Instructions / Checklist For Filling KYC Form

Instructions / checklist for filling KYC form
A. Important points
1. 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.
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 Co-Operative Bank / Multinational Foreign Banks / Gazetted
Officer / Notary Public / 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 apostilled 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 up to 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. 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.
In respect of other clients, documents as per risk management policy of the stock broker need to be provided by the client from time to time.
G. 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.
H. 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/others & their specimen signatures.
1
S. No. Name of the Document Brief Significance of the Document Page No
MANDATORY DOCUMENTS AS PRESCRIBED BY SEBI & EXCHANGES
A. KYC form - Document captures the basic information about 3
the constituent and an instruction/checklist.
1 Account Opening Form
B. Document captures the additional information about the 4–6
Constituent relevant to trading account and an instruction /check list.
2 Tariff Sheet Document detailing the rate/amount of brokerage and other charges 7
levied on the client for trading on the stock exchange(s).
Document stating the Rights & Obligations of stock broker /trading
3 Rights and Obligations member and client for trading on exchanges (including additional rights Annexure
& obligations in case of internet/wireless technology based trading). A
Risk Disclosure Document Document detailing risks associated with dealing in the securities Annexure
4 (RDD) market. B
Document detailing do’s and dont’s for trading on exchange for Annexure
5 Guidance note
education of investors C
6 Policies and Procedures Document describing significant policies and procedures of Annexure
Stock Broker. D
VOLUNTARY AND OPTIONAL DOCUMENTS AS PROVIDED BY THE STOCK BROKER
Undertaking Contains voluntary undertakings by the client with respect to Zerodha's

7 8–9
internal operations during the course of the relationship with Zerodha.
Running Account Authorization Letter of Authorization for maintaining a Running Account with Zerodha
8 10
and Mobile Declaration and Client consent letter for receiving SMS from Zerodha
Client Defaulter Declaration Client declaration stating that he is not a defaulter and Client
9 11
and Client Acknowledgment acknowledgment that he has read all the rules & regulations.
Annexure
10 Nomination Details Collects details of any nomination made for the account 1A
Name of the Trading Member Zerodha Broking Limited (hereinafter referred to as "Zerodha")
Name of the Clearing Member Zerodha Broking Limited
Cash Segment NSE, BSE : Zerodha Broking Limited
NSE: F&O: Zerodha Broking Limited SEBI Registration No. INZ000031633
CDS: Zerodha Broking Limited SEBI Registration No. INZ000031633
Derivatives
COM: Zerodha Broking Limited SEBI Registration No. INZ000031633
BSE: F&O: Zerodha Broking Limited SEBI Registration No. INZ000031633
CDS: Zerodha Broking Limited SEBI Registration No. INZ000031633
COM: Zerodha Broking Limited SEBI Registration No. INZ000031633
SEBI Registration Number:
Zerodha Broking Limited: Member of NSE & BSE – INZ000031633
CDSL: Depository services through Zerodha Broking Ltd. – IN-DP-431-2019
Zerodha’s Registered Office:
153/154, 4th Cross, Dollars Colony, Opp. Clarence Public School, J.P. Nagar, 4th Phase Bangalore -
560078. Ph : 080-47181888
Correspondence Address : Same as above
Compliance Officer: Venu Madhav, Phone No. & Email ID: 080-47181888, [email protected]
CEO: Nithin Kamath, Phone No. & Email ID: 080-47181888, [email protected]
For any grievance please contact Zerodha at the above address or email [email protected] &
Phone no. 91-8047181888.
In case not satisfied with the response, please contact the concerned exchange at:
1.NSE: [email protected] or contact at 022-26598100 | 2. BSE: [email protected] or contact at 022-22728097
2 Sign wherever you see
Know Your Client (KYC) Application Form - for Individuals
Please fill this form in English and BLOCK Letters
(Please tick the box on the left margin of the appropriate row where CHANGE/CORRECTION is required and provide the details in the corresponding window)
For office use only (To be filled by the financial institution)

Application Type* New Update KYC Number
Account Type* Normal Simplified (for low risk customers) Small
A. Identity details
Photograph
KARTHIK SOLLEPURA RAMANNA
1. Name (Same as ID Proof) Please affix your
recent passport size
1a. Maiden Name (If any) ---- photograph and
2. Father's/Spouse's Name Ramanna DS sign across it
2a. Mother's Name Laxmi Devi
Signed by: Karthik S R
eSigned using Aadhaar (digio.in)
F1
Date: 2021-07-02 11:23:26 IST
3a. Gender * Male Female Transgender 3b. Marital Status * Single Married Other 3c. DOB 1998-10-02
4a. Citizenship * Indian Other ___________________(ISO 3166 Country Code )
4b. Residential Status * Resident Individual Non Resident Indian Person of Indian Origin Foreign National
Tick if applicable Residence for tax purposes in jurisdiction(s) outside India

