Wellindia Equity Including BSDA

Branch Tag
Client Code
Wellindia Securities Ltd.
File No.
INDIVIDUAL / CORPORATE
Client Registration Form
Wellindia Securities Limited

(Trading & Clearing Member)
SEBI Registration Numbers :
Exchange
National Stock Exchange
Bombay Stock Exchange
MCX Stock Exchange
United Stock Exchange of India
Segment
Capital Market, Derivatives, Currency
Capital Market, Derivatives
Currency Derivatives
Currency Derivatives
Registered with SEBI Since

24/05/2007, 24/05/2007, 27/08/2008
07/09/2007, 01/08/2011
29/09/2008
18/06/2010
SEBI Registration Nos.: NSE -INB/INF/INE 231282931, BSE -INB/INF 011282937,

MCX-SX-INE261282931, USE -INE271282936
Corp. Office : A-78, Sector 2, Noida-201301, Uttar Pradesh
Regd. Office : 1249, Sector 19, Faridabad-121002 Haryana
Tel.: +91-9990799941-48 Fax : 0120-4313311
E-mail : [email protected] Website : www.wellindia.com
Clearing Member for : NSE, CURRENCY DERIVATIVE & MCX-SX, CURRENCY DERIVATIVE :
Name : GLOBE CAPITAL MARKET LIMITED
Address : 609, Ansal Bhawan, 16, Kasturba Gandhi Marg, New Delhi-110001 Tel.: 23316916-20
SEBI Regn. No.: (NSE Currency) INE 230663732, Clg. Code : M50302
SEBI Regn. No.: (MCX-SX) INE 260663732, Clg. Code : 1004
CEO
Compliance Officer
RAVI PRAKASH GUPTA
Ph. : 9990799988
E-mail : [email protected]
RAJIV AGRAWAL
Ph. : 9990799941-47
E-mail : [email protected]
For any grievance/dispute please contact WELLINDIA SECURITIES LIMITED at the above address or email [email protected] and Phone No. +91-9990799941-48. In case not satisfied with the response, please contact the
concerned exchange(s) at
Exchange Name
E-mail ID
Phone No.
National Stock Exchange of India Ltd.
[email protected]
011-23344313
Bombay Stock Exchange Ltd.
[email protected]
011-43007413
MCX Stock Exchange Ltd.
[email protected]
022-67319000
United Stock Exchange Ltd.
[email protected]
011-43007413
ACKNOWLEDGEMENT
To,
Dated :...................................

I/We hereby acknowledge the receipt of duly executed copy of Right and Obligations, Risk Disclosure Document & Guidance Note with
duly executed copy of KYC and other documents. Further I/We confirm that the supporting documents for KYC submitted by me/us are
true and correct. I/We acknowledge that the other details related to my/our account are as under:
Name..................................................................... Address............................................................................................................
......................................................................................................................Trading Code.............................................................
UCC....................................................... My Email Id.......................................................................................................................
(Signature of Client)
INSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM

A.
1.
IMPORTANT POINTS:
Self attested copy of PAN card is mandatory for all clients, including Promoters/Partners/Karta/Trustees and whole
time directors and persons authorized to deal in securities on behalf of company/firm/others.
2. Copies of all the documents submitted by the applicant should be self-attested and accompanied by originals for
verification. In case the original of any document is not produced for verification, then the copies should be properly
attested by entities authorized for attesting the documents, as per the below mentioned list.
3. If any proof of identity or address is in a foreign language, then translation into English is required.
4. Name & address of the applicant mentioned on the KYC form, should match with the documentary proof submitted.
5. If correspondence & permanent address are different, then proofs for both have to be submitted.
6. Sole proprietor must make the application in his individual name & capacity.
7. For non-residents and foreign nationals, (allowed to trade subject to RBI and FEMA guidelines), copy of passport/PIO
Card/OCI Card and overseas address proof is mandatory.
8. For foreign entities, CIN is optional; and in the absence of DIN no. for the directors, their passport copy should be
given.
9. In case of Merchant Navy NRI's, Mariner's declaration or certified copy of CDC (Continuous Discharge Certificate) is
to be submitted.
10. For opening an account with Depository participant or Mutual Fund, for a minor, photocopy of the School Leaving
Certificate/Mark sheet issued by Higher Secondary Board/Passport of Minor/Birth Certificate must be provided.
11. Politically Exposed Persons (PEP) are defined as individuals who are or have been entrusted with prominent public
functions in a foreign country, e.g., Heads of States or of Governments, senior politicians, senior Government/judicial/
military officers, senior executives of state owned corporations, important political party officials, etc.
B. Proof of Identity (POI) : - List of documents admissible as Proof of Identity:
1. Unique Identification Number (UID) (Aadhaar)/ Passport/ Voter ID card/ Driving license.
2. PAN card with photograph.
3. 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, Colleges affiliated to Universities, Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council
etc., to their Members; and Credit cards/Debit cards issued by Banks.
C. Proof of Address (POA): - List of documents admissible as Proof of Address:
(*Documents having an expiry date should be valid on the date of submission.)
1. Passport/ Voters Identity Card/ Ration Card/ Registered Lease or Sale Agreement of Residence/ Driving License/ Flat
Maintenance bill/ Insurance Copy.
2. Utility bills like Telephone Bill (only land line), Electricity bill or Gas bill - Not more than 3 months old.
3. Bank Account Statement/Passbook -- Not more than 3 months old.
4. Self-declaration by High Court and Supreme Court judges, giving the new address in respect of their own accounts.
5. Proof of address issued by any of the following: Bank Managers of Scheduled Commercial Banks/Scheduled CoOperative Bank/Multinational Foreign Banks/Gazetted Officer/Elected representatives to the Legislative
Assembly/Parliament/Documents issued by any Govt. or Statutory Authority.
6. 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, Colleges affiliated to Universities and Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to
their Members.
7. For FII/sub account, Power of Attorney given by FII/sub-account to the Custodians (which are duly notarized and/or
apostiled or consularised) that gives the registered address should be taken.
8. The proof of address in the name of the spouse may be accepted.
D. Exemptions/clarifications to PAN
(*Sufficient documentary evidence in support of such claims to be collected.)
1. In case of transactions undertaken on behalf of Central Government and/or State Government and by officials
appointed by Courts e.g. Official liquidator, Court receiver etc.
2. Investors residing in the state of Sikkim.
3. UN entities/multilateral agencies exempt from paying taxes/filing tax returns in India.
4. SIP of Mutual Funds upto Rs 50, 000/- p.a.
5.
In case of institutional clients, namely, FIIs, MFs, VCFs, FVCIs, Scheduled Commercial Banks, Multilateral and Bilateral
Development Financial Institutions, State Industrial Development Corporations, Insurance Companies registered with
IRDA and Public Financial Institution as defined under section 4A of the Companies Act, 1956, Custodians shall verify
the PAN card details with the original PAN card and provide duly certified copies of such verified PAN details to the
intermediary.
E. List of people authorized to attest the documents:
1. Notary Public, Gazetted Officer, Manager of a Scheduled Commercial/ Co-operative Bank or Multinational Foreign
Banks (Name, Designation & Seal should be affixed on the copy).
2. In case of NRIs, authorized officials of overseas branches of Scheduled Commercial Banks registered in India, Notary
Public, Court Magistrate, Judge, Indian Embassy /Consulate General in the country where the client resides are
permitted to attest the documents.
F. In case of Non-Individuals, additional documents to be obtained from non-individuals, over & above the
POI & POA, as mentioned below:
Types of entity
Documentary Requirments
Corporate
Copy of the balance sheets for the last 2 financial years (to be submitted every year).
Copy of latest share holding pattern including list of all those holding control, either directly or
indirectly, in the company in terms of SEBI takeover Regulations, duly certified by the
company secretary/Whole time director/MD (to be submitted every year).
Photograph, POI, POA, PAN and DIN numbers of whole time directors/two directors in
charge of day to day operations.
Photograph, POI, POA, PAN of individual promoters holding control-either directly or
indirectly.
Copies of the Memorandum and Articles of Association and certificate of incorporation.
Copy of the Board Resolution for investment in securities market.
Authorised signatories list with specimen signatures.
Partnership Firm
Certificate of registration (for registered partnership firms only).
Copy of partnership deed.
Authorised signatories list with specimen signatures.
Photograph, POI, POA, PAN of Partners.
Trust
Certificate of registration (for registered trust only).
Copy of Trust deed. List of trustees certified by managing trustees/CA.
Photograph, POI, POA, PAN of Trustees.
HUF
PAN of HUF.
Deed of declaration of HUF/ List of coparceners.
Bank pass-book/bank statement in the name of HUF.
Photograph, POI, POA, PAN of Karta.
Unincorporated
association or a
body of individuals
Proof of Existence/Constitution document.

Resolution of the managing body & Power of Attorney granted to transact business on its
behalf.
Authorized signatories list with specimen signatures.
Banks/Institutional
Investors
Foreign Institutional
Investors (FII)
Copy of the constitution/registration or annual report/balance sheet for the last 2 financial years.
Army Government
Bodies
Self-certification on letterhead.
Registered Society
Copy of SEBI registration certificate.

Copy of Registration Certificate under Societies Registration Act.

List of Managing Committee members.
Committee resolution for persons authorised to act as authorised signatories with specimen signatures.
True copy of Society Rules and Bye Laws certified by the Chairman/Secretary.
ANNEXURE - 1
ACCOUNT OPENING KIT

INDEX OF DOCUMENTS
MANDATORY DOCUMENTS AS PRESCRIBED BY SEBI & EXCHANGES
S.No.
1.
2.
Name of the Document
Brief Significance of the Document
Account Opening Form
A. KYC Form - Document captures the basic information

about the constituent and an instruction / check list.
1-4
B. Document captures the additional information about the constituent

relevant to trading account and an instruction / check list.
5-8
C. Additional KYC Form For Opening a Demat Account
9-13
Rights and Obligations
Page No.
Document stating the Rights & Obligations of stock broker/ trading

member, sub-broker and client for trading on exchanges (including
additional rights & obligations in case of internet/wireless technology
based trading).
As per
Separate
Document detailing risks associated with dealing in the securities market. Printout
3.
Risk Disclosure Document (RDD)
4.
Guidance Note
Documents detailing do's and don'ts for trading on exchange,

for the education of the investors.
5.
Policies and Procedures
Document describing significant policies and procedure of the stock broker.
6.
Brokerage Structure
Document detailing the rate / amount of brokerage and other

charges levied on the client for trading on the stock exchange(s)
14-15
16
VOLUNTARY DOCUMENTS AS PROVIDED BY THE STOCK BROKER

