Page 1 of 3

MHW1/181D/1-1/WBF-M/03-12

MS.SHARADA VIJAYAKUMAR Your Base Branch: NO.47,5TH CROSS ROAD,5TH

MAIN,,MALLESWARAM,,560003
113/12,1A CROSS,VENKATASWAMAPPA LAYOUT
NEAR NANJAPPA CIRCLE,VIDYARANYAPURA
BANGALORE Visit www.icicibank.com
KARNATAKA - INDIA - 560097 Dial your Bank 33667777

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 KYC details for your Account.

Summary of Accounts held under Cust ID: 516493558 as on May 29, 2024
ACCOUNT DETAILS - INR
ACCOUNT TYPE A/c BALANCE(I) FIXED DEPOSITS (LINKED) BAL.(II) TOTAL BALANCE(I+II) NOMINATION
Savings A/c 007801529119 12,31,949.77 0.00 12,31,949.77 Registered
TOTAL 12,31,949.77 0.00 12,31,949.77

Statement of Transactions in Savings Account Number: 007801529119 in INR for the period November 29, 2023 - May 29, 2024
DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE
29-11-2023 B/F 11,29,602.87

02-12-2023 Ph/cmidentortho2@f/Federal 1925.00 11,27,677.87

Bank/YBL9f30bccf3a864668b53cf18ee1ade6bf/
UPI/370265196813/Payment from
02-12-2023 Ph/9964483398@ybl/Canara 106.00 11,27,571.87
Bank/YBL9dee51653fa040be99e02b1f51f95641/
UPI/333784785339/You are
04-12-2023 paying/amazon@yapl/Yes Bank 439.00 11,27,132.87
Ltd/APYfbb7e1aea67649a49e9fec3006f465bb/
UPI/370323959569/Payment from
04-12-2023 Ph/7022263965@ybl/State Bank Of 1,500.00 11,25,632.87
I/YBLa69abee6af1c4d34914e7631d1e099be/
UPI/333874920465/Payment from
04-12-2023 Ph/paytmqrp23sa08b/Paytm Payments 90.00 11,25,542.87
/YBL2e09bc459d9e45a09e40fc9029cf3207
UPI/334762217768/Pay/licofindia.bdpg/ICICI
13-12-2023 Bank/YBL8f9d283597f84ba29db7ecbf6e2334c0/ 4,641.00 11,20,901.87
UPI/334737845903/Pay/licofindia.bdpg/ICICI
13-12-2023 Bank/YBL176b9afedd7d40298ed059c73c5b5610/ 4,513.00 11,16,388.87
UPI/334813727768/Zivame Payment/paytm-
14-12-2023 8918634@p/Paytm Payments 848.00 11,15,540.87
/PYTM3121422699195872265/
UPI/334820481567/Pay to
14-12-2023 BharatPe/BHARATPE9072762/Yes Bank 245.00 11,15,295.87
Ltd/YBLb6d925c791a74e0497e3fb9b715b8d8d/
UPI/334825824564/Payment from
14-12-2023 Ph/cmiphysioopd@fb/Federal 1,000.00 11,14,295.87
Bank/YBL8d40eecc70534fd6b1c6e9e5247d6ae3/
UPI/334874558633/You are
14-12-2023 paying/amazon@yapl/Yes Bank 7,489.00 11,06,806.87
Ltd/APY646edc54d2a64ce99bde4c44369ec120/
UPI/371520095925/Airtel
15-12-2023 UPI/AIRTELPGONLINEB/Yes Bank 779.00 11,06,027.87
Ltd/YBLcd694db0b60743f7bc4e684a423e140e/
UPI/334931359253/UPI/sbvarshika.1991/State Bank
15-12-2023 Of I/ICIbecc93fcb3404f689003520317aecf2c/ 1,000.00 11,05,027.87
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MS.SHARADA VIJAYAKUMAR

