Director Personal Information

Full Name of Director *

Title (Mr/Ms/Dr/Prof) *

DIN (Director Identification Number) *

Date of Birth *

Gender *

Nationality *

Father's Name *

Mother's Name

Identification Documents

PAN (Permanent Account Number) *

Aadhaar Number (Masked - Last 4 digits) *

Passport Number (if any)

Passport Country (if any)

Voter ID / Electoral Roll Number (optional)

Driving License Number (optional)

Permanent Address

Street/Building Name *

City/Town *

State/UT *

Postal Code/PIN *

Country *

Residing at above address since

Present Address (if different)

Street/Building Name

City/Town

State/UT

Postal Code/PIN

Country

Residing at above address since

Permanent address same as Present Address *

Contact Information

Primary Mobile Number *

Alternate Mobile Number

Personal Email Address *

Official Email Address

Residence Phone Number

Educational Qualification

Highest Educational Qualification *

Field of Education *

University/Institute Name

Professional Qualifications (CA/CS/CMA/etc.)

Additional Certifications/Training

Occupation & Professional Details

Primary Occupation *

Specific Profession/Business Type *

Current Organization/Firm Name

Current Designation

Years of Experience in the Field

Industry/Sector of Expertise

Director Status & Disqualifications

First Appointment as Director (Date)

Number of Current Directorships *

Other Companies where Director (Company names)

Ever been disqualified as Director (Yes/No) *

If disqualified, provide details

Any criminal conviction (Yes/No) *

If convicted, provide details

Any insolvency/bankruptcy (Yes/No) *

If insolvent, provide details

Family & Dependents

Marital Status *

Spouse Name (if married)

Number of Dependent Children

Children Names (if dependent)

Declaration & Undertaking

I declare the above information is true and accurate *

I undertake to inform of any changes in personal details within 30 days *

I consent to company using this information for regulatory purposes *

Additional Remarks/Notes (if any)

Signature & Certification

Date of Form Filling *

Place of Signature *

Director Signature Date *

Please fill all required fields to generate.

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DIRECTOR INFORMATION & KYC FORM

DIR-3 Under Companies Act, 2013 Rule 8

Director Name
DIN
Date of Birth

PERSONAL PARTICULARS

Full Name
DIN
Date of Birth
Gender
Nationality
Father's Name
Mother's Name

IDENTIFICATION DOCUMENTS

Verified identification documents are as follows:

PAN
Aadhaar (Masked)
Passport Number
Passport Country
Voter ID
Driving License

RESIDENTIAL ADDRESS

Permanent Address:

Street/Building
City/Town
State/UT
Postal Code
Country
Residing Since: N/A

CONTACT INFORMATION

Primary Mobile
Alternate Mobile
Personal Email
Official Email
Residence Phone

EDUCATIONAL QUALIFICATIONS

Highest Qualification
Field of Study
University/Institute

Professional Qualifications:

Additional Certifications:

OCCUPATION & PROFESSIONAL DETAILS

Primary Occupation
Profession/Business
Current Organization
Designation
Years of Experience
Industry/Sector

DIRECTORSHIP STATUS

First Appointment as Director: Date on record. Current Number of Directorships: .

Other Companies/Bodies where Director:

REGULATORY COMPLIANCE DECLARATIONS

As required under the Companies Act, 2013 and Insolvency & Bankruptcy Code, the following declarations are made:

Disqualification as Director: Yes -
Criminal Conviction: Yes -
Insolvency/Bankruptcy: Yes -

FAMILY INFORMATION

Marital Status
Spouse Name
Number of Dependent Children
Children Names

DIRECTOR'S DECLARATION

I, , DIN: , hereby declare that:

The information provided in this KYC form is true, correct, and complete to the best of my knowledge and belief.
I undertake to inform the Company of any changes in the personal details provided herein within thirty (30) days of such change.
I consent to the Company using this information for statutory compliance and regulatory purposes.
All documents submitted are authentic and have not been forged or falsified.

SIGNATURE & CERTIFICATION

This KYC Form (DIR-3) has been filled and submitted as on at .

Director Signature
DIN
Date
Place

Additional Remarks:

DIR-3 Director KYC Form