S.No.
1.
2.
3.
4.
5.
6.
7.
8.
Name of the Document
Brief Significance of the Document
Letter where in Client Authorises Stock Broker to

maintain running account and to accept verbal orders etc.
Where the client wishes to open a demat account with us as
CDSL DP
Page No.
1.
Letter of Authority
2.
CDSL Form
3.
Following formats related to account opening and modifications are available at our
website www.wellindia.com in download section.
17-18
19-28
INSTRUCTIONS FOR THE APPLICANTS FOR FILLING ACCOUNT OPENING FORM (DEMAT ACCOUNT)
Signatures can be in English or Hindi or any of the other languages contained in the 8th schedule of the Constitution of India. Thumb
impressions and signatures other than the above mentioned languages must be attested by a Magistrate or a Notary Public or a
Special Executive Magistrate under his/her official seal.
Signatures should be preferably in black ink and at all places marked
Details of the Names, Address and Tel No. etc. of the Magistrate / Notary Public / Special Executive Magistrate are to be provided in
case of any attestation done by them.
In case of additional signatures (For accounts other than individuals), separate annexures should be attached to the application form.
In case of applications under a Power of Attorney, the relevant Power of Attorney or the certified and duly notarized copy thereof must
be lodged alongwith the application.
All correspondence / queries shall be addressed to the first / sole applicant.
Strike off whichever is not applicable.
Please submit the following documents alongwith A/c opening form.
ADDITIONAL DOCUMENTS FOR SPECIAL TYPE OF ACCOUNTS (DEMAT ACCOUNT ONLY)

Accounts of Minors
1. Birth certificate of the minor. 2. Proof of identity and address documents of the guardian as above. 3. One photograph of the
minor and one of the guardian with guardians signature across both the photographs. 4. PAN card of the minor.
MANDATORY DOCUMENT
Acknowledgement No.
KNOW YOUR CLIENT (KYC) APPLICATION FOR INDIVIDUALS

PHOTOGRAPH
NEW
CHANGE REQUEST (Please tick the appropriate)
Please fill this form in ENGLISH and in BLOCK LETTERS
(Please tick the box on left margin of appropriate row where CHANGE/CORRECTION
is required and provide the details in the corresponding row)
Please affix
the recent
passport size
photograph
and sign across it
A IDENTITY DETAILS
Name of the Applicant

: ........................................................................................................................................
(As Appearing in Supporting Identification Documents)
Father's/Spouse Name
: ........................................................................................................................................
Gender
Date of Birth
Status
Male
Female
Resident Individual
Marital Status :
Single
Nationality :
Indian
Non Resident
Married
Other..........................
(Please Specify)
Foreign National
Permanent Account Number (PAN) :

Unique Identification Number (UID) / Aadhaar, if any : ...........................................................................................................
Specify the proof of identity submitted :
Other..........................(Please Specify)
PAN Card
B ADDRESS DETAILS
Correspondence Address
: .........................................................................................................................................
.........................................................................................................................................
City/Town/Village : ................................................. State : ..............................................
Country: .................................................................. Pin Code :
Contact Details
: Tel.: (O) ..................................................... Tel. (R) .........................................................

Mobile ...................................................... Fax ..............................................................
E-mail ..............................................................................................................................
Specify the proof of address submitted : .........................................................................................................................................

for correspondence address
Validity Expiry Date of Proof of Address Submitted D D M M Y Y Y Y
Permanent Address
(If different from above or
overseas address, mandatory
for Non-Resident Applicant)
: .........................................................................................................................................
.........................................................................................................................................
Country: .................................................................. Pin Code :
Specify the proof of address

submitted for Permanent address
: .........................................................................................................................................
Validity Expiry Date of Proof of Address Submitted
(1)
D D
M M
Y Y Y Y
MANDATORY DOCUMENT
C OTHER DETAILS
Gross Annual Income Details : Income Range per annum :
(please specify)
Rs. 5 Lac to 10 Lac
Below Rs. 1 Lac
Rs. 1 Lac to 5 Lac
Rs. 10 Lac to 25 Lac
>25 Lac
Net-worth as on (date)............................................... D D
(Net worth should not be older than 1 year)
M M
OR
Y Y Y Y
Occupation
(please tick any one
and give brief details)
Please tick, if applicable
Any other information
: .........................................................................................................................................
Private Sector
Agriculturist
Public Sector
Retired
Government Service
Housewife
Politically Exposed Person (PEP)
Student
Business
Professional
Others_________Please Specify
Related to Politically Exposed Person (PEP)
D DECLARATION
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I 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 aware that I may be held liable for it.
Date : D D
Signature of the Applicant
M M
Y Y Y Y
FOR OFFICE USE ONLY

In Person Verification (IPV) Details :
Name of the person who has done the IPV :

...............................................................................................................
Designation :..........................................................................................
Seal/Stamp of the Intermediary
Employee ID :........................................................................................
Name of the Organization : WELLINDIA SECURITIES LIMITED
Date of IPV:
D D
M M
Y Y Y Y
Signature of the person who has done the IPV
(Originals verified) True Copies of documents received

(Self-Attested) Self Certified Document copies received
Date
Signature of the Authorised Signatory
(2)
MANDATORY DOCUMENT
Acknowledgement No.
KNOW YOUR CLIENT (KYC) APPLICATION FOR INDIVIDUALS
Please Tear Here
Please note that the KYC Application Form and overleaf instructions should be printed on the same page (back to back). If printed separately then both the pages should be attached and signed by the applicant.

PHOTOGRAPH
NEW
Please affix
the recent
passport size
photograph
and sign across it
A IDENTITY DETAILS

: ........................................................................................................................................
(As Appearing in Supporting Identification Documents)
Father's/Spouse Name
: ........................................................................................................................................
Gender
Date of Birth
Status
Male
Female
Resident Individual
Marital Status :
Single
Nationality :
Indian
Non Resident
Married
Other..........................
(Please Specify)
Foreign National

Unique Identification Number (UID) / Aadhaar, if any : ...........................................................................................................
Specify the proof of identity submitted :
Other..........................(Please Specify)
PAN Card
B ADDRESS DETAILS
: .........................................................................................................................................
.........................................................................................................................................
Country: .................................................................. Pin Code :
Contact Details
: Tel.: (O) ..................................................... Tel. (R) .........................................................

Mobile ...................................................... Fax ..............................................................
E-mail ..............................................................................................................................

Permanent Address
(If different from above or
overseas address, mandatory
for Non-Resident Applicant)
: .........................................................................................................................................
.........................................................................................................................................
Country: .................................................................. Pin Code :

submitted for Permanent address
: .........................................................................................................................................
(3)
D D
M M
Y Y Y Y
MANDATORY DOCUMENT
Please Tear Here
Please note that the KYC Application Form and overleaf instructions should be printed on the same page (back to back). If printed separately then both the pages should be attached and signed by the applicant.
C OTHER DETAILS
Gross Annual Income Details : Income Range per annum :
(please specify)
Rs. 5 Lac to 10 Lac
Below Rs. 1 Lac
Rs. 1 Lac to 5 Lac
>25 Lac
Net-worth as on (date)............................................... D D
(Net worth should not be older than 1 year)
M M
OR
Y Y Y Y
Occupation
(please tick any one
and give brief details)
Please tick, if applicable
: .........................................................................................................................................
Private Sector
Agriculturist
Public Sector
Retired
Government Service
Housewife
Student
Business
Professional
Others_________Please Specify
D DECLARATION
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I 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 aware that I may be held liable for it.
Date : D D
Signature of the Applicant
M M
Y Y Y Y
FOR OFFICE USE ONLY


...............................................................................................................
Designation :..........................................................................................
Employee ID :........................................................................................
Date of IPV:
D D
M M
Y Y Y Y

Date
(4)
MANDATORY DOCUMENT
Acknowledgement No.
KNOW YOUR CLIENT (KYC) APPLICATION FOR NON-INDIVIDUALS

PHOTOGRAPH
NEW
Please affix
the recent
passport size
photograph
and sign across it
IDENTITY DETAILS
: ........................................................................................................................................
Date of incorporation
Place of incorporation
: ........................................................................................................................................
Date of commencement of business :

Registration No. (e.g. CIN)
: ........................................................................................................................................
Status (Please tick any one)
Private Limited Co.

NGO's
FI
Public Ltd. Co.
FII
HUF
Defense Establishment
BOI
Body Corporate
Partnership
Trust
Charities
AOP
Bank
Govt. Body
Non-Govt. Organization
Society
LLP
Others_____________(Please Specify)
ADDRESS DETAILS
: .........................................................................................................................................
.........................................................................................................................................
Country: .................................................................. Pin Code :
Contact Details
: Tel.: (O) ..................................................... Tel. (R) .........................................................

Mobile ...................................................... Fax ..............................................................
E-mail ..............................................................................................................................

Registered Address
(If different from above)
: .........................................................................................................................................
.........................................................................................................................................
Country: .................................................................. Pin Code :

submitted for Registered address
: .........................................................................................................................................
(5)
D D
M M
Y Y Y Y
MANDATORY DOCUMENT
OTHER DETAILS
Below Rs. 1 Lac
Rs. 1 Lac to 5 Lac
Gross Annual Income Details: Income Range per annum :
(please specify)
Rs. 5 Lac to 10 Lac
Rs. 25 Lac to 1 Crore
>1 Crore
Net Worth (Net worth should not be older than 1 year) Amount Rs..............................................................................
as on (date) D D M M Y Y Y Y
Name, PAN, Residential Address and photographs of Promoters/Partners/Karta/Trustees and whole time directors :
If space is insufficient, enclosed these details separately (illustrative format enclosed)
............................................................................................................................................................................................
DIN/UID OF Promoters/Partners/Karta and whole time directors :.................................................................................
If space is insufficient, enclosed these details separately (illustrative format enclosed)
Please tick, if applicable, for any of your authorised signatories/Promoters/Partners/Karta/Trustees/whole time directors :
: .........................................................................................................................................
D DECLARATION
I/We hereby declare that the details furnished above are true and correct to the best of my/are 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.
Date : D D
Name & Signature of the Director / Authorised Signatory(ies)
M M
Y Y Y Y
FOR OFFICE USE ONLY


...............................................................................................................
Designation :..........................................................................................
Employee ID :........................................................................................
Date of IPV:
D D
M M
Y Y Y Y

Date
(6)
Details of Promoters/Partners/Karta/Trustees and whole time directors forming a part of

Know Your Client (KYC) Application Form for Non-Individuals
Name of Applicant
PAN of the Applicant
1. Name
PHOTOGRAPH
2. Relationship with Applicant (i.e. promoters, whole time directors etc.)

