NSDL
NSDL
NSDL
Regd. Office : 301, Centre Point, Dr. Babasaheb Ambedkar Road, Parel, Mumbai - 400 012.
Phone : 91-22-6177 9400 to 09 Fax: 91-22-6177 9058 Website : www.shcil.com CIN : U67190MH1986GOI040506
PART I-KNOW YOUR CLIENT (CENTRAL - KYC) APPLICATION FORM (For Individuals)
Simplified (for low risk customers)
DP Temp ID
GST IN
City of Birth
Agriculturist
Brief Details for above
OTHER DETAILS ( Please refer to Sr no. 3 of the instructions )
Gross Annual Income Details: Income Range per annum (please tick any one) As on Date: (Should not be older than 1 Yr.)
Below ` 1 lac ` 1-5 lac ` 5-10 lac ` 10-25 lac More than ` 25 lac
Educational Qualifications : Below SSC SSC HSC Graduate Masters Professionals( CA, CS, CMA, etc.)
Please Tick If Applicable Politically exposed person Related to politically exposed person (PEP)
Are you a Tax Resident (i.e. Citizen / Resident / Green Card holder / Assessed for Tax) in any country other than India? £ YES / £ No AND are you US
Person ? £ YES / £ NO (If YES then please fill point no. (2) of C-KYC)
If TIN is not available, reason for non-submission / mentioning TIN details to be provided. Please tick any one of the following:
The Country where the account holder is liable to pay tax does not issue TIN to its residents.
No TIN required (select the reason only if the authorities of the respective country of tax residence does not require TIN to be collected)
Other Reason (Please specify)
GST IN
S- Simplified Measure Account - Document Type Code Identification Number
District*
District*
*
*
GST IN
S- Simplified Measure Account - Document Type Code Identification Number
FATCA /CRS Declaration: I understand that StockHolding is relying on this information for the purpose of determining the status of the applicant named above
in compliance with FATCA/CRS. StockHolding cannot offer any tax advice on CRS or FATCA or its impact on the applicant. I/we shall seek advice from
professional tax advisor for any tax questions. I also undertake to keep StockHolding informed in writing about any changes / modification to the above
information in future within 30 days and also undertake to provide any other additional information as may be required at your end or by domestic or overseas
regulators/ tax authorities. I agree that as may be required by domestic regulators/tax authorities StockHolding may also be required to report, reportable details
to CBDT or suspend my account. I/we certify that the information provided in this form is true, correct, and complete including the taxpayer identification number
of the applicant. I also confirm that I have read and understood the FATCA & CRS Terms and Conditions given below and hereby accept the same.
Facebook ID
Twitter ID
Linkedin ID
Ver. 1.0.0 PAGE-2
KYC VERIFICATION /
CENTRAL KYC REGISTRY | Instructions / Check list / Guidelines for filling Individual KYC Application Form
General Instructions:
1 Fields marked with ‘*’ are mandatory fields.
2 Tick ‘ ’ wherever applicable.
3 Self-Certification of documents is mandatory.
4 Please fill the form in English and in BLOCK Letters.
5 Please fill all dates in DD-MM-YYYY format.
6 Wherever state code and country code is to be furnished, the same should be the two-digit code as per Indian Motor Vehicle, 1988 and ISO 3166 country code
respectively list of which is available at the end.
7 KYC number of applicant is mandatory for updation of KYC details.
8 For particular section update, please tick ( ) in the box available before the section number and strike off the sections not required to be updated.
9 In case of ‘Small Account type’ only personal details at section number 1 and 2, photograph, signature and self-certification required.
B Clarification / Guidelines on filling details if applicant residence for tax purposes in jurisdiction(s) outside India
1 Tax identification Number (TIN): TIN need not be reported if it has not been issued by the jurisdiction. However, if the said jurisdiction has issued a high integrity
number with an equivalent level of identification (a “Functional equivalent”), the same may be reported. Examples of that type of number for individual include, a social
security/insurance number, citizen/personal identification/services code/number, and resident registration number)
D Clarification / Guidelines on filling ‘Proof of Address [PoA] - Current / Permanent / Overseas Address details’ section
1 PoA to be submitted only if the submitted PoI does not have an address or address as per PoI is invalid or not in force.
