Certificate Application Attestation Form

Applicant Personal Data (as entered on the Online Enrollment Form) with the latest passport photograph:
Full Name *

Paste latest passport size photo here, duly Attested by Banker

E-mail Address *
Phone Number *
Postal Address *
Applicants Signature    Date *     (dd/mm/yyyy)

Banker to Complete the Following Section


The Applicant personally presented himself to me, the Banker, for the purpose of identity verification.

Signature and photograph of Mr./Mrs./Ms. who maintains an account with this Bank, as appearing above, is hereby attested, with reference to the records maintained by the Bank.

Bank Manager's Signature:  
Bank Manager's Name:*
Bank Manager's official code number: *
Bank Name and Address:*
Banks Official Phone number:  *
(Place Bank Seal/Stamp)

Documentation Requirements for RCAI Class-3 Individual and Organization


           A. Certificate applicant attestation form
           B. 3 forms of ID’s of which one must be a government issued photo-id
           C. Proof of Right of Organisation to do Business
           D. Letter of Employment of Applicant
           E. Signature Verification Letter

     A. Certificate Applicant Attestation Form (Format Attached).

  1. Print out this Form after completing it as required
  2. Place a copy of your latest passport-size photograph on the top right corner , same needs to be attested by banker.
  3. Bring this Form to your banker for attestation.
        a.      You are responsible for all fees charged by the banker
  4. Instruct the banker to read the instructions below and complete the Acknowledgment.

     B. Three Forms of ID’s

  1. One widely recognized, government issued Photo-ID such as
    a) Passport
    b) Driving License
    c) Income Tax Identity (PAN) Card
    d) Voters ID card
    e)Service Identity Card issued to its employees by State/Central Govt

     2.  Two other ID’s which are nationally valid and which need not necessarily be photo-ID’s such as
         a) Passport
         b) Driving License
         c) Income Tax Identity (PAN) Card
         d) Voters ID card
         e) Service Identity Card issued to its employees by State/Central Govt
         f)  Ration Card
         g) Photo Credit Cards / Debit card
         h) Bank / Kisan / Post Office Passbooks
         i)  Pension Documents such as Ex-Servicemen’s Pension Book / Pension Payment Order
         j)  Ex-Servicemen’s Widow / Dependent Certificates
         k) Mediclaim or similar insurance cards
         l)  Student SSC / HSC / graduation / post graduation degrees
        m) Birth certificate
        n)  School leaving certificate
        o)  Electricity bill
        p)  Mobile / Telephone bill

NOTE for (B):

      1. Make a copy of each of the 3 forms of ID’s
      2. Have the copies Notarized / Attested by a Notary Public or Class 3 Gazetted Officer or your Banker.

       C. Proof of Right of Organisation to do Business

        Please give "Any One" of the following as Proof of Right to do Business
         1. Certificate of Incorporation
         2. Articles of Incorporation
         3. Memorandum of Association
         4. Partnership Papers, in case of a Registered Partnership
         5. Acts or other valid business license document

           NOTE for (C):     
                      Copy must be signed with Company seal by Authorized Signatory.

        D. Letter of Employment of Applicant

                  This is required only when Authorized Signatory is not the Certificate Applicant. (Format Attached).


<< To be Printed on the Company Letter Head >>

Letter of Employment

Certificate Applicant Information

First Name:   _______________________

Last Name:   _______________________

Email ID:      _______________________

  I, (Name of the Authorised Signatory) _____________, certify that on (Date) ____________, (Name of the Certificate Applicant) _______________ is an     employee of our organization (Organisation Name) _____________________ and that the Applicant’s Employee ID is (Employee ID) ______________. I     acknowledge by my signature, that the Applicant information in this document is complete and accurate as per our office records.


                      (Signature of Authorised Signatory)                                                                         (Company Seal)

         Details of Authorised Signatory

       Full Name: _________________________

       Organisation Name: __________________

       Designation: ________________________

       Email Address: ______________________

       Phone Number: ______________________




        E. Signature Verification Letter

                                                 You must send us a letter that proves that the person who signed the documents above is the   Authorized Signatory of your organization. The letter must be counter-signed by the official Banker of your organization.This must be in the format available attached.


