. (II) TOTAL BALANCE (I+II) NOMINATION
Savings A/c 029401525294 8,165.17 0.00 8,165.17 Registered

TOTAL 8,165.17 0.00 8,165.17

Statement of Transactions in Savings Account Number: 029401525294 in INR for the period April 01, 2017 - April 30, 2017

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

01-04-2017 B/F 13,059.42
03-04-2017 DEBIT CARD IPS/Big Bazaar /20170402134320/0 907.00 12,152.42
03-04-2017 MOBILE BANKING MMT/709215486843/2222222222 1,177.95 13,330.37
04-04-2017 ICICI ATM ATM/CASH WDL/04-04-17/0 3,000.00 10,330.37
04-04-2017 UPI/709420988171/ravibambhaniya@upi 2,558.00 7,772.37
06-04-2017 OTHER ATMS NFS/CASH WDL/06-04-17 500.00 7,272.37
07-04-2017 Dt:30/03/17 WWW.ALIEXPRESS.COM 0.29 7,272.66
07-04-2017 ICICI ATM ATM/CASH WDL/07-04-17/0 2,000.00 5,272.66
07-04-2017 ICICI ATM ATM/CASH WDL/07-04-17/0 1,200.00 4,072.66
10-04-2017 MOBILE BANKING MMT/710022440270/2222222222 753.42 4,826.08
11-04-2017 ICICI ATM ATM/CASH WDL/11-04-17/0 1,500.00 3,326.08
12-04-2017 MOBILE BANKING MMT/710217631698/2222222222 859.00 4,185.08
13-04-2017 NET BANKING MIN/WWW.ALIEXPR/20170413092838/0 160.50 4,024.58
13-04-2017 NET BANKING MIN/ali*aliexpr/20170413093009/0 64.46 3,960.12
13-04-2017 NET BANKING MIN/WWW.ALIEXPR/20170413093116/0 204.82 3,755.30
13-04-2017 OTHER ATMS NFS/CASH WDL/13-04-17 1,000.00 2,755.30
13-04-2017 OTHER ATMS NFS/CASH WDL/13-04-17 500.00 2,255.30
15-04-2017 NET BANKING BIL/001189956741/Sumeet Arvindbhai Ch/NSP 530.00 2,785.30
020901008246/SHAHEENA MOHAMMED LATIF SHEIKH
15-04-2017 NET BANKING IIN/I-Debit/Amazon /20170414140652 499.00 2,286.30
15-04-2017 NET BANKING MIN/WWW.ALIEXPR/20170414203206/0 252.14 2,034.16
15-04-2017 NET BANKING MIN/WWW.ALIEXPR/20170414203329/0 252.14 1,782.02
17-04-2017 ICICI ATM ATM/CASH WDL/16-04-17/0 500.00 1,282.02
17-04-2017 ICICI ATM ATM/CASH WDL/16-04-17/0 200.00 1,082.02
17-04-2017 OTHER ATMS NFS/CASH WDL/17-04-17 500.00 582.02
18-04-2017 ICICI ATM ATM/CASH WDL/18-04-17/0 500.00 82.02
19-04-2017 MOBILE BANKING MMT/710916843422/9601250250 3,140.00 3,222.02
0137SAECSDRR/ECS DEBIT RETURN A/C
19-04-2017 ICICI ATM ATM/CASH WDL/19-04-17/0 500.00 2,722.02
19-04-2017 NET BANKING BIL/001193262799/ICICI BANK CREDIT CA/43755147044 1,522.00 1,200.02
21-04-2017 ICICI ATM ATM/CASH WDL/21-04-17/0 500.00 700.02
21-04-2017 MOBILE BANKING MMT/711122858947/8980305411 800.00 1,500.02
0137SAECSDRR/ECS DEBIT RETURN A/C
24-04-2017 ICICI ATM ATM/CASH WDL/22-04-17/0 500.00 1,000.02
24-04-2017 MOBILE BANKING MMT/711315712638/2222222222 942.19 1,942.21
24-04-2017 Dt:13/04/17 ali aliexpress.com 0.08 1,942.29
24-04-2017 Dt:13/04/17 WWW.ALIEXPRESS.COM 0.16 1,942.45
24-04-2017 Dt:13/04/17 WWW.ALIEXPRESS.COM 0.27 1,942.72
24-04-2017 Dt:14/04/17 WWW.ALIEXPRESS.COM 0.10 1,942.62
Total: 8,203.36 19,320.16 1,942.62
 Page 2 of 2 M-791980

