MONEYLICIOUS SECURITIES PVT. LTD.
A 302 THE WESTERN EDGE I, OFF WESTERN EXPRESS HIGHWAY
BORIVALI EAST, Mumbai -400066 Tel No. 022 43116666
E-mail ID dp@[Link], DP ID – 12083400
Account Details Addition / Modification / Deletion Request Form
MONEYLICIOUS SECURITIES PVT. LTD.
A-302 THE WESTERN EDGE I, OFF WESTERN EXPRESS HIGHWAY
BORIVALI EAST, Mumbai -400066 Tel No. 022 43116666
E-mail ID dp@[Link], DP ID – 12083400
Application no: Date D D M M Y Y Y Y
Please fill all the details in Block Letters in English
DP ID Client ID
Account Holder’s Details
Name of First / Sole Holder
Name of Second Holder
Name of Third Holder
I/We request to carry out the change of correspondence/permanent address / signature in the demat account
I/We request to carry out the change of address / signature in the KRA and demat account
I/We request you to make the following additions / modifications / deletions to my/our account in your records.
DETAILS
(Please specify change of Addition /
correspondence Modification / Existing Details New Details
/permanent address, Deletion
bank details, telephone (Please specify)
number, sub-status etc.)
Attach an Annexure (with signature(s)) if the space above is found insufficient.
First / Sole Holder Second Holder Third Holder
Name
Signature
Acknowledgement Receipt
Received Account Details Addition / Modification / Deletions request as per details given below:
Application No. Date
DP ID Client ID
Name of the Sole / First Holder
Name of Second joint Holder
Name of Third joint Holder
Modification requested for[Specify reason]
Depository Participant Seal and Signature