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Account Details Modification Request Form

This document is an account details addition/modification/deletion request form for a trading and demat account. It requests changes to contact details, addresses, bank details, email IDs and contact numbers. Supporting documents are required for any changes and may include identification documents, address proofs, bank statements or passbooks. The client declares that all information provided is true and correct and agrees to inform the company of any future changes.

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Raju Mondal
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249 views1 page

Account Details Modification Request Form

This document is an account details addition/modification/deletion request form for a trading and demat account. It requests changes to contact details, addresses, bank details, email IDs and contact numbers. Supporting documents are required for any changes and may include identification documents, address proofs, bank statements or passbooks. The client declares that all information provided is true and correct and agrees to inform the company of any future changes.

Uploaded by

Raju Mondal
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Account Modification Request Form

ACCOUNT DETAILS ADDITION/MODIFICATION /DELETION REQUEST FORM

Regd office address: 11/6B, Shanti Chamber, Pusa Road, New Delhi – 110 005
CRF & DP office address: 9B, Netaji Subhash Marg, Daryaganj, Delhi – 110 002

Please fill the details in BLOCK letters in English(Strike Off, If not applicable)

Application No Date D D M M Y Y Y Y

Trading A/C No. Demat A/C No. 1 2 0 1 9 1 0 1


AAcA/c No
Account Holders Details
Name of First Holder
Name of Second Holder
Name of Third Holder

I/We request you to make the following changes to my/our account in your records.

□ Trading Account □ Demat Account □ Both

Please tick the details to be change.


Address Bank Email-ID Contact No
□Correspondence □ Addition □ Addition □ Addition
□ Permanent □ Modification □ Modification □ Modification
 Addition of bank details will be added only in Trading account & will not be considered for funds payout purpose.
Supporting Document
Fields Existing Details New Details
Enclosed
□ Valid Passport
□ Valid Driving License
□ Voter Id Card
□ Ration Card
□ Telephone Bill(landline)*
Address Details □ Electricity Bill*
□ Bank Passbook / Bank
Statement*
□ Registered Lease / Sale
Agreement of residence
□ If others, Please specify,
_____________________
*Not more than three months old
□ Copy of latest bank Passbook
Bank Details □ Copy of bank statement
(Not more than three months)
□ Original Cancelled Cheque
(With Preprinted name of
account holder)
Email ID Duplicate email id is not accepted.
Duplicate Mobile Number is not
Contact No accepted.

SMS/Email Alert □ SMS □ Email □ Both Tick any one to receive transaction
alert by Stock Exchange
Facility
(for Trading A/c Only)
I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/We undertake to inform you of any
changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting. I am/we are aware that
I/we may be held liable for it.
1ST Holder 2nd Holder 3rd Holder Verified By Branch /Sub Broker
Signature Of Client with Stamp
For Office Use only:
Maker Checker Date

ACCOUNT DETAILS ADDITION/MODIFICATION /DELETION REQUEST FORM Regd office address: 11/6B, Shanti Chamber, Pusa Roa

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