2 State / U.T Code and Pin / Post Code will not be mandatory for Overseas addresses.
3 In case of Simplified Measures Accounts for verifying the address of the applicant, any one of the following documents can also be submitted and undernoted relevant
code may be mentioned in point 4.1.
Document Code Description
01 Utility bill which is not more than two months old of any service provider (electricity, telephone, post-paid mobile phone, piped gas, water
bill).
02 Property or Municipal Tax receipt.
03 Bank account or Post Office savings bank account statement.
04 Pension or family pension payment orders (PPOs) issued to retired employees by Government Departments or Public Sector Undertakings, if
they contain the address.
05 Letter of allotment of accommodation from employer issued by State or Central Government departments, statutory or regulatory bodies,
public sector undertakings, scheduled commercial banks, financial institutions and listed companies. Similarly, leave and license agreements
with such employers allotting official accommodation.
06 Documents issued by Government departments of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India.
E Clarification / Guidelines on filling ‘Proof of Address [PoA] - Correspondence / Local Address details’ section
1 To be filled only in case the PoA is not the local address or address where the customer is currently residing. No separate PoA is required to be submitted.
2 In case of multiple correspondence / local addresses, Please fill ‘Annexure A1’
H Clarification / Guidelines on filling ‘Related Person details – Proof of Identity [PoI] of Related Person’ section
1 Mention identification / reference number if ‘Z- Others (any document notified by the central government)’ is ticked.
I/We request you to open a depository account in my/our name as per the
Following details : Date D D M M Y Y Y Y
Please fill in ENGLISH and in BLOCK LETTERS with BLACK INK
PAN
OCCUPATION
private private sector Agriculturist private sector Agriculturist
sector Agriculturist
Brief Details
B) For Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., although the account is opened in the name of the
natural persons, the name & PAN of the Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., should be
mentioned below:
a) Name b)PAN
C) Type of account
NRI-Repatriable NRI-Non
Ordinary Resident
Foreign National Repatriable
Qualified Foreign Investor
Margin Others (Please specify) _______ Promoter
G) Bank Details
1 Bank account type Saving Account Current Account Others (Please specify) -----------------------
4 Branch Address
H) Standing Instructions
1 We authorize you to receive credits Yes No
automatically in our account
Account to be operated through Power of
2 Yes No
Attomey(PoA)
3 No download for email-ID to Issuers /RTA 1st Holder 2nd Holder 3rd Holder
I) Guardian Details (where sold holder is minor ):[For account of minor ,two KYC Application Forms must be filled i.e one for the
guardian and another for minor (to be signed for guardian)]
Guardian Name
PAN
PINCODE
6 Email ID of nominee(S)
SIGNATURE
PINCODE
SIGNATURE
(b) Details of the DP staff who has carried out ‘in - person’ verification.
(c) Date and place where ‘in-person’ verification was carried out ________________________________
Declaration
The rules & regulations of the Depository and Depository Participants pertaining to an account which are in force now have been read by me/us and
I/we have understood the same and I/we agree to abide by and to be bound by the rules as are in force from time to time for such accounts. I/we hereby
declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we undertake to inform you of any
changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am/ we are aware
that I/we may be held liable for it. In case nonresident account, I/we also declare that I/we have complied and will continue to comply with FEMA
regulations. I / we acknowledge the receipt of copy of the document, ''Rights & Obligations of the Beneficial Owner and Depository Participant'' / I/We
understand that a copy of the ''Rights & Obligations of the Beneficial Owner and Depository Participant'' will be received by email since opted for the
same.
Third Holder(Mr./Ms.) X
Notes:
All communication shall be sent at the address of the Sole/First holder only.
1. Thumb impressions and signatures other than English or Hindi or any of the other language not contained in the 8th
Schedule of the Constitution of India must be attested by a Magistrate or a Notary Public or a Special Executive
Magistrate.
2. Instructions related to nomination, are as below:
I. The nomination can be made only by individuals holding beneficiary owner accounts on their own behalf singly or
jointly. Non- individuals including society, trust, body corporate, partnership firm, Karta of Hindu Undivided Family,
holder of power of attorney cannot nominate. If the account is held jointly all joint holders will sign the nomination form.
