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Lat:26.439116, Long:80.

2829069

SMC Global Securities Limited


DEMAT ACCOUNT OPENING FORM
Application Number* 290467

Account Type* Individual Resident Individual Resident Indian

1. Personal Details (Sole / First Holder)


Name* SHAKTI PANDEY
Maiden Name (If any*)

Father/Spouse Name* Suresh chandra pandey


Mother Name*
Sushma Rani pandey
Date of Birth*
23-07-1996 00:00:00
Gender* FEMALE
Marital Status* UnMarried Sign Here

Citizenship* Indian
Residential Status* INDIVIDUAL
Occupation Type* Student
Residence for Tax
Purposes In
Jurisdiction(s) Outside
India*

Country of Jurisdiction of
Residence*

Tax Identification
Number or Equivalent(If
issued by jurisdiction)*

Place/City of Birth*

Country of Birth*

2. Proof of Identity
Passport Number Passport Expiry Date

Voter ID Card

PAN Card (Mandatory) EKLPP5403B


Driving Licence Driving Licence Expiry Date

UID (Aadhaar)

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 1
3. Proof of Address
Address Type* RESIDENTIAL/BUSINESS

Proof of Address*

Correspondence Address

Address Line 1* D/O Suresh Chandra Pandey 204/2 purani basti naubasta
Address Line 2 Kanpur Kanpur Nagar
Address Line 3

City/Town/Village* District*

State* Uttar Pradesh Country* INDIA


PIN Code* 208021
Permanent Address

Address Line 1*
D/O Suresh Chandra Pandey 204/2 purani basti naubasta
Address Line 2
Kanpur Kanpur Nagar
Address Line 3

City/Town/Village* Kanpur District* Kanpur


State* Uttar Pradesh Country* India
PIN Code*
208021

4. Contact Details
Tel.(Off.) Tel.(Res.)

Mobile No.* 9889878428 Fax

Email ID* FDBV6714@GMAIL.COM

5. Details of Related Person


Name NA

Related Person Type NA

PAN NA

KYC Number of Related


Person (if available*)

6. PROOF OF IDENTITY [PoI] OF RELATED PERSON


Passport Number Passport Expiry Date

Voter ID Card

PAN Card (Mandatory)

Driving Licence Driving Licence Expiry Date

UID (Aadhaar)

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 2
7. Applicant 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. Sign Here
• I hereby consent to receiving information from Central KYC Registry through
SMS/Email on the above registered number/email address.
Date: 25-07-2021 Place:
18:59:30
New Delhi

8. Attestation/For Office use only


Document Received Certified Copies

In-person verification (IPV), Documents verified with original & Client


Intermediary/Institution Details
interviewed by

SMC Global Employee/SB/AP name


Name Securities
Limited Code Designation

Signature
CKYC Institution Code IN1100
Date

9. ACCOUNT OPENING FORM FOR INDIVIDUALS


SMC Global Securities Ltd.
11/6B, Shanti Chamber, Pusa Road, Delhi - 110005.
DP ID: 12019100 | Regn. No.: IN-DP-130-2015

Client ID 1201910000770092
BRANCH

BRANCH CODE

I/We request you to open a depository account in my/our name as per the following details:
DATE

A) TYPE OF ACCOUNT
Type of Account Individual Resident

B) Details of Account holder(s):


Account Holder(s) Sole / First Holder Second Holder Third Holder

Name SHAKTI PANDEY Not Applicable Not Applicable

PAN EKLPP5403B Not Applicable Not Applicable

Occupation Not Applicable Not Applicable


Student
Gross Annual Income Detail 5 Lakh to 10 lakh Not Applicable Not Applicable

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 3
C) Bank Details
Bank Account Type

Bank Account Number 100017985129


Bank Name Equitas
Branch Address(Mandatory) Lucknow
Pin Code

IFSC ESFB0017005
MICR Code 226756002

D) Service Request
Account statement requirement As Per SEBI Regulation

I/We instruct the DP to receive each and every credit in my / our account YES

I/We wish to receive dividend/interest directly into my/our Bank A/c through ECS
(If not marked, the default option would be 'Yes'. ECS is mandatory for locations YES
notified by SEBI from time to time.)