3a. PAN
3b. DIN/ UID
Please affix
your recent passport
size photograph and
sign across it
4. Residential/ Registered Address
City / Town / Village
Pin Code
Country
State
5. Please tick, if applicable :
1. Name
PHOTOGRAPH

3a. PAN
3b. DIN/ UID
Please affix
size photograph and
sign across it
Pin Code
Country
State
1. Name
PHOTOGRAPH

3a. PAN
3b. DIN/ UID
Please affix
size photograph and
sign across it
Pin Code
Country
State
(7)
1. Name
PHOTOGRAPH

3a. PAN
3b. DIN/ UID
Please affix
size photograph and
sign across it
Pin Code
Country
State
1. Name
PHOTOGRAPH

3a. PAN
3b. DIN/ UID
Please affix
size photograph and
sign across it
Pin Code
Country
State
1-A
Name & Signature of the Authorised Signatory(ies)
Date
PEP: Politically Exposed Person
RPEP: Related to Politically Exposed Person
(8)
MANDATORY DOCUMENT
ANNEXURE - 3
(For Individuals & Non-Individuals)
TRADING ACCOUNT RELATED DETAILS

A. BANK ACCOUNT(S) DETAILS (Through which transactions shall generally be routed)
Bank Name
Branch Address
Account Number
Account Type
MICR Number
IFSC Code
Saving
Current
Others in case of NRI /
NRE / NRO
B. DEPOSITORY ACCOUNT(S) DETAILS (Through which transactions shall generally be routed)

Depository Participant
Name
Name of Depository
NSDL
CDSL
NSDL
CDSL
NSDL
CDSL
Beneficiary Name
DP ID
Beneficiary ID (BO ID)
C. TRADING PREFERENCES
Please sign in the relevant boxes where you wish to trade. The segment not chosen should be struck off by the client.
Stock Exchange
NSE
Market Segment/s
Cash
F&O
Currency
Derivative
BSE
Cash
MCX-SX
Currency
Derivative
F&O
Currency
Derivative
In future, if you want to trade on any new segment/new exchange please submit separate authorization / letter. (for format
download from our website)
ONLINE / OFFLINE PREFERENCES
USE
Capital Market (NSE & BSE), Derivative (NSE & BSE),

Currency Derivative (NSE, MCX-SX, USE)
Offline
Online
Both
D. PAST ACTIONS
Details of any action/proceedings initiated/pending/ taken by SEBI/ Stock exchange/any other authority against the
applicant/constituent or its Partners/promoters/whole time directors/authorized persons in charge of dealing in
securities during the last 3 years :
.........................................................................................................................................................................................
.........................................................................................................................................................................................
E. DEALINGS THROUGH SUB-BROKERS AND OTHER STOCK BROKERS
If client is dealing through the sub-broker, provide the following details:
Sub-broker's Name : ......................................................................................................................................................
SEBI Registration number : .............................................................................................................................................
Registered office address : ..............................................................................................................................................
.........................................................................................................................................................................................
Ph :........................................... Fax :............................................. Website :................................................................
(9)
MANDATORY DOCUMENT
Whether dealing with any other stock broker/sub-broker (if case dealing with multiple stock brokers/sub-brokers,
provide details of all)
Name of stock broker :....................................................................................................................................................
Name of Sub-Broker, if any :............................................................................................................................................
Client Code :.............................................. Exchange :....................................................................................................
Details of disputes/dues pending from/to such stock broker/sub- broker :
..........................................................................................................................................................................................
F. ADDITIONAL DETAILS
Whether you wish to receive physical contract note or Electronic Contract Note (ECN) (please specify) :
.........................................................................................................................................................................................
Specify your Email id, if applicable : ...................................................................................................................................
Whether you wish to avail of the facility of internet trading/ wireless technology (please specify) :
..........................................................................................................................................................................................
Number of years of Investment/Trading Experience : ...............................................................................
In case of non-individuals, name, designation, PAN, UID, signature, residential address and photographs of persons
authorized to deal in securities on behalf of company/firm/others:
PHOTOGRAPH
PHOTOGRAPH
Sign across the

Photograph
Sign across the

Photograph
Name.................................................................................
Name.................................................................................
Designation........................................................................
Designation........................................................................
PAN...................................................................................
PAN...................................................................................
UID....................................................................................
UID....................................................................................
Residential Address............................................................
Residential Address............................................................
...........................................................................................
...........................................................................................
...........................................................................................
...........................................................................................
Signature............................................................................
Signature............................................................................
Any other information : ....................................................................................................................................................

.........................................................................................................................................................................................
G. INTRODUCER DETAILS (optional)
Name of the introducer :...................................................................................................................................................
(Surname)
(Name)
(Middle Name)
PAN No. of introducer (if any) :

Status of the Introducer :
Sub Broker
Auth. Person
Existing Client
Others________________
Address and Ph. No. of the Introducer :.............................................................................................................................

................................................................................Sign. of the Introducer........................................................................
(10)
MANDATORY DOCUMENT
H. NOMINATION DETAILS (for individuals only)

I/We wish to nominate
I/We do not wish to nominate
Name of the Nominee :.....................................................................................................................................................

Relationship with the Nominee :........................................................................................................................................
PAN of Nominee :................................................................ Date of Birth of Nominee :...................................................
Address and Ph. No. of the Nominee :...............................................................................................................................
..........................................................................................................................................................................................
If Nominee is a minor, details of guardian :
Name of the Guardian :.....................................................................................................................................................
Address and Ph. No. of Guardian :.....................................................................................................................................
..........................................................................................................................................................................................
Sign. of Guardian...............................................................................................................................................................
WITNESSES (Only applicable in case the account holder has made nomination)
Name_______________________________________
Name_______________________________________
Signature_____________________________________
Signature_____________________________________
Address______________________________________
Address______________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
DECLARATION
1.
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/we am/are aware that I/we may be held liable for it.
2.
I/We confirm having read/been explained and understood the contents of the document on policy and procedures of
the stock broker and the tariff sheet.
3.
I/We further confirm having read and understood the contents of the Rights and Obligations document(s) and Risk
Disclosure Document. I/We do hereby agree to be bound by such provisions as outlined in these documents. I/We
have also been informed that the standard set of documents has been displayed for Information on
www.wellindia.com.
Place __________________
2
Signature of Client / All Authorized Signatory (ies)
Date __________________
(11)
MANDATORY DOCUMENT
FOR OFFICE USE ONLY

UCC Code allotted to the Client :________________________
Document verified
with Originals
In-Person Verification
Done by
Client Interviewed
By
Name of the Employee

Employee Code
Designation of the Employee
Date
Signature
I / We undertake that we have made the client aware of 'Policy and Procedures', tariff sheet and all the non-mandatory documents.
I/We have also made the client aware of 'Rights and Obligations' document (s), RDD and Guidance Note. I/We have given/sent him
a copy of all the KYC documents. I/We undertake that any change in the 'Policy and Procedures', tariff sheet and all the nonmandatory documents would be duly intimated to the clients. I/We also undertake that any change in the 'Rights and Obligations'
and RDD would be made available on www.wellindia.com if any for the information of the clients.

Date __________________
Seal / Stamp of the Stock Broker
INSTRUCTIONS / CHECK LIST

1.
2.
3.
4.
5.
Additional documents in case of trading in derivatives segments - illustrative list :

Copy of ITR Acknowledgement
Copy of Annual Accounts
In case of salary income - Salary Slip, Copy of Form 16
Net Worth Certificate
Copy of Demat Account Holding Statement
Bank Account Statement for last 6 months
Any other relevant documents substantiating ownership

of assets
Self declaration with relevant supporting documents.
Copy of cancelled cheque leaf/ pass book/bank statement specifying name of the constituent, MICR Code or/and IFSC
Code of the bank should be submitted.
Demat master or recent holding statement issued by DP bearing name of the client.
For individuals:
a. Stock broker has an option of doing 'in-person' verification through web camera at the branch office of the stock
broker/sub-broker's office.
b. In case of non-resident clients, employees at the stock broker's local office, overseas can do in-person' verification.
Further, considering the infeasibility of carrying out 'In-person' verification of the non-resident clients by the stock
broker's staff, attestation of KYC documents by Notary Public, Court, Magistrate, Judge, Local Banker, Indian
Embassy / Consulate General in the country where the client resides may be permitted.
For non-individuals:
a. Form need to be initialized by all the authorized signatories.
b. Copy of Board Resolution or declaration (on the letterhead) naming the persons authorized to deal in securities on
behalf of company/firm/others and their specimen signatures.
(12)
MANDATORY DOCUMENT
POLICIES AND PROCEDURES AS PER SEBI CIRCULAR NO. MIRSD/ SE/CIR-19/2009 DATED 3 DEC, 2009
POLICIES AND PROCEDURES:

1. Refusal of orders for penny stocks:
Stock broker is advising to the clients not to deal in
penny securities and if client deals with the penny
stocks, 100% margin will be taken from the client and
these shares will not be taken to as Margin deposit. The
stock broker shall have authority from time to time
limit (quantity/ value) or refuse orders in one or more
securities due to various reasons including market
liquidity, value of security(ies) or may require
compulsory settlement / advance payment of expected
settlement value/ delivery of securities for settlement
prior to acceptance / placement of order(s) as well, the
order being for securities which are not in the
permitted list of the stock broker / exchange(s) / SEBI
or does not commensurate with the risk profile of the
client as assessed by the broker. Decision of Broker will
be binding on the client and will be final.
2. Setting Up Clients Exposure Limits:
The client agrees to abide by the exposure limits, if any,
set by the stock broker or by the Exchange or Clearing
Corporation or SEBI from time to time. The client is
aware and agrees that the stock broker may need to
vary or reduce or impose new limits urgently on the
basis of the stock brokers risk perception, risk profile
of the client and other factors considered relevant by
the stock broker including but not limited to limits on
account of exchange/ SEBI directions/ limits (such as
broker level/ market level limits in security specific /
volume specific exposures etc.).
The stock broker may be unable to inform the client of
such variation, reduction or imposition in advance. The
client agrees that the stock broker shall not be
responsible for such variation, reduction or imposition
or the clients inability to route any order through the
stock brokers trading system on account of any such
variation, reduction or imposition of limits. Sometimes
clients sauda may go to IOC (Immediate or Cancel)
instead of normal bidding if broker terminal is on
square off mode.
The Stock Broker at its sole discretion can give extra
exposure or intraday limit to the client, such extra
exposure will automatically be squared off by trading
mechanism without any further reference to the client
appx. 15 minutes before the scheduled closing.
3. Applicable Brokerage Rate
a.
For Cash Market Segment:
The maximum brokerage chargeable in relation
to trades effected in the securities admitted to
dealings on the Capital Market segment of the
Exchange shall be 2.5 % of the contract price
exclusive of statutory levies. It is hereby further
clarified that where the sale / purchase value of a
share is Rs.10/- or less, a maximum brokerage of
25 paise per share may be collected.
b.
4.
5.
(13)
For Option contracts:

Brokerage for option contracts would not
exceed Rs.100/- per lot single side or such other
rates as provided by the exchanges.
Imposition of penalty/delayed payment charges
by either party, specifying the rate and the period
(This must not result in funding by the broker in
contravention of the applicable laws)
Client shall be liable to penalty and other charges on
nonpayment of margin money, short selling of securities
or units, failure on payment of auction, cheque bounce,
non delivery of shares, increase open position or on any
orders / trades / deals / actions of the client which are
contrary to this agreement / rules / regulations / bye
laws of the exchange or any other law for the time being
in force as per Rules, Regulations, Guidelines and
Circulars issued by SEBI and stock exchange time to
time and client will be kept informed about the rate of
such penalties & fines. Similarly in case of non receipt of
full payment of value of delivery purchased, margin
imposed (initial + MTM) interest will be charged at
2% p.m. calculated on daily basis on shortfall amount till
the date of actual realization of money.
All fines/penalties and charges levied upon the Client
due to its acts / deeds or transactions will be recovered
by the Stock Broker directly from the clients account.
The right to sell clients securities or close clients
positions, without giving notice to the client, on
account of non-payment of clients dues (This
shall be limited to the extent of settlement/
margin obligation)
1.
If payment/securities towards the Margin or
shortfall in Margin is not received instantaneously
to enable restoration of sufficient Margin in the
Clients account.
2.
In case of benefit of margin will be given only after
realization of instrument..
3.
If the client gives orders / trades in the
anticipation of the required securities being
available subsequently for pay in through
anticipated payout from the exchange or through
borrowings or any off market delivery(s) and if
such anticipated availability does not materialize
in actual availability of securities / funds for pay in
for any reason before the close of market .
4.
The stock broker has the right but not the
obligation, to cancel all pending orders and to
sell/close/liquidate all open positions/ securities /
shares at the pre-defined square off time or when
Mark to Market (M-T-M) percentage reaches or
crosses stipulated margin percentage mentioned
5
MANDATORY DOCUMENT
6.
7.
on the website, whichever is earlier. similarly all

1.
For non-payment or erosion of margins or other
amounts, outstanding debts, etc. and adjust the
transactions outstanding under limit by
proceeds of such liquidation / close out, if any,
whatsoever name called may be closed out at
against the clients liabilities/ obligations.
specified time if not squared off by the client.
2.
Any order which is executed without the
5.
In case open position (Le. short/long) gets
required Margin in the Clients account or the
converted into delivery due to non square off
brokers exposure is more than 90% and above
because of any reason whatsoever, the client
so
no fresh trade will be taken.
agrees to provide securities/funds to fulfill the
3.
The
client hereby authorizes the Stock Broker to
payin obligation failing which the client will have
square
up all his outstanding positions at the
to face auctions or internal close outs; in addition
discretion
of the Stock Broker, which are not
to this the client will have to pay penalties and
marked
for
delivery 15 minutes before the
charges levied by exchange in actual and losses, if
closing time of the normal market or if the clients
any.
margin is evapourated by 90% in any of
6.
Any reference in these terms to sale or transfer
exchanges, .......... reserves the right to square off
of securities by the Stock Broker shall be deemed
positions.
to include sale of the securities which form part
4.
Under certain market conditions, it may be
of the Margin maintained by the Client with the
difficult or impossible to liquidate a position in the
Stock Broker.
market at a reasonable price or at all, when there
Shortages in obligations arising out of internal
are no outstanding orders either on the buy side
netting of trades
or the sell side, or if trading is halted in a security
due to any action on account of unusual trading
The policy and procedure for settlement of shortages
activity or stock hitting circuit filters or for any
in obligations arising out of internal netting of trades is
other
reason as prescribed or instructed by SEBI.
as under:
5.
The
stock
broker is entitled to disable / freeze the
a.
The short delivering client is debited by an
account
or
trading facility / any other service if, in
amount equivalent to 20% above of closing rate
the
opinion
of the stock broker, the client has
of day prior to Pay-in/Payout Day. The securities
committed
a crime, fraud or has acted in
delivered short are purchased from market on T
contradiction
of this agreement or / evade /
+3 day which is the Auction Day on Exchange,
violate
any
laws,
rules, regulations, directions of a
and the purchase consideration (inclusive of all
lawful authority whether Indian or foreign or if
statutory taxes & levies + upto 5% extra) is
the stock broker so apprehends.
debited to the short delivering seller client along
with reversal entry of provisionally amount Any profit/loss arising out of these transactions shall be at the
risk of and borne by the client.
debited earlier.
8. Temporarily suspending or closing a clients
b.
If securities cannot be purchased from market
account at the clients request
due to any force majeure condition, the short
Client may instruct the member to close out the
delivering seller is debited at the closing rate on T
account or suspend the trading through clients account
+3 day or Auction day on Exchange +10%.
for the period as specified in the request in written and
Where the delivery is matched partially or fully at
duly signed by him.
the Exchange Clearing, the delivery and debits/
The stock broker can with hold the payouts of client
credits shall be as per Exchange Debits and
and suspend his trading account due to his surveillance
Credits after deducting exchange penalties.
action or judicial or / and regulatory order/action
c.
In cases of securities having corporate actions all
requiring client suspension.
cases of short delivery of cum transactions which 9. Policy regarding treatment of inactive accounts:
cannot be auctioned on cum basis or where the
When Trade is not done in an account for more than 3
cum basis auction payout is after the book
months, Stock Broker reserves the right to temporarily
closure / record date, would be compulsory
suspend the operations. The Management may allow
closed out at higher of 10% above the official
operations in such account after making such
closing price on the auction day or the highest
verification as it deems fit.
traded price from first trading day of the 10. Deregistering a client
settlement till the auction
A client is at liberty to deregister himself / itself from the
Conditions under which a client may not be
member. For that purpose client will be liable first to
allowed to take further position or the broker
settle his account in full. In case of any shortfall or any
may close the existing position of a client.
dues or payment remaining after adjusting the margin
account, the client will be liable to make payment of the
The stock broker may refuse to execute / allow
same. And in case of surplus arising out after netting of
execution of orders due to but not limited to the reason
account,
client shall be entitled to receipt of the same.
of lack of margin / securities or the order being outside
The member shall also have power to deregister the
the limits set by stock broker / exchange/ SEBI and any
client after settling his account at its sole discretion.
other reasons which the stock broker may deem
appropriate in the circumstances.
6
(14)
MANDATORY DOCUMENT
DISCLOSURE OF PROPRIETARY TRADING BY WSL

Dear Client,
In term of SEBI circular No. SEBI/MRD/SEC/Cir-42/2003 dated 19th November, 2003, member is required to disclose to its
client about the proprietary trades.
In view of this circular, we wish to inform you that, we do proprietary trades in the Cash, F&O and currency derivatives
segment of NSE, BSE, MCX-SX & USE.
I have noted the above
7
Date :
Sole / First Applicant Signature

PMLA - DECLARATION
I______________________________having the trading code no.________________with WSL confirm and declare that I
have read and understood the contents and the provisions of the PMLA Act, 2002 and it was also explained by WSL official. I
further declare that I shall adhere to the rules and regulations and requirements mentioned in the PMLA Act, 2002.
Clients Signature
BROKERAGE STRUCTURE
CASH SEGMENT
Slab in %
Brokerage Slab
Minimum Paise
Min. Per Transaction
Delivery Based
Daily Square up (Intra Day)
Z Group Transaction
DERIVATIVES SEGMENT
Slab in %
Minimum Paise
Borkerage Slab
Min. Per Lot
Intra Day
Future
Carry Forward
Intra Day
Option
Carry Forward
CURRENCY DERIVATIVES SEGMENT

Minimum brokerage per lot
Brokerage Slab %
Any Remarks :
Note :
1. Minimum Processing Fee of Rs. 25/- will be charged per contract note.
2. In Z Groups share 2% brokerage will be charged subject to minimum 10 paisa per share.
3. Service Tax, Securities Transaction Tax, Exchange Transaction Charge, SEBI charge, Stamp duty, other charges (if any) and the
levies shall be charged extra.
(15)
(Signature of Client)
VOLUNTARY DOCUMENT
LETTER OF AUTHORITY
To,
Date :

Sub : Letter of Authority - NSE / BSE / MCX-SX / USE

I/We am/are dealing in shares/securi ties with you at NSE/BSE /MCX-SX/USE in various segments and in order to facilitate
ease of operations. W e authori ze you as under :
1. Running Account:
That I/We desirous of regularly dealing in CM, F&O and Currency Derivative segment with you and request you to maintain a
Running Account for funds and securities on my/our behalf. I/We further agree to all the Terms and Conditions of Running Account
mentioned in SEBI Circular no. MIRSD/ SE /Cir-19/2009 dated December 3, 2009 and further request you to retain all amounts and
securities receivable by me/ us until specifically requested by me/ us in writing to be settled or to be dealt with in any other manner
Once a Calender Quarter
10
Once in a Month
Sign.......................................................
2. Set off of outstanding:

I/We authorize you to set off outstanding in any of my / our accounts against credits available or arising in any other accounts
maintained with you irrespective of the fact that such credits in the accounts may pertain to transactions in any segment of the
Exchange and / or against the value of cash margin or collateral shares provided to you by me / us. I further authorise you to
debit the financial charge @2% per month of the debit balance, if any, in my account and not settled as per the exchange
requirement.
3. Delivery of order/ trade confirmation/ cancellation:
I/We hereby authorize you not to provide me / us order confirmation / Modification / Cancellation Slips and Trade Confirmation slips
to avoid unnecessary paper work. I/we shall get the required details from contract notes and confirmation issued by you.
4. Authorization to Use Margin:
I/we hereby authorize you to keep all the securities which I/we give you in margin including the payout of securities received, to use
the securities for meeting margin / other obligation in stock exchange in whatever manner which may include pledging of shares in
favour of bank and/or taking loan against the same for meeting margin/pay-in obligation on our behalf or for giving the same as
margin to the Stock Exchange or otherwise.
I/we further authorize the stock broker as per the requirement of SEBI Circular no. MIRSD/ SE /Cir-19/2009 dated December 3, 2009 that
in case of any outstanding obligations on the settlement date, the stock broker may retain the requisite securities/funds towards such
obligations and may also retain the funds expected to be required to meet margin obligations for next 5 trading days, calculated in
the manner specified by the exchanges.
5. Telephonic Conversation:
I/We request you to consider my/our telephonic instructions for order placing/order modification/order cancellation as a written
instruction and give us all the confirmation on telephone unless instructed otherwise in writing. I/We am/are getting required details
from contracts issued by you.
6. Electronic Mode of delivery:
I/We request that you may send/ Dispatch me/ous contract notes other documents through E-mail: on my/our designated E-mail
address of............................................................................. I/We stress that I/we will not hold you responsible under any circumstances
in the event of an E-mail which you send gets bounced due to any reason such as mail box being full, inactive account or due to any
technical reason beyond your control.
7. Log Report:
I/We will completely rely on the log reports of your dispatching software as a conclusive proof of dispatch of E-mail to me and will not
dispute the same.
(16)
11
VOLUNTARY DOCUMENT
8. Change in E-mail Id:

I/We will inform you any change in my E-mail, if any, in future, in physical mode by regd. post or by hand delivery and through a
digitally signed E-mail.
19. Electronic Trading:
Trading of NSE is in Electronic Mode, based on VSAT, leased line, ISDN, Modem and VPN, combination of technologies and computer
systems to place and route orders. I/we understand that there exists a possibility of communication failure or system problems or slow
or delayed response from system or trading halt, of any such other problem/glitch whereby not being able to establish access to the
trading system/network, which may be beyond the control of you and may result in delay in processing or not processing buy or sell
orders either in part or in full. I/we agree that I/we shall be fully liable and responsible for any such problems glitch.
10. Sub Letting of Terminal:
I/We confirm that I/we will never sublet the trading terminal on any term of connectivity from my/our place to any other place without your
prior approval.
11. Inter Settlement of Securities:
I/We am/are agreeable for inter-settlement transfer of securities towards settlements.
12. Hold of funds Pay outs:
I/We am/are agreeable for & authorise you to with hold funds pay-out towards all the applicable margins and debits.
13. Fines & Penalties:
All fines/penalties and charges levied upon you due to my/our acts / deeds or transactions may be recovered by you from my/our account.
14. Charges & Balance Maintenance:
I/We have a Trading As well as depository relationship with ......................................... Please debit the charges relevant with depository services and courier charges for sending physical contract notes & other documents from my/our trading account on monthly
basis. I/We also agree to maintain the adequate balance in my/our trading account / pay adequate advance fee for the said reason.
15. I/We am/are aware that above authorisation is voluntary on my/our part and that I/We can revoke this authorisation at any point of
time during the operation of my/our trading account with you by giving you a notice in writing.
Thanking you,
Yours faithfully
,
12
(17)
Serial No.
Type of Account :
Normal
BSDA
CDSL

DP : CENTRAL DEPOSITORY SECURITIES LTD.
CDSL DP ID : 12058000 SEBI REGN. NO.: IN-DP-CDSL-483-2008

Tel.: +91-9990799941-48 Fax : 0120-4313311
ACCOUNT OPENING FORM

BO ID
IN PERSON VERIFICATION
Signature(s) of applicant(s) : (in the presence of the DP staff)
DP Name : Wellindia Securities Limited DP ID : 12058000

HO/Branch Name :..................................................................................................
Staff doing 'In person' Verification
13
Sole/First Holder Signature
Name of Employee :................................................................................................

3
Employee Code :.....................................................................................................

Signature : #............................................................................................................
Second Holder Signature
Date of In Person Verification :
Place of In Person Verification :...............................................................................
Third Holder Signature
(18)
ANNEXURE - 4

E-mail : [email protected] URL : www.wellindia.com
ACCOUNT OPENING FORM INDIVIDUALS

ADDITIONAL KYC FORM FOR OPENING A DEMAT ACCOUNT
(To be filled by the Depository Participant)
Date D
Application No.
DP Internal Reference No.

DP ID
1 2 0 5 8 0 0 0
Client ID
(To be filled by the applicant in BLOCK LETTERS in English)

I/We request you to open a demat account in my/our name as per following details :
HOLDERS DETAILS
Sole/First Holder's Name
PAN
Second Holder's Name
PAN
Third Holder's Name
PAN
Name*
* In case of Firms, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., although the account is
opened in the name of the natural persons, the name of the Firm, Association of Persons (AOP), Partnership Firm,
Unregistered Trust, etc., should be mentioned above.
TYPE OF ACCOUNT (Please tick whichever is applicable)

Individual
NRI
Foreign National
Individual Resident
Individual Director
Individual Director's Relative
Individual HUF/AOP
Individual Promoter
Minor
Individual Margin Trading A/c (Mantra)
Others (Specify)_________________
NRI Repatriable
NRI Non-Repatriable
NRI Repatriable Promoter
NRI Non-Repatriable Promoter
NRI - Depository Receipts
Others (Specify)_________________
Foreign National-Depository Receipts
Others (Specify)_________________
Foreign National
DETAILS OF GUARDIAN (in case the account holder is minor)

Guardian's Name
PAN
Relationship with the applicant

I/We instruct the DP to receive each and every credit in my/our account
(if not marked, the default option would be 'Yes')
Account Statement Requirement
As per SEBI Regulation
Daily
I/We request you to send Electronic Transaction-cum-Holding Statement

at the email Id______________________________________________
Do you wish to receive dividend/interest directly in to your bank account given
below through ECS? (If not marked, the default option would be 'Yes')
[ECS is mandatory for locations notified by SEBI from time to time]
(19)
[Automatic Credit]
Yes
No
Weekly
Yes
Yes
Fortnightly
No
No
Monthly
BANK DETAILS (Dividend Bank Details)

Bank Code (9 digit
MICR Code)
IFS Code (11 Character)
Account Number
Account Type
Saving
Current
Others (specify)___________________________
Bank Name
Branch Name
Bank Branch Address
City
(i)
(ii)
(iii)
(iv)
State
PIN
Country
Photocopy of the cancelled cheque having the name of the account holder where the cheque books is issued, (or)
Photocopy of the Bank Statement having name and address of the BO.
Photocopy of the Passbook having name and address of the BO, (or)
Letter from the Bank.
In case of option (ii), (iii) and (iv) above, MICR Code of the branch should be present/mentioned on the document.
Yes
SMS Alert Facility

MOBILE No.: +91Refer to Terms & Conditions [Mandatory, if you are giving Power of Attorney (POA)]
given as Annexure 2.4
(if POA is not granted & you do not wish to avail of this facility, cancel this option).
Easi
No
To register for easi, please visit our website www.cdslindia.com.

Easi allows a BO to view his ISIN balances, transactions and value of the portfolio online.
Yes
No
NOMINATION DETAILS
Date
Nomination Registration No.
I/We the Sole Holder/ Joint Holder / Guardian (in case of minor) hereby declare that :
I/We do not wish to nominate any one for this demat account.
I/We nominate the following person who is entitled to receive security balances lying in my/our account, particulars
whereof are given below, in the event of my/our death.
Full Name of the
Nominee
Address
City
State
Country
PIN
Telephone No.
Fax No.
E-mail ID
Relationship with BO
(if any)
Date of Birth (Mandatory if nominee is a minor)
(20)
As the nominee is a minor as on date, to receive the securities in this account on behalf of the nominee in the event of the
death of the Sole holder / all Joint holders, I/We appoint following person to act as Guardian :
Full Name of
Guardian of Nominee
Address
City
State
Country
PIN
Telephone No.
Fax No.
E-mail ID
Relationship of
Guardian with Nominee
This nomination shall supersede any prior nomination made by me/us and also any testamentary document executed by me/us.
Note : Two witnesses shall attest signature(s) / thumb impression(s).
Details of the Witness
First Witness
Second Witness
Name of Witness
Address of Witness
Signature of Witness
I/We have read the terms & conditions DP-BO agreement and agree to abide by and be bound by the same and by
the Bye Laws as are in force from time to time. I / We declare that the particulars given by me/us above are true and
to the best of my/our knowledge as on the date of making this application. I/We agree and undertake to intimate the
DP any change(s) in the details / Particulars mentioned by me / us in this form. I/We further agree that any false /
misleading information given by me / us or suppression of any material information will render my account liable for
termination and suitable action.
First / Sole Holder of
Guardian (in case of Minor)
Second Holder
Third Holder
.................................................................
.................................................................
Name
Signatures
.................................................................
(Signatures should be preferably in black ink)
(21)

ACCOUNT OPENING FORM NON-INDIVIDUALS

ADDITIONAL KYC FORM FOR OPENING A DEMAT ACCOUNT
(For entities other than Individuals)
(To be filled by the Depository Participant)
Date D
Application No.
DP Internal Reference No.
1 2 0 5 8 0 0 0
DP ID
Client ID
(To be filled by the applicant in BLOCK LETTERS in English)

I/We request you to open a demat account in my/our name as per following details :
HOLDERS DETAILS
Sole/First Holder's Name
PAN
PAN
Third Holder's Name
PAN
Search Name
Name*
* In case of Firms, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., although the account is opened in the
name of the natural persons, the name of the Firm, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., should
be made applicable.
TYPE OF ACCOUNT (Please tick whichever is applicable)
Sub-Status
(To be filled by the DP)
Status
Body Corporate
Banks
CM
Clearing House
FI
Trust
Mutual Fund
RBI Registration No.

(if applicable)
ROC Registration No.
(if applicable)
Indian
SEBI Registration Date
D D M M Y Y Y Y
RBI Approval Date
D D M M Y Y Y Y
ROC Registration Date
D D M M Y Y Y Y
Others (specify)__________________________
I/We instruct the DP to receive each and every credit in my/our account
(if not marked, the default option would be 'Yes')
Account Statement Requirement
FII
Other (Specify)________________________
SEBI Registration No.

(if applicable)
Nationality
OCB
As per SEBI Regulation
Daily
I/We request you to send Electronic Transaction-cum-Holding Statement

at the email Id______________________________________________
(22)
[Automatic Credit]
Yes
No
Weekly
Yes
Yes
Fortnightly
No
No
Monthly
CLEARING MEMBER DETAILS (To be filled by CMs only)

Name of Stock Exchange
Name of CC / CH
Trading Member ID
Clearing Member ID

[ECS is mandatory for locations notified by SEBI from time to time]
Yes
No
BANK DETAILS (Dividend Bank Details)

Bank Code (9 digit
MICR Code)
IFS Code (11 Character)
Account Number
Account Type
Saving
Current
Others (specify)___________________________
Bank Name
Branch Name
Bank Branch Address
City
(i)
(ii)
(iii)
(iv)
State
PIN
Country
Photocopy of the cancelled cheque having the name of the account holder where the cheque books is issued, (or)
Photocopy of the Bank Statement having name and address of the BO.
Photocopy of the Passbook having name and address of the BO, (or)
Letter from the Bank.
In case of option (ii), (iii) and (iv) above, MICR Code of the branch should be present/mentioned on the document.
MOBILE No.: +91SMS Alert Facility

Refer to Terms & Conditions [Mandatory, if you are giving Power of Attorney (POA)]
given as Annexure 2.4
(if POA is not granted & you do not wish to avail of this facility, cancel this option).
To register for easi, please visit our website www.cdslindia.com.
Easi allows a BO to view his ISIN balances, transactions and value of the portfolio online.
Easi
Yes
No
Yes
No
I/We have read the terms & conditions DP-BO agreement and agree to abide by and be bound by the same and by
the Bye Laws as are in force from time to time. I / We declare that the particulars given by me/us above are true and
to the best of my/our knowledge as on the date of making this application. I/We agree and undertake to intimate the
DP any change(s) in the details / Particulars mentioned by me / us in this form. I/We further agree that any false /
misleading information given by me / us or suppression of any material information will render my account liable for
termination and suitable action.
First / Sole Authorised Signatory
Second Authorised Signatory
Third Authorised Signatory
Name
Designation
4
Signature
.................................................................
(Signatures should be preferably in black ink)
.................................................................
.................................................................
(In case of more authorised signatories, please add annexure)

(23)
AGREEMENT
** In case of Joint holding, all joint holders must sign.