ISO 3166 Country Code of Jurisdiction of residence Place of birth_____________________________________
Tax Identification Number or Equivalent ISO3166 Country Code of Birth
5a. PAN EHOPR8794H

5b. Unique Identification Number (UID) / AADHAR, if any
6. Proof of Identity Submitted * Pan Card Other (Please Specify) ____________________________________
B. Address details
1. Contact Details
Telephone (Office) Mobile No 9738428508
Telephone (Residence) Email ID [email protected]
2. Residence/Correspondence Address Address Type: * Residential Business Unspecified
Address # 1999/A Up Stairs, Subhash Nagar 3rd Cross Subhash Nagar
Subhash Nagar Subhash Nagar
City/Town Mandya District Mandya Pin Code 571401
State/U.T Code KARNATAKA Country/ISO Code India
Specify the Proof of Address Submitted for Residence / Correspondence Address
C. 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 Signed by: Karthik S R
false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. eSigned using Aadhaar
(digio.in)
Date:F2
I hereby consent to receiving information from Central KYC Registry through SMS/email on the above registered Client Signature
2021-07-02 11:23:26 IST
number/email address.
Date :
FOR OFFICE USE ONLY

In Person Verification (IPV) Details:
Name of the Person who has done the IPV: ___________________________________________________
Designation: ____________________________________ Employee ID: __________________________
Name of the Organization: ZERODHA BROKING LIMITED
Seal/Stamp of the Intermediary
Date of the IPV: Signature of the Person who has done the IPV
Originals Verified and Self-Attested Document Copies Received
Date Signature of the Authorized Signatory

3. Permanent Address
Address # 1999/A Up Stairs, Subhash Nagar 3rd Cross Subhash Nagar
Subhash Nagar Subhash Nagar
City/Town Mandya District Mandya Pin Code 571401
State/U.T Code KARNATAKA Country/ISO Code India
4. Address in the jurisdiction details where applicant is resident outside India for tax purpose (if applicable)
Address
City/Town District Pin Code

State/U.T Code Country/ISO Code
D. Details of related person (In case of additional related persons, please fill below details)
Addition of Related Person Deletion of Related Person
KYC Number of Related Person (if available)
Related Person Type Guardian of Minor Assignee Authorized Representative
Name
(If KYC number & name are provided, below details are optional)
Proof Of Identity Of Related Person
Identity Proof Submitted Number
Expiry Date : D D M M Y Y Y Y
Others (any document notified by the Central Govt.) Identification No

Simplified Measures Account-Document Type Code Identification No
Trading account related details

A. Bank account details
Account Type: Savings * Current Others | In case of NRI Account: NRE NRO
Bank Name HDFC BANK LTD
Branch Address NO 1121 5D GROUND FLOOR
MANDYA KARNATAKA
Account Number 50100385488275
MICR Number 571240502 IFSC Code HDFC0002567
B. Other details
Gross Annual Income Details (please specify): Income Range per annum
Below Rs 1 Lakh 1-5 Lakh * 5-10 Lakh 10-25 Lakh 25 Lacs to 1 Cr >1Cr
Or Net-worth as on ________________date___________________ (Net worth should not be older than 1year)
Occupation
Private Sector Public Sector Government Service Business Professional Agriculturist Retired
Housewife Student Self Employed Others (please specify) ____________________________________
Others
Mode in which you wish to receive the RDD, Rights & Obligations, and Guidance Note: Physical Electronic *
Please tick, if applicable: Politically Exposed Person (PEP) Related to a Politically Exposed Person (PEP)
In what capacity do you trade commodities?

Farmer/Farmer Producer Organisation Value Chain Participant Others

C. 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___________________________________________________________________________________________
D. Depository account(s) details

Depository Name: NSDL CDSL *
Depository Participant Name Zerodha Broking Limited
Beneficiary Name KARTHIK SOLLEPURA RAMANNA
Depository ID 12081600 Beneficiary ID 85153061
E. Dealings through other stock brokers

Whether dealing with any other stock broker/sub-broker (in case dealing with multiple stock brokers/sub-brokers, provide
details of all)
Name of Stock Broker Sub Broker, if any
Client Code Exchange(s)
Website
Details of disputes/dues pending from/to such stock broker
F. Introducer details (optional)

