Mandatory Fields: Name of Organisation

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Version: 1.

6
* Ref No/ CRN No.
Received Date:

Requisition form for Addition / Deletion / Modification of Account Details in Equity/Commodity


EQUITY COMMODITY BOTH Date: ____/____/_______
To,
Motilal Oswal Securities Ltd. / Motilal Oswal Commodities Broker Pvt. Ltd.
2nd Floor, Palm Springs Center, Malad Link Road, Malad (W), Mumbai - 400064 *Mandatory Fields

I/We request you to make the following Additions / Deletion / Modifications to my/our account in your records. Account details are as under: -
* DP Number 1 2 0 1 0 9 * PAN of 1st Holder

* Trading Account * Date Of Birth *Gender Male / Female

* Marital Status Single / Married * Client Type INDIVIDUAL / NON-INDIVIDUAL

Father's /Spouse Name ________________________________________________________ Nationality Indian/ Others ____________________________


* Please tick Request & Category
Request For Category Existing Details New Details
1
Address Details
Correspondance
Modification Permanant
Email ID
Mobile / Landline Number
Bank Details
Signature
Name Change

Note: In case of Addition, please enter 'Nil' in "Existing Details'


2 Request For Category Existing Details New Details
Bank Details
Add with Dafaultt
Addition
Add without Dafault

Other DP Details
Modification
_____________ pls specify

_____________ pls specify

I/We wish to update the above changes in KRA / Demat / Back office account

Family Declaration:
Please Fill up below declaration in case Email/ Mobile is already updated in sole / first holder account and wish to update same details for Family member as
per SEBI guidelines.
I and my family members hereby request that mobile number being ________________and Email ID being _____________________________, belonging to sole / first account
holder shall be considered in your records for the purpose of receiving communication from you or Stock Exchanges or Depository with regard to details of trading / DP
transactions executed through you.
Thus, any communication relating to our trading and demat account should be sent to the above mentioned mobile number and e-mail ID. This facility shall be extended to us as
an exception, for our convenience of receiving transaction details at a single mobile number and e-mail ID. I understand that for the purpose of availing the above facility “family”
means self, spouse, dependent children and dependent parents.

Sr. No. Client Name Client Code Relationship with sole/ first holder Signature
1

Ϯ
3
4
Use separate sheet for more family members (if any)

Declaration : I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief. In case any of the above
information is found to be false or untrue or misleading or misrepresenting, I am/we are aware theat I/we may be held liable for it.
In case of email / mobile updation, I hereby give consent to receive all communication from MOSL / MOCBPL on the above email / mobile number

Client Name Client Signature Name of Organisation

NSE/BSE-SEBI/MCX/NCDX/AP Reg No
Sole / First Holder
Person Name doing IPV
IPV Verification
Designation/ MOSL Emp code Please Affix Rubber Stamp and Sign
Second Holder

Date of IPV/ Document Verification

Third Holder
Signature of the Person

R i d Additi
Received Addition / D l ti / Modificationrequest
Deletion M difi ti t ffor : Address Details Email ID Mobile / Landline Number Bank Details Signature Other DP Details

DP Account No 1 2 0 1 0 9
Receipt Date and Stamp
Trading Account No
Version: 1.6/

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