Mandatory Fields: Name of Organisation
Mandatory Fields: Name of Organisation
Mandatory Fields: Name of Organisation
6
* Ref No/ CRN No.
Received Date:
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
Other DP Details
Modification
_____________ 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
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
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/