Name of the Introducer
Status of the Introducer - Sub-broker/Remisier/Authorized Person/Existing Client
Address of the Introducer
Phone Number Signature (optional)
G. Trading preferences / experience

No Prior Experience *
Years in Equities 0 Years in Derivatives Years in other Investment Related Field
Please sign in the relevant boxes where you wish to trade. The segment not chosen should be struck off by the client.
*If, in future, the client wants to trade on any new segment, a separate authorization/letter should be taken from the client
by the broker.
Cash F&O Currency derivatives Commodity derivatives
NSE Signed by: Karthik S R

F3 (a) Client Signature
Date: 2021-07-02 11:23:26 IST F3 (b) Client Signature
Date: 2021-07-02 11:23:26 IST F3 (c) Client Signature
Date: 2021-07-02 11:23:26 IST F3 (d) Client Signature
Date: 2021-07-02 11:23:26 IST
BSE Signed by: Karthik S R Signed by: Karthik S R Signed by: Karthik S R Signed by: Karthik S R
eSigned using Aadhaar (digio.in) eSigned using Aadhaar (digio.in) eSigned using Aadhaar (digio.in) eSigned using Aadhaar (digio.in)
Date:F3 (e) Client
2021-07-02 11:23:26 IST Date:F3
Signature (f) Client
2021-07-02 Signature
11:23:26 IST Date:F3 (g) Client
2021-07-02 11:23:26 IST Date:F3
Signature (h)
2021-07-02 Client Signature
11:23:26 IST
H. Additional details
(I) Whether you wish to receive (a) Physical contract note (b) Electronic Contract Note (ECN) *
[email protected]
If ECN Specify your Email ID __________________________________________________________________________
(II) Whether you wish to avail the facility of internet trading/wireless technology/mobile trading Yes * No
I. Nomination details (Please tick the appropriate options)

I / We do wish to nominate (Fill Annexure 1A)
* I / We do not wish to nominate
5
Internet & wireless technology based trading facility provided by stock broker to the client
(All the clauses mentioned in the “Rights and Obligations”document(s) shall be applicable.
Additionally, the clauses mentioned herein shall also be applicable.)
1. Stock broker is eligible for providing Internet Based trading (IBT) and securities trading through the use of wireless technology
that shall include the use of devices such as mobile phone, laptop with datacard, etc. which use Internet Protocol (IP). The stock
broker shall comply with all requirements applicable to internet based trading/securities trading using wireless technology as
may be specified by SEBI & the Exchanges from time to time.
2. The client is desirous of investing/trading in securities and for this purpose, the client is desirous of using either the internet
based trading facility or the facility for securities trading through use of wireless technology. The Stock broker shall provide the
Stock broker’s IBT Service to the Client, and the Client shall avail of the Stock broker’s IBT Service, on and subject to
SEBI/Exchanges Provisions and the terms and conditions specified on the Stock broker’s IBT website provided that they are in
line with the norms prescribed by Exchanges/SEBI.
3. The stock broker shall bring to the notice of client the features, risks, responsibilities, obligations and liabilities associated with
securities trading through wireless technology/internet/smart order routing or any other technology should be brought to the
notice of the client by the stock broker.
4. The stock broker shall make the client aware that the Stock Broker’s IBT system itself generates the initial password and its
password policy is as stipulated in line with norms prescribed by Exchanges/SEBI.
5. The Client shall be responsible for keeping the Username and Password confidential and secure and shall be solely responsible
for all orders entered and transactions done by any person whosoever through the Stock broker’s IBT System using the Client’s
Username and/or Password whether or not such a person was authorized to do so. Also the client is aware that authentication
technologies and strict security measures are required for the internet trading/securities trading through wireless technology
through order routed system and undertakes to ensure that the password of the client and/or his authorized representative are not
revealed to any third party including employees and dealers of the stock broker.
6. The Client shall immediately notify the Stock broker in writing if he forgets his password, discovers security flaw in Stock
Broker’s IBT System, discovers/suspects discrepancies/unauthorized access through his username/password/account with full
details of such unauthorized use, the date, the manner and the transactions effected pursuant to such unauthorized use,etc.
7. The Client is fully aware of and understands the risks associated with availing of a service for routing orders over the
internet/securities trading through wireless technology and Client shall be fully liable and responsible for any and all acts done in
the Client’s Username/password in any manner whatsoever.
8. The stock broker shall send the order/trade confirmation through email to the client at his request. The client is aware that the
order/trade confirmation is also provided on the web portal. In case client is trading using wireless technology, the stock broker
shall send the order/trade confirmation on the device of the client.
9. The client is aware that trading over the internet involves many uncertain factors and complex hardware, software, systems,
communication lines, peripherals, etc. are susceptible to interruptions and dislocations. The Stock broker and the Exchange do
not make any representation or warranty that the Stock broker’s IBT Service will be available to the Client at all times without any
interruption.
10. The Client shall not have any claim against the Exchange or the Stockbroker on account of any suspension, interruption, non-
availability or malfunctioning of the Stock broker’s IBT System or Service or the Exchange’s service or systems or nonexecution
of his orders due to any link / system failure at the Client/Stock brokers/Exchange end for any reason beyond the control of the
stockbroker/Exchanges.
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 am/we 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 stock broker's designated website, if any.
Client Name ___________________________________________

