IIFL Capital Services Limited
(Formerly known as IIFL Securities Limited)
701, Ackruti Centre Point, Central Road, Marol MIDC, Andheri East, Mumbai – 400093, Maharashtra.
PLEDGE REQUEST FORM (PRF)
r Setup of Pledge r Confirmation of Pledge
PRF No. __________________
(Please fill all the details in BLOCK LETTERS in English) Date: / / 20
I/We request you to create the pledge/ confirm the creation of pledge for the following securities. I/ We have read and understood the
Depositories Act, SEBI Regulations and the Bye Laws in relation to pledge of securities and I/ We agree to abide by and be bound by the Act,
Regulations and the Bye Laws as are in force from time to time for such pledges.
Pledgor’s Details
DP ID 1 2 0 4 4 7 0 0 Client ID
1 3 0 1 4 4 0 0
Pledgor’s Name 1.
2.
3.
Pledgee’s Details
DP ID Client ID
Pledgee’s Name 1.
2.
3.
Details of Securities: r Free Securities r Locked – in Securities
Details of Securities offered for Pledge:
Sr. ISIN Company Name Quantity Date of PSN (System Accepted/ Pledge Value
No Release Generated) Rejected by (`)
(Lock-in) Pledgee
Attach an annexure duly signed by the account holder(s), if the space above is insufficient.
Pledge Execution Date
Pledge Expiry Date
Agreement No.
Date of Pledging
Pledge Reason (tick mark Collateral -Debt I Collateral for loan Collateral for loan by Margin Pledge/ MTF Personal use by
whichever is applicable) issuance by by Company/ the Third Party for Exchange Trade promoters and PACs
Company/Group Co. Group Co.
PAN of the Ultimate Lender
Note : As a pledgor and pledgee, We are aware that the pledge recorded in the system only prohibits the Pledgor from dealing with
securities until redemption/maturity/expiry date of the securities pledged and that the records of pledged securities may be removed from
the system as a result of redemption/maturity/expiry of the securities.
Undertaking
• The pledgee undertakes to provide reasonable notice to the pledger and comply with the requirements of Sections 176 and 177 of the Indian Contract Act,
1872.
• The pledger and pledgee undertake to abide with the provisions of the Indian Contract Act, 1872, the Depositories Act, SEBI Regulations, circulars, and bye-
laws in force from time to time, as may be applicable.
To be filled and signed in case of Set-up of Pledge by Pledgor BO
Signature of the Pledgor
First/ Sole Applicant Second Applicant Third Applicant
To be filled in case of acceptance of Pledge by Pledgee BO
Signature of the Pledgee(s)*
First/ Sole Applicant Second Applicant Third Applicant
*If the Pledgee is a bank DP, the signature of the Pledgee need not be taken on the Pledge request form.
IIFL Capital Services Limited