I/We request you to send Electronic Transaction-Cum-Holding Statement through E-mail YES

SMS Alert Facility on Mobile Number as given in KYC Form


(Mandatory, If you have given PoA. Refer to T&C given in Annexure 'CDSL SMS YES
alert facility or our website under download section.' )

I/We would like to instruct the DP to accept all the Pledge instructions in my / our account
YES
without any other further instruction from my / our end.

I/We would like to share the E-mail ID with the RTA. YES

I/We would like to recieve the annual report ELECTRONIC

To register for easi,please visit website www.cdslindia.com[easi allow a BO view his ISIN balances, transactions and value of the
portfolio online.]

Option for DIS booklet

Option 1 (YES)
I/We require you to issue Delivery Instruction Slip(DIS) booklet to me / us immediately on opening my / our CDSL account though
I/we have issued a Power of Attorney(POA)/ executed PMS agreement in favour of / with Moneywise finvest Limited(name of the
attorney / Clearing Member / PMS manager) for executing delivery instructions for setting stock exchange trades[settlement related
transactions]effected through such Clearing Member / PMS manager.

Option 2
I/We do not require the Delivery Instruction Slip(DIS)for the time being, since I/We have issued a POA/ Executed PMS agreement in
favour of/with Moneywise Finvest Limited(name of the attorney / Clearing Member / PMS manager)for executing delivery
instructions for setting stock exchange trades[settlement related transactions]effected through such Clearing Member / PMS
manager. However, the Delivery Instruction Slip (DIS) booklet should be issued to me/us immediately on my/our request at any later
date.

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 4
10. DECLARATION
I/We have received and read the Rights & Obligations document and Terms & Conditions 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.
Client Signature

First / Sole Holder Second Holder Third Holder

Sign of Client Sign Here NOT APPLICABLE NOT APPLICABLE

Date: Place:

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 5
11. FORM FOR NOMINATION/ CANCELLATION OF NOMINATION

I/We wish to make a nomination. [As per details given below]


I/We wish to make a nomination and do hereby nominate the following person(s) who shall receive all securities held in the
Depository by me / us in the said beneficiary owner account in the event of my / our death.
1st Nominee Details
Name of Nominee :
Mr./Ms./Mrs.

PAN

DOB (Mandatory in
case of minor)

Relationship with the


BO (If any)

Address of Nominee

Address Line 1*

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Email

As the Nominee is a Minor as on Date, to receive the securities and fund 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
Name of Guardian :
Mr./Mrs.

PAN

Address Line 1

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Mobile

Relationship of
Email
Guardian with Nominee

Percentage of Allocation of Securities*

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 6
2nd Nominee Details
Name of Nominee :
Mr./Ms./Mrs.

PAN

DOB (Mandatory in
case of minor)

Relationship with the


BO (If any)

Address of Nominee

Address Line 1*

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Email

As the Nominee is a Minor as on Date, to receive the securities and fund 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
Name of Guardian :
Mr./Mrs.

PAN

Address Line 1

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Mobile

Relationship of
Email
Guardian with Nominee

Percentage of Allocation of Securities*

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 7
3rd Nominee Details
Name of Nominee :
Mr./Ms./Mrs.

PAN

DOB (Mandatory in
case of minor)

Relationship with the


BO (If any)

Address of Nominee

Address Line 1*

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Email

As the Nominee is a Minor as on Date, to receive the securities and fund 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
Name of Guardian :
Mr./Mrs.

