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Account Modification Request Form

This document is a request form for adding, modifying, or deleting account details for trading, CDSL, or commodity accounts. It requires the account holder's personal information, the type of change requested, and signatures from all holders. An acknowledgment section confirms receipt of the request by the depository participant.

Uploaded by

Swapnil Parikh

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0% found this document useful (0 votes)

443 views2 pages

Account Modification Request Form

Uploaded by

Swapnil Parikh

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 CLIENT ID

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

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 CLIENT ID

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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Account Modification Request Form

Uploaded by

Account Modification Request Form

Uploaded by

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)

Account Holder Details:

NAME OF SECOND HOLDER

NAME OF THIRD HOLDER

Details: Please specify ‘Change of Type of change: Please

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

🖋 Please sign here First/Sole Holder or

Originals Verified and Documents Received ▢ Certified Copies

Organization Name Moneylicious Securities Private Limited

🖋 Employee sign here ( Moneylicious Securities Private Limited )

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

NAME OF FIRST / SOLE HOLDER

NAME OF SECOND HOLDER

NAME OF THIRD HOLDER

MODIFICATION REQUEST FOR

Signature and Seal

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