MR.SUMEET ARVINDBHAI CHAUHAN

Statement of Transactions in Savings Account Number: 029401525294 in INR for the period April 01, 2017 - April 30, 2017

DATE MODE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

24-04-2017 Dt:14/04/17 WWW.ALIEXPRESS.COM 0.10 1,942.52
24-04-2017 MOBILE BANKING MMT/711422859863/2222222222 599.00 2,541.52
24-04-2017 MOBILE BANKING MMT/711422859971/2222222222 559.91 3,101.43
24-04-2017 NET BANKING MIN/GUJARAT STA/20170424223816/0 233.00 2,868.43
24-04-2017 NET BANKING MIN/GUJARAT STA/20170424224151/0 233.00 2,635.43
25-04-2017 NET BANKING MIN/GUJARAT STA/20170425185036/0 233.00 2,402.43
26-04-2017 ICICI ATM ATM/CASH WDL/26-04-17/0 500.00 1,902.43
27-04-2017 NET BANKING MIN/WWW.ALIEXPR/20170427101504/0 801.66 1,100.77
27-04-2017 OTHER ATMS NFS/CASH WDL/27-04-17 300.00 800.77
27-04-2017 NET BANKING MIN/Book My Sho/20170427190406/0 633.60 167.17
28-04-2017 CMS TRANSACTION CMS/ ADECCO SAL - APR-2017 14,866.00 15,033.17
29-04-2017 OTHER ATMS NFS/CASH WDL/29-04-17/Fee Rs20.00 ST Rs3.00 523.00 14,510.17
29-04-2017 NET BANKING MIN/RAZORPAY ZO/20170429110634/0 345.00 14,165.17
29-04-2017 ICICI ATM ATM/CASH WDL/29-04-17/0 600.00 13,565.17
29-04-2017 ICICI ATM ATM/CASH WDL/29-04-17/0 5,400.00 8,165.17
TOTAL Total: 16,024.91 9,802.36 8,165.17

REWARD POINTS SUMMARY

SAVINGS ACCOUNT LINKED PAYBACK Points earned for the month of March, 2017
POINTS BALANCE*
NUMBER NUMBER
My Savings REWARD DEBIT CARD
029401525294 9401157246458404 0 53 538
To get current reward points balance and for other queries visit www.icicibank.com or call ICICI Bank Customer Care
* As on April 20, 2017, includes points earned through other PAYBACK partners
Points earned for the month will reflect with a lag of upto 50 days in the point balance.

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFSC CODE NAME OF NOMINEE*
Savings 029401525294 380229008 ICIC0000294 -
* Nominee name is displayed only on specific consent of customer.
Now update your Aadhar number by sending an SMS AADHAR <space>12 digit Aadhaar number <space> last 6 digits of Savings Account no. to 9222208888
from your registered mobile number or visit our branch.

For ICICI Bank Limited Legends for transactions in your account statement
VAT/MAT/NFS- Cash Withdrawal at other bank's ATM INF-Internet funds transfer in Linked accounts
EBA-Transaction at ICICIDirect BIL-Internet bill payment or Funds transfer to third party
VPS/IPS-Debit card transaction TOP- Mobile Recharge
RTGS-Real Time Gross Settlement (Instant transfer above Rs 2 Lakh) NEFT- National Electronic Fund Transfer
Authorised Signatory

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.
W.e.f. June 1, 2016, Service Tax will be charged at 15% as Government of India has
introduced Krishi Kalyan Cess (KKC) of 0.5%. Please note Swachh Bharat Cess (SBC) of
0.5% continues to be part of Service Tax.
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.
As per PMJJY, debit of Rs. 289 is towards insurance premium collected on behalf of ICICI
Prudential & Rs. 41 is towards administration charges by ICICI Bank (including Service Tax
@14%, SBC @ 0.5% & KKC @ 0.5%). For details, refer Terms and Conditions at
www.icicibank.com

www.icicibank.com
Corporate Office: ICICI Bank Ltd., ICICI Bank Towers, Bandra-Kurla complex, Mumbai - 400051, India. Category of service: Banking & Financial Services.
Registered Office: ICICI Bank Tower, Near Chakli Circle, Old Padra Road, Vadodara, Gujarat. Pin 390 007. Registration No. MIV/ST/Bank & Finc/4.
PAN Based STC No. AAACI1195HSST001.
This is an authenticated intimation/statement. CIN : L65190GJ1994PLC021012
Customers are requested to immediately notify the Bank of any discrepancy in the statement
ROG Dec_SOA_SLDP_CPCPN_SR56732755_121216