Form ISR – 1
(see SEBI Circular No. SEBI/HO/MIRSD/MIRSD-PoD-1/P/CIR/2023/37 dated March 16, 2023 on
Common and Simplified Norms for processing investor’s service request by RTAs and norms for
furnishing PAN, KYC details and Nomination)
REQUEST FOR REGISTERING PAN, KYC DETAILS OR CHANGES / UPDATION THEREOF
[For Securities (Shares / Debentures / Bonds, etc.) of listed companies held in physical form]
Date:___ /___ /______
A. I / We request you to Register / Change / Update the following (Tick relevant box)
󠄀 PAN 󠄀 Bank details 󠄀 Signature
󠄀 Mobile number 󠄀 E-mail ID 󠄀 Address
B. Security Details:
Name of the Issuer Company Folio No.:
Name(s) of the Security holder(s) 1.
as per the Certificate(s) 2.
3.
Number & Face value of
securities
Distinctive number of securities From To
(Optional)
C. I / We are submitting documents as per Table below (tick as relevant, refer to the
instructions):
Document / Instruction / Remark
Information
/ Details
1 PAN of (all) the (joint) holder(s)
PAN
󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀,
Whether it
is Valid
(linked to
󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀
󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀
Aadhaar):
Yes No
PAN shall be valid only if it is linked to Aadhaar by March 31, 2023*
For Exemptions / Clarifications on PAN, please refer to Objection Memo in Page
6&7
2 Demat
Account 󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀 󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀󠄀
Number Also provide Client Master List (CML) of your Demat Account, provided by the
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(Optional) Depository Participant.
3 Proof of Any one of the documents, only if there is change in the address;
Address of
the first 󠄀 Unique Identification Number (UID) (Aadhaar)
holder
󠄀Valid Passport/ Registered Lease or Sale Agreement of Residence /
Driving License
󠄀 Flat Maintenance bill accompanied with additional self-attested copy of
Identity Proof of the holder/claimant.
󠄀 Utility bills like Telephone Bill (only land line)/ Electricity bill / Gas bill -
Not more than 3 months old.
󠄀 Identity card / document with address, issued by any of the following:
Central/State Government and its Departments, Statutory / Regulatory
Authorities, Public Sector Undertakings, Scheduled Commercial Banks, Public
Financial Institutions duly attested by the employer with date and
organisation stamp
󠄀 For FII / sub account, Power of Attorney given by FII / sub-account to the
Custodians (which are duly notarized and / or apostilled or consularised) that
gives the registered address should be taken.
󠄀 Proof of address in the name of the spouse accompanied with self-
attested copy of Identity Proof of the spouse.
󠄀 Client Master List (CML) of the Demat Account of the holder / claimant,
provided by the Depository Participant.
4 Bank details Account Number: _________________________________#
(to be Bank Name: _____________________________________
updated for Branch Name: ___________________________________
first holder IFS Code: _______________________________________
in case of Provide the following:
joint
holding) 󠄀 Original cancelled cheque bearing the name of the security holder; OR
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󠄀 Bank passbook/statement attested by the Bank;
5 E-mail
address ___________________________________________#
6 Mobile
______________________________ #
* or any date as may be specified by the CBDT (DP: Depository Participant)
# In case it is not provided, the details available in the CML will be updated in the folio
Authorization: I/ We authorise you (RTA) to update the above PAN and KYC details in following
additional folio(s) held in my / our name (use Separate Annexure if extra space is required):
S. Name of the Issuer Folio No. Quantity of Face value of Distinctive number
No. Company securities securities of securities
(Optional)
in which I / We are the holder(s) (strike off what is not applicable).
Declaration: All the above facts stated are true and correct.
Holder 1 Holder 2 Holder 3
Signature
Name
Full address
PIN
󠄀󠄀󠄀󠄀󠄀󠄀󠄀 󠄀󠄀󠄀󠄀󠄀󠄀 󠄀󠄀󠄀󠄀󠄀󠄀
Mode of submission of documents to the RTA
Please use any one of the following mode:
1. Through ‘In Person Verification’ (IPV): The authorized person of the RTA shall
verify the original documents furnished by the investor and retain copy (ies) with
IPV stamping with date and initials.
2. Through Post: Hard copies of the documents which are self-attested.
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3. Through electronic mode with e-sign: The holder(s)/ claimant(s) may furnish the
documents to RTAs electronically including by way of email or through service
portal of the RTA provided the documents furnished shall have e-sign* of the
holder(s)/ claimant(s).
*E-Sign is an integrated service which facilitates issuing a Digital Signature
Certificate and performing signing of requested data by e-Sign user. The
holder/claimant may approach any of the empanelled e-Sign Service Providers,
details of which are available on the website of Controller of Certifying Authorities
(CCA), Ministry of Communications and Information Technology
([Link] for the purpose of obtaining an e-sign.
Note
Holders of physical securities in listed company are mandatorily required to furnish
PAN, KYC details (Contact details, Bank Account Details, Signature) and Nomination
(for all the eligible folios) to enable RTA to process any service request or complaints
received from the security holder(s)/ Claimants.