DATE PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/371878259870/Payment from
18-12-2023 Ph/keerthibkp@ybl/Kotak Mahindra 580.00 11,04,447.87
/YBL52b817d92a6e449aba6317d240d6259f/
UPI/372131950650/Payment from
21-12-2023 Ph/lingaraju8123@y/Union Bank of 3,000.00 11,01,447.87
I/YBL1d5ebf7bbfed4e398debca49778105b4
30-12-2023 007801529119:Int.Pd:30-09-2023 to 29-12-2023 599.00 11,02,046.87
RTGS/401737514846/vaniharish1983-/Bank of
17-01-2024 11,01,390.00 1,00,656.87
Baroda
02-02-2024 Ph/keerthibkp@ybl/Kotak Mahindra 20,000.00 80,656.87
/YBL39b0daf8a1cf45d89dc6b195b902225e/
UPI/403908068738/You are
08-02-2024 paying/amazon@yapl/Yes Bank 1,958.00 78,698.87
Ltd/APY018d88e84c72b71060773e502ca29b0c/
UPI/440627716803/OidZTDUPIC2499F/zomato-
09-02-2024 order@pa/Paytm Payments 663.71 78,035.16
/PTM4020924861575858237202402090544/
12-02-2024 SMSChgsOct23-Dec23+GST 3.35 78,031.81
UPI/404558443097/Pay via
14-02-2024 Razorpa/zomatoindia@ici/ICICI 519.89 77,511.92
Bank/ICI541b2c463b26481588c653ec5d3ecdc7/
22-02-2024 ACH/KPIT TECHNOLOGIES/3194313 210.00 77,721.92
22-02-2024 ACH/NTPC- 2ND INT DIV 23/NT0602240348704 81.00 77,802.92
UPI/405942645891/Sai Baba/GEETHA K W O
28-02-2024 VE/Bank 101.00 77,903.92
ofBaroda/AXIcb5bfb7ffc4345fe8b68ed4cf388a90d
UPI/406031950287/UPI/GOPAL JAGDISH G/Union
29-02-2024 11,000.00 66,903.92
Bank of I/ICIcd9aabe557db406bb22958aacaa7a73b/
UPI/442923661021/Payment from Ph/SRINIVAS
04-03-2024 D/Canara 180.00 66,723.92
Bank/YBL692e7002623d4b4f9b85916eaf08f198/
UPI/RVSL442923661021/Payment from
04-03-2024 Ph/SRINIVAS D/Canara 180.00 66,903.92
Bank/YBL692e7002623d4b4f9b85916eaf08f198
UPI/444027503444/UPI/SIRISAMRUDDHI G/State
14-03-2024 Bank Of I/ICIf28d2e77c59744fc98750c7260a4690f/ 10,000.00 56,903.92
UPI/407633684666/UPI/vivek.jathanna@/Axis Bank
16-03-2024 1,500.00 58,403.92
Ltd./AXI122b2b89391749f88fc4faed4c6cd489
UPI/407787570289/UPI/girijajan31@oki/ICICI
18-03-2024 Bank/ICI7259f7e0542b41d287c0aef94886e0d4 500.00 58,903.92
UPI/444439683458/UPI/sharada.vijayak/IDBI Bank
18-03-2024 20,000.00 38,903.92
Limit/ICIb0b3493e3a2f4552a44319133f2ee8fb/
19-03-2024 MOBILE BANKING MMT/IMPS/407918307482/IF/ to SHARADA VI 1.00 38,904.92
CMS/ 16680229/ICICI PRUDENTIAL LIFE
21-03-2024 CMS TRANSACTION 2,61,455.00 3,00,359.92
INSURANCE CO
CMS/ 16680229/ICICI PRUDENTIAL LIFE
23-03-2024 CMS TRANSACTION INSURANCE CO 2,49,955.00 5,50,314.92
TRF/VARSHIKA.15252453/
26-03-2024 CHEQUE 153151 5,11,250.00 39,064.92
LTD/ICI
UPI/408867359119/Swiggy Order
28-03-2024 Id/swiggyupi@axisb/Axis Bank 1,167.00 37,897.92
Ltd./AXISSDKV3f2443e15ddb94eaea46e8fcde8/
30-03-2024 007801529119:Int.Pd:30-12-2023 to 29-03-2024 761.00 38,658.92
UPI/445694573547/Payment for
30-03-2024 501/TRENTWESTSIDE@y/Yes Bank 2,398.00 36,260.92
Ltd/YBL609d1c2896d04b4daa000c85f134dfce/
UPI/445850375829/UPI/maniv9293@okhdf/State
02-04-2024 140.00 36,120.92
Bank Of I/ICI1ccf76cffe0d4e5db135efc8ee417faa/
UPI/447618156128/Payment from
19-04-2024 Ph/7022263965@ybl/State Bank Of 500.00 35,620.92
I/YBL86d1d63b72fc48b2aa68b3e9f1aeadb1/
25-04-2024 DCARDFEE4063MAR24-FEB25+GST 177.00 35,443.92
UPI/448899346853/You are
01-05-2024 paying/amazon@yapl/Yes Bank 2,527.00 32,916.92
Ltd/APY018f337f9ab90472c15febccc880e392/
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MS.SHARADA VIJAYAKUMAR

DATE MODE** PARTICULARS DEPOSITS WITHDRAWALS BALANCE

UPI/412955990601/Pay via
08-05-2024 Razorpa/razorpay.zomato/HDFC BANK 438.90 32,478.02
LTD/HDF59F4BA478ED94B4BA2D031F06B9C4966/
UPI/412955998927/Refund for
08-05-2024 RTGS/SHARADA VIJAYKUMAR/SELF TF/HDFC 12,00,000.00 12,32,478.02
BANK
UPI/414937031024/OidZTDUPIC246FF/zomato-
28-05-2024 order@pa/Yes Bank 528.25 12,31,949.77
Ltd/PTM40528805123172711457202405280640/
TOTAL 17,15,781.00 16,12,996.10 12,31,949.77

Account Related Other Information

ACCOUNT TYPE ACCOUNT NUMBER MICR CODE IFSC CODE NAME OF NOMINEE
Savings 007801529119 560229005 ICIC0000078 -

Nominee name is displayed only on specific consent of customer.

Sincerely,

Team ICICI Bank.

This is a system-generated statement. Hence, it does not require any signature.

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 of Rs 2 Lakh and up to Rs 10 Lakh) 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 • In absence of valid PAN, Form 15G / 15H shall not be treated as valid and tax will be deducted.
Customer then tax shall be deducted at the prevailing rate or 20%, whichever is higher. • In case your PAN is not updated in our record, please visit the nearest branch and provide a copy
• As per guidelines issued by CBDT on May 13, 2011, Form 16A (TDS Certificates) will be of the PAN card along with the original PAN card for verification.
generated
through the Income tax website for which the PAN of the customer needs to be necessarily updated •The address of the customer in Form 16A will be the last updated address in the data base of the
in Bank's record. Income tax department.

REGD ADDRESS: “LANDMARK”, RACE COURSE CIRCLE, VADODARA - 390 007, INDIA www.icicibank.com
This is an authenticated intimation/statement. Category of service: Banking & Financial Services.
Customers are requested to immediately notify the Bank of any discrepancy in the statement Registration No. MIV/ST/Bank & Finc/4.
MHW1-WBG-M-05-Mar-12/148405000053 - 525322040/207/207 - Utility - 1 of 1 PAN Based STC No. AAACI1195HSST001.