* Please stamp & Sign in case of HUF / Corporate Account
.................................................................
.................................................................
14
This Agreement made and entered into at this.................. Statement of Account

day of..........................................................................................., 3.1 The Participant shall furnish to the Beneficial Owner a
statement of his/its account at the end of every month if
between Wellindia Securities Limited, having its registered
there
has been even a single entry or transaction during
Office at 1249, Sector 19, Faridabad-121002 Haryana
that month, and in any event once at the end of each
(hereinafter called the Participant) of
quarter.
the One Part; AND.........................................................................
The statement of accounts to be provided to the
......................................................................................................,
Beneficial Owner under this Agreement shall be in the
having his/ its office/ registered office/address
at
form specified in Operating Instructions or as
communicated
by CDSL from time to time. The
......................................................................................................
Participant shall furnish such statements at such
......................................................................................................
shorter periods as may be required by the Beneficial
......................................................................................................
Owner on payment of such charges by the Beneficial
hereinafter called the Beneficial Owner of the Other Part.
Owner as may be specified by the Participant.
WHEREAS the Beneficial Owner is desirous of opening a 3.2 It is agreed that if a Participant is providing the services
beneficial owners account with the Participant and the Participant
of issuing the statement of accounts in an electronic
mode and if the Beneficial Owner is desirous of availing
has agreed to open an account in the name of the Beneficial Owner
such services from the Participant, then the Participant
and render services to the Beneficial Owner as a participant, on the
will furnish to the Beneficial Owner the statement of
terms and conditions recorded hereinbelow:
accounts under its digital signature, as governed under
NOW THIS AGREEMENT WITNESSETH AND IT IS HEREBY
the Information Technology Act, 2000. Provided
AGREED BY AND BETWEEN THE PARTIES HERETO AS
however
that in the event of the Beneficial Owner
FOLLOWS:
requiring a physical copy of the statement of accounts,
General Clause
despite receiving the same in the electronic mode, then
1. The parties hereto agree to abide by the provisions of the
irrespective of having forwarded the same via electronic
Depositories Act, 1996, SEBI (Depositories and Participants)
mode, the Participant shall be obliged to provide a
Regulations, 1996, Bye Laws and Operating Instructions
physical copy thereof to the BO.
issued by CDSL from time to time in the same manner and to 3.3 It is agreed and understood between the parties that if
the same extent as if the same were set out herein and
the Participant does not have the facility of providing the
formed part of this Agreement.
statement of account in the electronic mode, then the
Fees, Charges and deposits
Participant shall be obliged to forward the statement of
account only in physical form.
2. The Participant shall be entitled to change or revise the fees,
charges or deposits from time to time provided however that Beneficial Owner shall intimate change of particulars
no increase therein shall be effected by the Participant unless 4. The Participant shall not be liable or responsible for any
loss that may be caused to the Beneficial Owner by
the Participant shall have given at least one months notice in
reason
of his/its failure to intimate change in the
writing to the Beneficial Owner in that behalf. In case the
particulars furnished to the Participant from time to time,
Beneficial Owner committing a default in the payment of any
unless
notified by the Beneficial Owner.
such amount payable to the Participant on their respective
Depository
not
liable for claims against Beneficial
due dates or within fifteen days of the same being demanded
Owner
(where no such due date is specified), the Participant shall be
entitled to charge interest @ 15% on the amount remaining 5. CDSL shall not be liable to the Beneficial Owner in any
manner towards losses, liabilities and/ or expenses
outstanding or unpaid per annum or part thereof. On such
arising from the claims of third parties or for any fees,
continued default, the Participant after giving two days notice
charges, taxes, duties, levies or penalties levied,
to the Beneficial Owner shall have a right to stop processing
imposed or demanded by any Central, State, statutory
of instructions of Beneficial Owners till such time he makes
or revenue authority in respect of securities credited to
the payment along with interest if any.
the Beneficial Owners account.
.................................................................
AGREEMENT BETWEEN A PARTICIPANT AND A PERSON SEEKING TO OPEN A BENEFICIAL OWNERS ACCOUNT
15
.................................................................
.................................................................
(24)
.................................................................
Authorised Representative
6. Where the Beneficial Owner is a body corporate or a legal
entity, it shall, simultaneously with the execution of the
Agreement furnish to the Participant, a list of officials
authorized by it, who shall represent and interact on its behalf
with the Participant. Any change in such list including
additions, deletions or alterations thereto shall be forthwith
communicated to the Participant.
Termination
7. The parties may at any time terminate this agreement, provided
that a notice of not less than thirty days is given in the manner
and on the terms and conditions and procedure set out in the
Bye Laws and the Operating Instructions. In the event of
termination by either party, the Participant shall deal with the
securities lying in the account of a Beneficial Owner in
accordance with the instructions of such Beneficial Owner.
Stamp Duty
8. Any stamp duty (including interest or penalty levied thereon)
payable on the Agreement and/or on any deed, document or
writing executed in pursuance hereof between the parties
hereto shall be borne and paid by the Beneficial Owner.
Force Majeure
9. Notwithstanding anything contained herein or in the Bye Laws,
neither party hereto shall be liable to indemnify or compensate
the other for any breach, non-performance or delay in
performance of any obligations under the Agreement or for any
harm, loss, damage or injury caused to the other due to causes
reasonably beyond its control including but not limited to tide,
storm, cyclone, flood, lightning, earthquake, fire,
blast,explosion or any other act of God, war, rebellion,
revolution, insurrection, embargo or sanction, blockade, riot,
civil commotion, labour action or unrest including strike, lockout or boycott, interruption or failure of any utility service,
enemy action, criminal conspiracy, act of terrorism or

vandalism, sabotage, or intrusion, or any other irresistible
force or compulsion.
Service of Notice
10. Any notice or communication required to be given under the
Agreement shall not be binding unless the same is in writing
and shall have been served by delivering the same at the
address set out hereinabove against a written
acknowledgement of receipt thereof or by sending the same
by pre-paid registered post at the aforesaid address or
transmitting the same by facsimile transmission, electronic
mail or electronic data transfer at number or address that shall
have been previously specified by the party to be notified.
Notice given by personal delivery shall be deemed to be given
at the time of delivery. Notice given by post in accordance with
this clause shall be deemed to be given at the commencement
of business of the recipient of the notice on the third working
day next following its posting. Notice sent by facsimile
transmission, electronic mail or electronic data transfer shall
be deemed to be given at the time of its actual transmission.
Arbitration
11. The parties hereto shall, in respect of all disputes and
differences that may arise between them, abide by the
provisions relating to arbitration and conciliation specified
under the Bye Laws.
Jurisdiction
12. The parties hereto agree to submit to the exclusive jurisdiction
of the courts in Delhi.
Governing Law
13. The Agreement shall be governed by and construed in
accordance with the laws in force in India.
IN WITNESS WHEREOF the parties hereto have hereunto set and
subscribed their respective hands/ seals to this Agreement in
duplicate on the day, month, year and place first hereinabove
mentioned.
Witness
Signature :
Signed and delivered by Client

16
Name
: .......................................................................................................................................
Address : .......................................................................................................................................
: .......................................................................................................................................
6
Witness
Signature :
Signed and delivered by Participant

For Wellindia Securities Limited (DP ID 12058000)
Name
: .......................................................................................................................................
Address : .......................................................................................................................................
Authorised Signatory
: .......................................................................................................................................
Place :................................
Date :................................

(25)
POWER OF ATTORNEY
TO ALL TO WHOM THESE PRESENTS SHALL COME I __________________________________________________ India, Indian inhabitant SEND
GREETINGS.
Whereas I hold a Beneficiary account no. _________________with Central Depository Service (India) Limited, through Wellindia Securities Limited, Regd.
Office: 1249, Sector 19, Faridabad 121002, Haryana bearing DPID 12058000 (DP - SEBI Registration No. IN-DP-CDSL-483-2008).
And Whereas I an investor engaged in buying and selling of securities through Wellindia Securities Limited, a member of National Stock Exchange &
Bombay Stock Exchange, MCX Stock Exchange & United Stock Exchange Limited bearing SEBI Registration No. (NSE-INB/INF/INE231282931,
INB/INF011282937, INE261282931 & INE271282936).
And Whereas due to exigency and paucity of time, I am desirous of appointing an agent/attorney to operate the aforesaid beneficiary account on my behalf
for a limited purpose in the manner hereinafter appearing;
NOW KNOW WE ALL AND THESE PRESENTS WITNESSTH THAT I THE ABOVE NAMED DO HEREBY NOMINATE, CONSTITUTE /AND APPOINT
Wellindia Securities Limited as my true and lawful attorney (hereinafter referred to as the attorney) for me / us and on my / our behalf and in my / our name to
do instruct the aforesaid Depository Participant and to do the following acts and deeds:
1.
To sign all the debit instruction and forms relevant to the operation of the said beneficiary account issued in favour of Wellindia Securities Limited
in following accounts.
NSDL POOL ID
CDSL POOL ID
NSDL POOL ID
NSE
BSE
CDSL POOL ID
Depository ID
Beneficiary ID
CDSL
12058000-00002102
10515172
12058000-00002161
10515180
12058000-00002155
12058000-00002174
12058000
CM - BP ID
IN565592
CM - BP ID
IN655630
NSDL
IN300966
for meeting out of Settlement / Margin Obligation arising out of the trades executed by me / us on the stock exchange through Wellindia Securities
Limited.
2.
This authority is restricted to the pay-in / margin obligations and ratifies the instruction given by above said attorney to the Depository Participant
named herein above in the manner specified herein above.
3.
The Stock Broker is hereby authorized to send consolidated summary of Client's scrip-wise buy and sell positions taken with average rates to the
client by way of SMS / email on a daily basis, notwithstanding any other document to be disseminated as specified by SEBI from time to time.
4.
The Power of Attorney is given to Stock Broker subject to the condition that the Stock Broker would return to the client , the securities that may
have been received by it erroneously or those securities it was not entitled to receive from the client.
I/We further agree and confirm and understand that this power of attorney shall be revocable at any time by giving a notice in writing
SIGNED AND DELIVERED By the within named Beneficial Owner
17
.................................................................
IN THE PRESENCE OF
Client ID
_________________________
Client Code
_________________________
Mobile No.
_________________________
(For SMS Alert Mandatory)
.................................................................
.................................................................
FOR HUF ACCOUNT ONLY
Name Signature of Coparceners

SR.
Name
Signature
1
2
We accept the above the Power Attorney for and behalf of

WELLINDIA SECURITIES LIMITED
A-78, Sector 2, Noida-201301 (Uttar Pradesh)
3
4
5
* Sign of Karta
(Authorised Signatory)
Witness
Signature :
Witness
Signature :
Name
Name
: .......................................................................................................................................
: .......................................................................................................................................
Address : .......................................................................................................................................
Address : .......................................................................................................................................
: .......................................................................................................................................
: .......................................................................................................................................
(26)