Upon receipt or up-dation of bank details, the RTA shall, suo-moto, generate request
to the company’s bankers to pay electronically all the moneys of / payments to the
holder that were previous unclaimed / unsuccessful.
RTA shall update the folio with PAN, KYC details and Nominee, within timelines as
mentioned in the circular no. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/670
dated November 26, 2021. However, cancellation of nomination, shall take effect
from the date on which this intimation is received by the company / RTA.
RTA shall not insist on Affidavits or Attestation / Notarization or indemnity for
registering / up-dating / changing PAN, KYC details and Nomination.
Specimen Option A
Signature i. Security holder shall provide the following documents:
(a) Original cancelled cheque with name of the security holder
printed on it; or
(b) Self-attested copy of Bank Passbook/ Bank Statement;
and
ii. Banker’s attestation of the signature of the same bank account
as mentioned in (i) above as per Form ISR - 2.
OR
Option B
The investor may get his or her signature changed or updated
by visiting the Office of the RTA in person. In such a case, the
investor shall sign before the authorized personnel of the RTA,
along with PAN card and any one additional document
mentioned at Serial Nos. 1-4 of Annexure – E of
SEBI/HO/MIRSD/MIRSD-PoD-1/P/CIR/2023/37 dated March
16, 2023, in original for verification by the RTA, and submit self-
attested copies of the same.
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Nomination** Providing Nomination: Please submit the duly filled up
Nomination Form (SH-13) or ‘Declaration to Opt out of
Nomination’ as per Form ISR–3, in SEBI Circular No.
SEBI/HO/MIRSD/MIRSD-PoD-1/P/CIR/2023/37 dated March
16, 2023
Variation in Existing Nomination: Please use Form SH-14
Cancellation of Existing Nomination and opting out: use Form SH-
14 & Form ISR – 3
** Nomination (Form SH-13 or SH-14) / ‘Declaration to Opt-Out of nomination’ (Form ISR –
3), has to be furnished by the holder(s) separately for each listed company.
(Page 6 & 7 is for information to investors; print out of the same is not required)
Page 5 of 7
Objection Memo that can be raised by the RTA
(only if the relevant document / details is / are not available in the folio or if there is a
mismatch / discrepancy in the same or change thereof)
Note
RTAs shall raise all objections, if any / at all, in one instance only; the RTA shall not
raise further objections on the same issue again and again, after the holder / claimant
furnishes all the prescribed documents and details, unless there is any deficiency /
discrepancy in the same.
No. Item Documents / Details to be provided to the RTA by
the holder(s) / claimant(s)
1 PAN – Exceptions ‘Exemptions/clarifications to PAN’, as provided in clause
and Clarification D to ‘Instructions/Check List for Filing KYC Forms’ in
Annexure – 1 to SEBI circular No. MIRSD/SE/Cir-
21/2011 dated October 05, 2011 on Uniform Know Your
Client (KYC) Requirements for the Securities Market,
shall also applicable for holder(s) / claimant(s) of
securities held in physical mode.
2 Minor mismatch in The RTA shall intimate the holder at the existing address,
Signature - minor seeking objection, if any, within 15 days
3 Major mismatch in Option A
Signature or its
non-availability i. Security holder shall provide the following
with the RTA documents:
(a) Original cancelled cheque with name of the
security holder printed on it; or
(b) Self-attested copy of Bank Passbook/Bank
Statement;
and
ii. Banker’s attestation of the signature of the same
bank account as mentioned in (i) above as per Form
ISR - 2
OR
Option B
The investor may get his or her signature changed or
updated by visiting the Office of the RTA in person. In
such a case, the investor shall sign before the
authorized personnel of the RTA, along with PAN card
and any one additional document mentioned at Serial
Nos.1-4 of Annexure – E of SEBI Circular No.
SEBI/HO/MIRSD/MIRSD-PoD-1/P/CIR/2023/37
dated March 16, 2023, in original for verification by the
RTA, and submit self-attested copies of the same.
4 Mismatch in Name Furnish any one of the following documents, explaining
the difference in names;
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Unique Identification Number (UID) (Aadhaar)
Valid Passport
Driving license in Smart Card form, Book form or copy
of digital form
Identity card / document with applicant’s Photo,
issued by any of the following: Central / State
Government and its Departments, Statutory /
Regulatory Authorities, Public Sector Undertakings,
Scheduled Commercial Banks, Public Financial
Institutions.
PAN card with photograph
Marriage certificate
Divorce decree
5 Present address of In case the signature of the holder matches with the
the holder is not record available with the RTA, the request for change in
matching with the address may be processed within the prescribed
address available timelines.
in the folio
In case there is a difference in signature, the RTA shall
follow the procedure as prescribed for mismatch in
signature as laid down at Para – 1 of Annexure C of SEBI
Circular No. SEBI/HO/MIRSD/MIRSD-PoD-1/P/CIR/
2023/37 dated March 16, 2023
(Page 6 & 7 is for information to investors; print out of the same is not required)
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