PAN

Address Line 1

Address Line 2

Address Line 3

City/Town/Village* State*

Country* PIN Code*

Phone Mobile

Relationship of
Email
Guardian with Nominee

Percentage of Allocation of Securities*

Name(s) of holder(s) Signature(s) of holder

Sole/ First Holder/ Guardian (in case sole holder


Sign Here
is minor) (Mr./Ms.)

Second Holder (Mr./Ms.) Not Applicable Not Applicable

Third Holder (Mr./Ms.) Not Applicable Not Applicable

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 8
Charges for Depository Services

Annual Maintenance Charges (Individual) Rs. 300/-

Annual Maintenance Charges (Non-Individual) Rs. 1000/-

Transaction Charges (Market) Rs.10/-per transaction plus Depository Charges at actual

Transaction Charges (Off market/Inter


0.03% or Rs. 25/- whichever is higher
depository)

Pledge Charges
Rs.20/-per transaction plus Depository Charges at actual
(Creation/closer/ConfirmationLQYRFDWLRQ)

0DUJLQ3OHGJHcharges Rs. 0/- per transaction

Dematerialisation Charges Rs. 150/- per certificate

Rematerialisation Charges Rs. 150/- per certificate plus depository charges at actual

Repurchase/Redemption Charges Rs. 25/- per transaction plus depository charges at actual

Demat Rejection charges Rs. 35/- per certificate

Securities Lending & Borrowing Charges Rs. 25/- per transaction plus depository charges

Failed / Rejected Transaction Charges Rs. 50/- per transaction

Rs. 50/- per request plus courier charges at actual. Rs. 500/- for foreign
Adhoc / Non-periodic statement charges
address

Cheque Bounce Charges At actual

Note:
1. GSTwill be levied separately as applicable from time to time.
2. The Company reserves the right to review charges after one year with sufficient prior notice.

I/We have read the above tariff sheet and agree to pay the same.

Name(s) of holder(s) Signature(s) of holder

Sole/ First Holder/ (Mr./Ms.) Sign Here

Second Holder (Mr./Ms.) Not Applicable Not Applicable

Third Holder (Mr./Ms.) Not Applicable Not Applicable

Client Declaration
I hereby confirm that I have read and understood the contents of the form including declarations, authorization and have
also verified the information in the form. I hereby confirm that I have digitally signed the form including declarations,
authorizations and copy of documents at all places with inscription
‘Digitally Signed by: ’.

Signature of Client Sign Here

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Page 9
Signature

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
Pan

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST
सूच ना
आधार प चान का माण है, नाग रकता का नह |
पहचान का माण ऑनलाइन ऑथे टकेशन ारा ा कर |
यह एक इले टॉिनक ि या ारा बना हआ प है |

नामांकन मांक/ Enrolment No.: XXXX/XXXXX/XXXXX INFORMATION


To Aadhaar is a proof of identity, not of citizenship.
शि पा डे य To establish identity, authenticate online.
Shakti Pandey
Download Date: 25/07/2021

D/O Suresh Chandra Pandey This is electronically generated letter.


204/2,purani basti
naubasta
Kanpur
Kanpur Nagar Uttar Pradesh-208021
Generation Date: 08/07/2011

Signature Not Verified


Digitally signed by DS
UNIQUE IDENTIFICATION
AUTHORITY OF INDIA 04
Date: 2021.07.25 18:16:35
IST

XXXX XXXX 7671

Address: पता :
शि पा डे य
D/O Suresh Chandra Pandey, D/O सुरशे च पा डे य, 204/2,पुरानी ब ती,
Shakti Pandey
ज म ित थ/DOB: 23/07/1996 204/2,purani basti, naubasta, नौब ता, कानपुर, कानपुर नगर,
मिहला/ FEMALE Kanpur, Kanpur Nagar, उ र देश, 208021
Uttar Pradesh, 208021

XXXX XXXX 7671 XXXX XXXX 7671

Signed by: SHAKTI PANDEY


eSigned using Aadhaar (digio.in)
Date: 2021-07-25 19:02:41 IST

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