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Bank Details Modification Request Form

This document is a Bank Details Addition/Modification Request Form for updating bank account information associated with trading and demat accounts. It requires personal and financial details of account holders, along with supporting documents for verification. The form must be filled out in block letters and includes sections for signatures and office use only.

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mayank23.mj
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8 views1 page

Bank Details Modification Request Form

This document is a Bank Details Addition/Modification Request Form for updating bank account information associated with trading and demat accounts. It requires personal and financial details of account holders, along with supporting documents for verification. The form must be filled out in block letters and includes sections for signatures and office use only.

Uploaded by

mayank23.mj
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

BANK DETAILS ADDITION / MODIFICATION REQUEST FORM

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

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

Trading code Date D D M M Y Y

CDSL DP A/C No. 1 2 0


NSDL DP A/C No. I N 3 0 3 6 5 5
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

Bank Details New Details


Bank Name

A/C Number

□ Primary IFSC
0
MICR

Bank Name

A/C Number

□ Secondary IFSC
0
MICR

Supporting DocumentEnclosed
□Copy of latest bank Passbook □Copy of latest bank statement Original □Cancelled Cheque
(With Preprinted name ofaccount holder, IFSC Code & MICR Code)

Financial Details
 Below Rs 1 Lakh  Rs 1 - 5 Lakh  Rs 5 - 10 Lakh
Gross Annual Income Details (Please Specify)  lRs 10 - 25 Lakh  Above Rs 25 Lakh

Net worth (should not be older than 1 year)(Mandatory for Rs. ____________as on date / /20 _
Non- Individual)

#Provide document in support of financial details (mandatory for Derivatives)


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
Client Sign /Sub
Brokerwith
Stamp

For Office Use only:

Maker Checker Date D D M M Y Y

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