DECLARATION OF SOURCE OF FUNDS
 
Legislation and State Bank of India (Canada) policy designed to prevent money-laundering activities requires the Bank to only accept for deposit funds, which arise from the legitimate operations of its customers. In some cases, particularly those involving large cash transactions, the bank is legally obligated to verify the source of funds before accepting the deposits. By agreeing to complete this form, you are helping us to protect the public, the bank and its law-abiding customers from those who might use the Bank to disguise the source of their funds for improper or illegal purposes.
Select Branch 
State Bank of India (Canada)
Branch 		Date:
 
Acknowledge and agree that the Bank has a duty to the public to ensure that its facilities are not used for illegal purposes and that it is illegal to launder proceeds of crime.
 
I declare that currency/funds totaling CAD/USD was deposited by me at the Branch listed above for the following purpose:
Deposit into my account No
Purchase of Demand Draft/Wire Transfer for INR / CAD / USD
Others (Pl. Specify)
Date of Birth
Email *  
 
I declare that the source of this currency / funds is And it was withdrawn from my Account No. with
Customer’s Name
Customer’s Signature ________________________________________
Address
Occupation
Designation
Phone No. (Home)
Phone No. (Work)
   
 
 
IDENTIFICATION (Please attach a photo copy of one of these)
 
Social Insurance No. Passport No.
       
Driver’s License No. Health Card No.
       
Province Province
       
Other Documents (Specify)
 
 

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