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Account Modification Request Form

This document is a request form for adding, modifying, or deleting account details related to a demat account. It requires information such as DP ID, client ID, PAN, and AADHAAR, along with the names of account holders and the specific changes requested. The form also includes sections for attestation and acknowledgment by the organization handling the request.

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0% found this document useful (0 votes)
265 views2 pages

Account Modification Request Form

This document is a request form for adding, modifying, or deleting account details related to a demat account. It requires information such as DP ID, client ID, PAN, and AADHAAR, along with the names of account holders and the specific changes requested. The form also includes sections for attestation and acknowledgment by the organization handling the request.

Uploaded by

getsharmagunjan
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 DETAILS ADDITION / MODIFICATION / DELETION REQUEST FORM

CHANGE ACCOUNT DETAILS ▢ Trading ▢ CDSL ▢ Commodity

APPLICATION NO: Date D D M M Y Y Y Y

(Please fill all details in BLOCK LETTERS in English)

DP ID 12083400 CLIENT ID (Last 8 digit of Demat account number)

PAN AADHAAR

Account Holder Details:


NAME OF FIRST/SOLE HOLDER

NAME OF SECOND HOLDER

NAME OF THIRD HOLDER

TICK EITHER ONE BOX OR BOTH BOXES TO SPECIFY CHANGE ▢ Permanent Address ▢ Correspondence Address

▢ I / We request to carry out the change of 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 Type of change: Please


address’, ‘Change of bank details’, specify if addition / Existing details New details
‘Change of telephone number’, etc. modification / deletion

Modification

Addition

Deletion

NOTE: Attach an annexure [duly signed by the account holder(s)] in the above format if the space is not sufficient.

Name of First Holder Name of Second Holder Name of Third Holder

🖋 Please sign here First/Sole Holder or


Guardian (in case of Minor) 🖋 Please sign here (Second Holder) 🖋 Please sign here (Third Holder)

1
ATTESTATION / FOR OFFICE USE ONLY

Originals Verified and Documents Received ▢ Certified Copies

Organization Name Moneylicious Securities Private Limited

Documents Verified and In-Person Verification done by (Details of the Employee / Stock Broker / Authorised Person)

Name

Employee Code

Designation

Branch

Date D D / M M / Y Y Y Y

Place ▢ India

Signature
Stamp and Seal

🖋 Employee sign here ( Moneylicious Securities Private Limited )

----------------------------------------------------------------------------------(Please tear here)-----------------------------------------------------------------------------------

Acknowledgement
Application Number: Date:

We have received the account modification/addition/deletion request for the account with details below:
DP ID 12083400 CLIENT ID (Last 8 digit of Demat account number)

NAME OF FIRST / SOLE HOLDER

NAME OF SECOND HOLDER

NAME OF THIRD HOLDER

MODIFICATION REQUEST FOR

Signature and Seal


(Depository Participant)

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