SMS ALERT FACILITY
Annexure-A
Terms & Conditions-Cum-Registration / Modification Form for receiving SMS Alerts from CDSL
Definitions :
In these Terms and Conditions the terms shall have following
meaning unless indicated otherwise.
Fees, Charges and deposits
1. "Depository" means Central Depository Services (India)
Limited a company incorporated in India under the Companies
Act 1956 and having its registered office at 17th Floor, P.J.
Tower, Dalal Street, Fort, Mumbai-400001 and all its branch
offices and includes its successors and assigns.
2. 'DP' means Depository Participant of CDSL. The term covers all
types of DPs who are allowed to open demat accounts for
investors.
3. 'BO' means an entity that has opened a demat account with the
depository. The term covers all types of demat accounts, which
can be opened with a depository as specified by the depository
from time to time.
4. SMS means "Short Messaging Service"
5. 'Alerts' means a customized SMS sent to the BO over the said
mobile phone number.
6. 'Service Provider' means a cellular service provider(s) with
whom the depository has entered/will be entering into an
arrangement for providing the SMS alerts to the BO.
7. 'Service' means the service of providing SMS alerts to the BO
on best effort basis as per these terms and conditions.
Availability :
1. The service will be provided to the BO at his/her request and at
the discretion of the depository. The service will be available to
those account holders who have provided their mobile numbers
to the depository through their DP. The service may be
discontinued for a specific period/indefinite period with or
without issuing any prior notice for the purpose of security
reasons or system maintenance or for such other reasons as
may be warranted. The depository may also discontinue the
service at any time without giving prior notice for any reason
whatsoever.
2. The service is currently available to the BOs who are residing in
India.
3. The alerts will be provided to the BOs only if they remain within
the range of the service provider's service area or within the
range forming part of the roaming network of the service
provider.
4. In case of joint accounts and non-individual accounts the
service will be available, only to one mobile number i.e. to the
mobile number as submitted at the time of registration /
modification.
5. The BO is responsible for promptly intimating to the depository
in the prescribed manner any change in mobile number, or loss
of handset, on which the BO wants to receive the alerts from the
depository.
In case of change in mobile number not intimated to the

depository, the SMS alerts will continue to be sent to the last
registered mobile phone number. The BO agrees to indemnify
the depository for any loss or damage suffered by it on account
of SMS alerts sent on such mobile number.
Receiving Alerts :
1. The depository shall send the alerts to the mobile phone
number provided by the BO while registering for service or to
any such number replaced and informed by the BO from time to
time. Upon such registration / change, the depository shall
make every effort to update the change in mobile number within
a reasonable period of time. The depository shall not be
responsible for any event of delay or loss of message in this
regard.
2. The BO acknowledges that the alerts will be received only if the
mobile phone is in 'ON' and in a mode to receive the SMS. If the
mobile phone is in 'Off' mode i.e. unable to receive the alerts
then the BO may not get / get after delay any alerts sent during
such period.
3. The BO also acknowledges that the readability, accuracy and
timeliness of providing the services depend on many factors
including the infrastructure, connectivity of the service provider.
The depository shall not be responsible for any non-delivery,
delayed delivery or distortion of the alert in any way whatsoever.
4. The BO further acknowledge that the service provided to him is
an additional facility provided for his convenience and is
susceptible to error, omission and/or in accuracy. In case of BO
observes any error in the information provided in the alert, the
BO shall inform the depository and/or the DP immediately in
writing and the depository will make best possible efforts to
rectify the errors as early as possible. The BO shall not hold the
depository liable for any loss, damages, etc. that may be
incurred/suffered by the BO an account to avail SMS alerts
facility.
5. The BO authorized the depository to send any message such
as promotional, greeting or any other message that the
depository may consider appropriate, to the BO. The BO
agrees to an ongoing confirmation for use of name, email
address and mobile number for marketing offers between
CDSL and any other entity.
6. The BO agrees to inform the depository and DP in writing of any
unauthorized debit to his BO account/unauthorized transfer of
securities from his BO account, immediately, which may come
to his knowledge on receiving SMS alerts. The BO may send an
email to CDSL at [email protected] The BO is advised
not to inform the service provider about any such unauthorized
debit to/transfer of securities from his BO account by sending a
SMS back to the service provider as there is no reverse
communication between the service provider and the
depository.
18
.................................................................
.................................................................
(27)
.................................................................
7. The information sent as an alert on the mobile phone number

shall be deemed to have been received by the BO and the
depository shall not be under any obligation to confirm the
authenticity of the person(s) receiving the alert.
8. The depository will make best efforts to provide the service. The
BO cannot hold the depository liable for non-availability of the
service in any manner whatsoever.
9. If the BO finds that the information such as mobile number etc.,
has been changed without proper authorization, the BO should
immediately inform the DP in writing.
Fees :
Depository reserves the right to change such fees from time to time
as it deems fit for providing this service to the BO.
Disclaimer :
The depository shall made reasonable efforts to ensure that the
BO's personal information is kept confidential. The depository does
not warranty the confidentiality or security of the SMS alerts
transmitted through a service provider. Further, the depository
makes no warranty or representation of any kind in relation to the
system and the network or their function or their performance or for
any loss or damage whenever and howsoever suffered or incurred
by the BO or by any person resulting from or in connection with
availing of SMS alerts facility. The Depository will not be liable for any
unauthorized use or access to the information and/or SMS alert sent

on the mobile phone number of the BO or for fraudulent, duplicate or
erroneous use/ misuse of such information by an third person.
Liability and Indemnity :
The Depository shall not be liable for any breach of confidentiality by
the service provider or by any third person due to unauthorized
access to the information meant for the BO. In consideration of the
depository providing the service, the BO agrees to indemnify and
keep safe, harmless and indemnified the depository and its officials
from any damages, claims, demands, proceedings, loss, cost,
changes and expenses whatsoever which a depository may at any
time incur, sustain, suffer or be put to as a consequence of or arising
out or interference with or misuse, improper or fraudulent use of the
service by the BO.
Amendments :
The depository may amend the terms and conditions at any time
with or without giving any prior notice to the BOs. Any such
amendments shall be binding on the BOs who are already
registered as user of this service.
Governing Law and Jurisdiction :
Providing the Service as outlined above shall be governed by the
laws of India and will be subject to the exclusive jurisdiction of the
courts in Mumbai.
I/We wish to avail the SMS Alerts facility provided by the depository on my/our mobile number provided in the registration form subject to the
terms and conditions mentioned below. I/We consent to CDSL providing to the service provider such information pertaining to
account/transactions in my/our account as is necessary for the purpose of generating SMS Alerts by service provider, to be sent to the said
mobile number.
I/We have read and understood the terms and conditions mentioned above and agree to abide by them and any amendments thereto made
by the depository from time to time. I/we further undertake to pay fee/charges as may be levied by the depository from time to time.
I/We further understand that the SMS alerts would be sent for a maximum four ISINs at a time. If more than four debits take place, the BOs
would be required to take up the matter with their DP.
I/We am/are aware that more acceptance of the registration form does not imply in any way that the request has been accepted by the
depository for providing the service.
I/We provide the following information for the purpose of registration/modification (Please cancel out what is not applicable).
DP ID
BO ID
Sole/First Holder's Name :

:
Third Holder's Name
Mobile No. on which
messages are to be sent
1
(Please write only the mobile number without prefixing country code or zero)
The Mobile Number is registered in the name of :

E-mail Id :
(Please write only ONE valid email Id on which communication; if any, is to be sent)
19
.................................................................
.................................................................
Place :.............................
Date :..............................

(28)
.................................................................
EASY / EASIEST FACILITY

ANNEXURE - B
Central Depository Services (India) Ltd. (CDSL)

17th Floor, Phiroze Jeejebhoy Towers, Dalal Street, Mumbai-400 023
Phone : 22723333 Fax : 91-22-22723199 Website : http://www.cdslindia.com
ELECTRONIC ACCESS TO SECURITIES INFORMATION & EXECUTIVE OF SECURE TRANSACTION (EASIEST)
REGISTRATION FORM - Beneficial Owner (BO)
Name of the Beneficial Owner(s) 1.
2.
3.
DPID
Client ID
Login ID (To be given by BO)

DP Name
DP Address
Corp. Office : A-78, Sector 2, Noida-201301, (U.P.), Regd. Office : 1249, Sector 19, Faridabad-121002 Haryana
Email Address of the BO

Mobile No.
Tel. No. with STD Code

Transfer Option (Y/N)
Trusted A/c
Account of Choice
Details of Trusted A/c
(Submit the under taking from Trusted a/c holders are per format attached, applicable only if Trusted A/c option is selected)
DP ID
Sr. No.
Client ID
1.
2.
3.
I/We would like to register above mentioned account for the easiest service. I/We hereby agree to the terms
and conditions I/we have read earlier for availing the said service.
Date..................................
Signature
20
Place........................................
10
10
(To be filled by DP)
This is to certify that

1.......................................................2.......................................................3..............
........................................ are
maintaining BO A/c No.....................................................with us. We have verified the signature of the said a ccount
holders and they match with the specimen signatures as per our records.
Signature______________
Date_____________________
(29)
Place___________________
ELECTRONIC ACCESS TO SECURITIES INFORMATION & EXECUTIVE OF SECURE TRANSACTION (EASIEST)

TRUSTED FORM - Beneficial Owner (BO)
Letter from the Trusted Account Holder

Date
Name of the Beneficial Owner(s)
1.
2.
3.
Address
Client ID
DPID
Dear Sir/Madam,
We acknowledge your request to nominate our depository account as a trusted account for the purpose of receiving
credits from your account. We have no objection for the same.
We agree that if any securities are moved to our account which are not due to us for any reasons including but not
limited to an error or fraud, we undertake to immediately return the securities to you. The details of our account
(trusted a/c) are as under.
Client ID
DPID
Yours faithfully,
(Authorised Signatories)
To be signed by the Trusted a/c holder
I/We hereby nominate the above account holder as our trusted account for easiest services where securities can be
credited from my/our account using the common infrastructure through interne.
Signature(s)
21
.................................................................
11
.................................................................
To be signed by the BO
(30)
111
.................................................................
DECLARATION FOR AVAILING OF BASIC SERVICES DEMAT ACCOUNT (BSDA) FACILITY
To,