(To be printed on company letter Head)

Signature Verification Letter




                                             This is to Certify that …………...………………………………….. (Name of the Organisation) with the Office at ………………………………….………. (Address of the Organisation) is maintaining a bank account (A/c No. ……………………………) with our Bank ……………….……..........…………. (Bank Name), and operating that account in the normal course of its business/activities. Mr./Ms./Mrs..………………………..……. is the authorized signatory for the operation of the account. His/Her signature as appearing below is duly attested (as per the records available with the bank).



               (Signature of the Authorised Signatory)                                       (Signature of the Branch Manager)

                           Name : ___________________                                                   Name : _______________________
                           Designation: ___________________                                           Designation : __________________
                                                                                                                         Phone No: _____________________



                                Date: ___________________                                                     (Bank Seal)




   Instructions to Applicant

  1. Make and retain a copy of the completed form in a secure location. You will need to reference your name and e-mail address as listed below should you have a question regarding this certificate application.
  2. If your Organisation Name is to be included in the certificate then:
    1. Submit Proof of Right to do Business document
    2. Submit the Letter of Employment
    3. Submit the Signature Verification Letter
  3. Submit all documentation to SafeScrypt either through the SafeScrypt authorized agents or by courier to the following address:
  4. Customer Support

    SafeScrypt Ltd.,
    667 & 668, Keshava Towers,
    11th Main, 4th Block,
    Bangalore – 560011

  5. Your attested application will be reviewed within 48 hours of receipt; please allow additional time for mail delivery, which can vary from region to region. As soon as your application is approved, you will receive a confirmatory e-mail (sent to the e-mail address listed in the application) that will provide instructions for picking up your Digital ID. If you have any questions about this application, please e-mail SafeScrypt at support@safescrypt.com


The challenge phrase that you provided at the time of enrolment will be required for performing any of the certificate life-cycle management functions such as revocation and renewal. You are required to remember this phrase and/or store it in a secure location for future use. You must also ensure that others do not have access to this phrase. SafeScrypt does not have access to your challenge phrase.

   Instructions to Banker

The document you are attesting is part of the enrolment process for a SafeScrypt Digital ID. SafeScrypt requires that the personal identity of the applicant be validated. If you would like more information about Digital IDs or the enrolment process please visit SafeScrypt at www.safescrypt.com.

  1. Complete the Acknowledgment in the Certificate Application Attestation Form.
  2. The Applicant must hold a valid account in your bank.
  3. You may retain a copy of the completed Certificate Application Attestation Form
  4. In this context, the Banker is the Branch Manager of the bank where the applicant holds a valid bank account. The banker can also be any other employee of the same bank of a grade equal to or higher than the Branch Manager.

    Final Check list before sending the Documents to Certifying Authority
    1. In a case where authorized Signatory is taking Digital Certificate total no. of documents should be Six , which are as follows;
      1. Certificate Applicant Form
      2. 3 ID Proofs
      3. Signature Verification Letter
      4. Proof of right to do business


    2. Photo on the Certificate Applicant form should be duly attested (crossed signed and stamped ) by the banker
    3. All the fields of lower section of the Certificate Applicant form should be completely filled by the same banker who has attested the photograph of the certificate applicant.
    4. Proof of right to do business (Copy of Certificate of incorporation, partnership deed or sales tax registration) should be duly self attested by the authorized signatory only.
    5. Signature verification letter (SVL) should be on the letterhead of company or bank and same banker who has attested the photo , filled the lower section of certificate application form should only sign the SVL. (it is very important that signatures on all the three places should be of same banker to maintain the uniformity)
    6. For ID Proofs, following points should be noticed in case of providing following Ids;
      • In case of providing telephone bill , same should not be older than three months
      • In case of providing Ration card , certificate applicant should be a head of family only in that ration card not as the member of family.
      • Any other id which is provided here should be under its validity period as on date.


    In a case of a Pvt Ltd or Ltd. firm where an employee of the organization is becoming the Certificate applicant in place of an authorized signatory to no. of documents should be Seven ( additional document would be letter of employment ) same should be duly signed by the authorized signatory of the company. Letter of Employment must be on the letterhead of the organization.