II. A minor can be nominated. In that event, the name and address of the Guardian of the minor nominee shall be provided
by the beneficial owner.
III. The Nominee shall not be a trust, society, body corporate, partnership firm, Karta of Hindu Undivided Family or a power
of Attorney holder. A nonresident Indian can be a Nominee, subject to the exchange controls in force, from time to time.
IV. Nomination in respect of the beneficiary owner account stands rescinded upon closure of the beneficiary owner
account. Similarly, the nomination in respect of the securities shall stand terminated upon transfer of the securities.
V. Transfer of securities in favor of a Nominee shall be valid discharge by the depository and the Participant against the
legal heir.
VI. The cancellation of nomination can be made by individuals only holding beneficiary owner accounts on their own behalf
singly or jointly by the same persons who made the original nomination. Non- individuals including society, trust, body
corporate, partnership firm, Karta of Hindu Undivided Family, holder of power of attorney cannot cancel the nomination.
If the beneficiary owner account is held jointly, all joint holders will sign the cancellation form.
VII. On cancellation of the nomination, the nomination shall stand rescinded and the depository shall not be under any
obligation to transfer the securities in favor of the Nominee.
VIII. Nomination can be made upto three nominees in a demat account. In case of multiple nominees the client must specify
the % of share for each nominee that shall total upto 100%. In the event of the beneficial owner not indicating any % of
allocation / share for each of the nominees, the default option shall be to settle the claims equally amongst all the
nominees.
IX. On request of Substitution of existing nominees by the beneficial owner, the earlier nomination shall stand rescinded.
Hence, details of nominees as mentioned in the FORM 10 / Nomination form at the time of substitution will be
considered. Therefore, please mention the complete details of all the nominees.
X. Copy of any proof of identity must be accompanied by original for verification or duly attested by any entity authorized
for attesting the documents, as provided in Annexure D.
XI. Savings bank account details/demat account details shall only be considered if the account is maintained with the
same participant.
3. For receiving Statement of Account in electronic form:
I. Client must ensure the confidentiality of the password of the email account.
II. Client must promptly inform the Participant if the email address has changed.
III. Client may opt to terminate this facility by giving 10 days’ prior notice. Similarly, Participant may also terminate this
facility by giving 10 days’ prior notice.
4. Strike off whichever is not applicable.
(To be filled in by SHCIL)
Checked by
I Verify that the Account Opening Form is in order
Entered in ISA
Name:
Authenticated in ISA
Employee Code:
Released in DPM
Signature:
Acknowledgement *
Received the application from Mr./Ms. as the sole / First holder along with and as the second and third holders
respectively for openingof a depository account. Please quote the DP ID & Client ID allotted to you in all your
future correspondence.
DP ID Client ID Date
Name of account holder
□ Mobile Number
□ Email ID
I hereby declare that the aforesaid mobile number or E-mail ID belongs to □ Me or □ My family
(spouse, dependent children and dependent parents).
DP ID Client ID Date
Name of account holder
□ Mobile Number
□ Email ID
I hereby declare that the aforesaid mobile number or E-mail ID belongs to □ Me or □ My family
(spouse, dependent children and dependent parents).
DP ID Client ID Date
Name of account holder
□ Mobile Number
□ Email ID
I hereby declare that the aforesaid mobile number or E-mail ID belongs to □ Me or □ My family
(spouse, dependent children and dependent parents).
UMRN DATE
with bank Name of customers bank IFSC or MICR
an amount of Rupees
FREQUENCY X Mthly X Qtly X HYrly X Yrly As & when presented DEBIT TYPE X Fixed Amount Maximum Amount
Client ID Phone No.
DP ID Email ID
"I agree for the debit of mandate processing charges by the bank whom I am authorizing to debit my account as per latest schedule of charges of the bank."
PERIOD
From
To
Signature Primary Account holder Signature of Account holder Signature of Account holder
or Until Cancelled
1. Name as in bank records 2. Name as in bank records 3. Name as in bank records
This is confirm that the declaration has been carefully read, understood & made by me/us. I am authorizing the user entity/Corporate to debit my account, based on the instructions as agreed and signed by me.
I have understood that I am authorize to cancel / ammend this mandate by appropriately communicating the cancellation / amendment request to the user entity / corporate or the bank where I have authorized the debit.