Dated :______________________
Dear Sir / Madam

I / We wish to avail the BSDA facility for the new account for which we have submitted my / our account opening form
I / We wish to avail the BSDA facility for my / our below mentioned demat account number
DP ID
1 2 0 5 8 0 0 0
Client ID
NAME
PAN
Sole/First Holder
Second Holder
Third Holder
I/We have read and understood the regulatory (SEBI) guidelines for opening a Basic Services Demat Account and
undertake to comply with the aforesaid guidelines from time to time. I/we also undertake to comply with the guidelines issued
by any such authority for BSDA facility from time to time. I/We also agree that in case our demat account opened under
BSDA facility does not meet the eligibility for BSDA facility as per guideline issued by SEBI or any such authority at any point
of time, my / our BSDA account will be converted to regular demat account without further reference to me/us and will be
levied charges as applicable to regular accounts as informed by the DP.
I, the first / Sole holder also hereby declare that I do not have / propose to have any other demat account across depositories
as a first / sole holder.
Signature(s)
21
.................................................................
11
.................................................................
111
.................................................................
(Please Tear Here)
Acknowledgement Receipt
Received BSDA declaration from :
DP ID
1 2 0 5 8 0 0 0
Client ID
Name
Address
Depository Participant Seal and Signature
(31)
Name
Address
2.
3.
........................................................................................................
:.......................................................................................................
:.......................................................................................................
1 2 0 5 8 0 0 0
9-Digit MICR Code*
B)
Date of effect
Periodicity
(M/Bim/Qly/etc.
Amount of installment/
Amt of bill with
upper limit
Number of installments/
Valid up to (in case of
utility bills) / End date
(As per bank's record)
Signature of the Applicant(s)
Date :
Bank's Stamp :
Signature of Authorised Bank Offical
Certified that the particulars furnished above are correct as per our records.
Date :
23
I, hereby, declare that the particulars given are correct and complete. If the transaction
is delayed or not effected at all for reasons of incomplete information, I would not hold
the user responsible. I hereby agree to discharge the responsible. I have read the
option invitation letter and agree to discharge the responsibility expected of me as a
participant under the scheme.
ECS Debit state date:
Name of the
Scheme
Account No.
Cash Credit (Code 13)
Ledger No./Folio No. :...............................................................................................
Current A/c (Code 11)
D)
SB A/c (Code 10)
Account Type
C)
MICR 9 Digit code number of the bank & branch (appearing on the MICR cheque issued by the bank):
Branch Name :.......................................................................................................
A)
:.......................................................................................................
Bank Name
4.
Unique Identifier Code
I hereby authorize you to debit my account for making payment to Rs. ........................
through ECS (Debit) clearing as per the details given as under.
(As per Bank's proof)
DP A/c. No.
1.
ELECTRNOIC CLEARING SER VICE (DEBIT CLEARING) MANDA TE FORM
DEPOSITORY DIVISION
A-78, Sector 2, Noida-201301, Uttar Pradesh

:.......................................................................................................
:.......................................................................................................
........................................................................................................
SB A/c (Code 10)
Date :
Amt of bill with
upper limit

(A/c holder's Signature should be the same as in bank A/c. In case of joint account both the holder must sign the mandate form)
Date :
Bank's Stamp :
1
13
Signature_____________________________________Name_________________________________
Signature_____________________________________Name_________________________________
13
Signature_____________________________________Name_________________________________
24
Periodicity
(M/Bim/Qly/etc.
........................................................................................................
:.......................................................................................................
:.......................................................................................................
Date of effect
Name of the
Scheme
Address
Name
Account No.
Account Type
9-Digit MICR Code*
Phone No.
Branch Address:.......................................................................................................
Branch Name :.......................................................................................................
Bank Name
The Manager
AUTHORISATION TO BANK FOR DEBITING THE ACCOUNT

A-78, Sector 2, Noida-201301, Uttar Pradesh
DEPOSITORY DIVISION
DP A/c. No.
:.......................................................................................................
1 2 0 5 8 0 0 0
ELECTRNOIC CLEARING SER VICE (DEBIT CLEARING) MANDA TE FORM
Name
:.......................................................................................................
1.
2.
Address
3.
........................................................................................................
4.
Branch Name :.......................................................................................................
Bank Name
:.......................................................................................................
A)
9-Digit MICR Code*
Account Type
Periodicity
(M/Bim/Qly/etc.
Amt of bill with
upper limit
SB A/c (Code 10)
B)
C)
D)
Date of effect
Account No.
Name of the
Scheme
25
Signature of the Applicant(s)
Date :
(As per bank's record)
Bank's Stamp :
Date :
AUTHORISATION TO BANK FOR DEBITING THE ACCOUNT
:.......................................................................................................

Bank Name
The Manager
Branch Name :.......................................................................................................
:.......................................................................................................
........................................................................................................
Branch Address:.......................................................................................................
Phone No.
9-Digit MICR Code*
SB A/c (Code 10)
Account Type
:.......................................................................................................
Account No.
Name
:.......................................................................................................
Date of effect
Periodicity
(M/Bim/Qly/etc.
Amt of bill with
upper limit
........................................................................................................
Address
Name of the
Scheme
Date :
26
Signature_____________________________________Name_________________________________
14
Signature_____________________________________Name_________________________________
1
14
Signature_____________________________________Name_________________________________
Bank's Stamp :
Date :
(A/c holder's Signature should be the same as in bank A/c. In case of joint account both the holder must sign the mandate form)

DP : CENTRAL DEPOSITORY SECURITIES LTD.
Tel.: +91-9990799941-48 Fax : 0120-4313311 E-mail : [email protected] Website : www.wellindia.com
ACKNOWLEDGEMENT RECEIPT
We hereby acknowledge the receipt of the Account Opening application form :
Name of the Sole/First Holder
Name of the Second Holder
Name of the Third Holder
(Depository Participant Seal and Signature)
VOLUNTARY DOCUMENT
CHECK LIST FOR CLIENT REGISTRATION FORM

FORM RECEIVING DATE :
BRANCH CODE :
ACCOUNT OPENING DATE :
GROUP CODE :
CLIENT CODE
1.
CHECKING DETAILS
a)
Name as it appears on the ID & Address Proof (in capital letter)
b)
Signature of Client on all pages and wherever necessary (Witness wherever required)
c)
Signature Checked and Verified.
d)
Photograph (duly signed)
e)
A copy of PAN Card (Self Attested)
f)
Address Proof (Self Attested)
g)
Bank Proof containing Client Name (Self Attested)
h)
Demat Account Proof (Self Attested)
i)
Brokerage :
j)
Exchange given :
YES
Intra Day
Delivery
F & O Intra Day
____________
____________
____________
NSE (CM)
BSE F&O
2.
Minimum ______________
Minimum ______________
Option
______________
NSE F&O
NSE (Currency)
MCX-SX (Currency)
BSE (CM)
USE (Currency)
Sub-broker and Client to be informed if any of the above detail is missing or invalid
by_______________________Date_________________Time___________________
3.
Details Punched in Computer by TM__________________ DP__________________
4.
Cross Checking done by TM__________________ DP__________________
5.
UCC UPLOADED :
NSE
6.
BSE
MCX-SX
USE
ENTERED IN FORM DATA
BACK OFFICE WEB LOGIN

User Name ID________________________Password _______________________
7.
DP WEB LOGIN
User Name ID________________________Password _______________________
8.
Details sent to Surveillance by_______________Date :_________ Time :__________
9.
Client ID Mapping done by ________________________

Branch ID_________________User ID:_______________Dealer ID :_______________
10.
INTERNET TRADING
Odin Diet
Welltrade
Now
Mobile Trading
User ID___________________________Password ____________________________

11.
Form sent to DP by_________________Date :_____________Time :_____________
12.
Client Instruction Book issued by
13.
Client Account Status Report issued by
14.
Form Returned to Compliance by_________________Date :___________Time :__________
15.
Kit Dispatched on________________(Date)
16.
Confirmation from Client (Telephonic Verfication)
Extn. No. __________________
Date : ________________ Time : ________________
Verified by _________________
REMARKS
Our Group Services
Broking
Equity
Commodity
Currency
Research & Advisory

Equity
Commodity
Currency
Invesments
Mutual funds
Bonds
IPOs
Fds
Life & General Insurance

Real Estate
Our Group Websites
www.wellindia.com
(Financial)
www.news.wellindia.com
(Monthly News Updates)
www.pr.wellindia.com
(Media Presence)
www.ibbm.co.in
(Financial Education)
www.22acre.com
(Real Estate)
www.yatra4u.com
(Travel)
Financial Education IBBM
www.snacksindia.com
Tour & Travels - Yatra4u
(Restaurant)

MEMBER : NSE, BSE, MCX-SX & USE
SEBI Registration Nos.: NSE -INB/INF/INE 231282931,
BSE -INB/INF 011282937, MCX-SX-INE261282931,
USE -INE271282936
Tel.: +91-9990799941-48, Fax : 0120-4313311
For more information visit us at www.wellindia.com or SMS WELL at 56677

Wellindia Equity Including BSDA

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Branch Tag

Wellindia Securities Ltd.

Client Registration Form

Wellindia Securities Limited

Registered with SEBI Since

SEBI Registration Nos.: NSE -INB/INF/INE 231282931, BSE -INB/INF 011282937,

National Stock Exchange of India Ltd.

Bombay Stock Exchange Ltd.

MCX Stock Exchange Ltd.

United Stock Exchange Ltd.

Wellindia Securities Limited

Corp. Office : A-78, Sector 2, Noida-201301, Uttar Pradesh

INSTRUCTIONS / CHECK LIST FOR FILLING KYC FORM

Proof of Existence/Constitution document.

Copy of SEBI registration certificate.

Copy of Registration Certificate under Societies Registration Act.

ACCOUNT OPENING KIT

Name of the Document

Brief Significance of the Document

Account Opening Form

A. KYC Form - Document captures the basic information

B. Document captures the additional information about the constituent

C. Additional KYC Form For Opening a Demat Account

Rights and Obligations

Document stating the Rights & Obligations of stock broker/ trading

Risk Disclosure Document (RDD)

Documents detailing do's and don'ts for trading on exchange,

Policies and Procedures

Document describing significant policies and procedure of the stock broker.

Document detailing the rate / amount of brokerage and other

VOLUNTARY DOCUMENTS AS PROVIDED BY THE STOCK BROKER

Name of the Document

Brief Significance of the Document

Letter where in Client Authorises Stock Broker to

ADDITIONAL DOCUMENTS FOR SPECIAL TYPE OF ACCOUNTS (DEMAT ACCOUNT ONLY)

KNOW YOUR CLIENT (KYC) APPLICATION FOR INDIVIDUALS

Wellindia Securities Limited

Name of the Applicant

Permanent Account Number (PAN) :

: Tel.: (O) ..................................................... Tel. (R) .........................................................

Specify the proof of address submitted : .........................................................................................................................................

Specify the proof of address

Validity Expiry Date of Proof of Address Submitted

Below Rs. 1 Lac

Rs. 1 Lac to 5 Lac

Rs. 10 Lac to 25 Lac

Please tick, if applicable

Any other information

Politically Exposed Person (PEP)

Related to Politically Exposed Person (PEP)

Signature of the Applicant

FOR OFFICE USE ONLY

Name of the person who has done the IPV :

Seal/Stamp of the Intermediary

Signature of the person who has done the IPV

(Originals verified) True Copies of documents received

Signature of the Authorised Signatory

KNOW YOUR CLIENT (KYC) APPLICATION FOR INDIVIDUALS