Registration Form


Client Type
Name*

PAN *
Marital Status*

Gender
DOB *

Citizenship: *
Residential status: *

Occupation *

Proof of Identity

POI (Proof of Indetitity) one document to be uploaded as a proof *
  

Permanent Address


Cerified copy of any one of the following Proof Of Address[POA] needs to be submitted

Address Type*
Proof Of Address *


POA (Proof of Address) one document to be uploaded as a proof *
  

ADDRESS :

LINE 1 : *
LINE 2 : *

LINE 3 : *
CITY / TOWN / VILLAGE : *

DISTRICT : *
STATE : *

PIN/POST CODE : *



ADDRESS :

LINE 1 : *
LINE 2 : *

LINE 3 : *
CITY / TOWN / VILLAGE : *

DISTRICT : *
STATE : *

PIN/POST CODE : *

POA (Proof of Correspondence Address) one document to be uploaded as a proof *
  

Contact Details


TEL (Off) :
TEL (Res) :

MOBILE : *
EMAIL ID : *

Photo

Photo *
  


Depository Details

Depository: *

DP ID *
Client Beneficiary ID *

Gross Annual income/Net-worth details

Gross Annual Income Details (please specify) : Income Range per annum: Below Rs
OR
Net-worth as on (date)


Past Actions

Details of any action/proceedings initiated/pending/ taken by SEBI/ Stock exchange any other authority against the applicant/constituent or its Partners/promoters/whole time directors/authorized persons in charge of dealing in securities / commodity futures and options during the last 3 years

Politically Exposed Person (PEP) *
Related to a Politically Exposed Person (PEP)*


GST Declaration


Do You Have GST ? *

GST NO *
Address Line 1 *

Address Line 2 *
Address Line 3 *

City *
State *

Pin Code *
GST Certificate *
  

Terms & Conditions and Undertaking