Place ___________________________
Mandya Signed by: Karthik S R
eSigned using Aadhaar
(digio.in)
Date:F4
Date : 2021-07-02 Client Signature
2021-07-02 11:23:26 IST

Tariff sheet
To
Zerodha Broking Limited
153/154, 4th Cross, 4th Phase, JP Nagar, Dollars Colony, Opp. Clarence School, Bangalore - 560078
Charges for Zerodha Trading Services
2021-07-02
I/ We agree to pay the charges as per following charges structure for our Trading account with Zerodha effective ____________
EM3776
Client ID: _______________________
Charge Head Brokerage / Charges
Equity Intraday Rs. 20 per executed order or 0.03% of Turnover whichever is lower
Equity Delivery Zero Brokerage
Futures Rs. 20 per executed order or 0.03% of Turnover whichever is lower
Options* Rs. 20 per executed order
Currency Futures Rs. 20 per executed order or 0.03% of Turnover whichever is lower
Currency Options* Rs. 20 per executed order
Call & Trade Services Rs. 50 per order placed through a Dealer at Zerodha
NRI - Equity Delivery Rs. 100 per executed order or 0.1% of Turnover whichever is lower
NRI - Futures & Options Rs. 100 per executed order placed using a CP code
Disclaimer: For Delivery based trades, a minimum of Rs. 0.01 will be charged per contract note. Clients who opt to receive physical
contract notes will be charged Rs. 20 per contract note plus courier charges. A brokerage of 0.5% of the contract value will be
charged for contracts where physical delivery happens. In addition to the brokerage charge the following charges will also be
levied.
Schedule of Charges:
1. Exchange transaction charges | 2. Clearing charges | 3. Securities Transaction Tax | 4. Goods & Services Tax | 5. SEBI
Turnover fees | 6. Stamp Duty
Note : Brokerage will not exceed the rates specified by SEBI and the Exchanges
All Statutory and Regulatory charges will be levied at actuals
Brokerage is also charged on expired, exercised, and assigned Options contracts
*Turnover for Options is calculated as (Strike + Premium)*Lot Size
Charges for other value added services will be applicable at the time of availing such
service, upon your consent. Detailed explanation of all charges is available online at : Signed by: Karthik S R
https://zerodha.com/charge-list (digio.in)
F5 Client Signature
Date: 2021-07-02 11:23:26 IST
For office use only

EM3776
UCC Code allotted to the Client _________________________________________________________________________
Documents verified In-Person
Client interviewed by
with originals Verification done by
Name of the Employee
Employee Code
Designation of 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 non-mandatory
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 my/our website, if any, for the information of the clients.
Signature of the Authorised Signatory Seal/Stamp of the stock broker

Date : 2021-07-02

Zerodha Voluntary
153/154, 4th Cross, Dollars Colony, 4th Phase, JP Nagar, Opp. Clarence Public School, Bangalore - 560078.
Sub: Voluntary Undertaking/Authorisation
With respect to member-constituent relationship and mandatory and voluntary (optional) documents executed
between us, I/we do hereby authorize Zerodha to do the following:
1.ORDER PLACEMENT INSTRUCTIONS
I understand that you require written instructions from me for placing/modifying/cancelling orders. However, since it is not
practical for me to give written instructions for placing/modifying/cancelling order. Even If I have facility to trade online through
Internet and wireless technology, I may have to place orders by physically visiting/calling/emailing the call centre/branch
specified for the said purpose by Zerodha in case of breakdown of internet connectivity or other similar reasons. I hereby
request you to kindly accept my verbal orders/instructions, in person or over phone and execute the same. I understand the
risk associated with placement of verbal orders and accept the same. I shall not disown orders under the plea that the same
were not placed by me provided I am sent ECN/Physical contract notes or trade confirmations through SMS andother
approved modes. I/we also agree that non-receipt of bounced mail notification by you shall amount to delivery of contract
note at my/our email ID. I indemnify Zerodha and its employees against all trade related losses, damages, actions which you
may suffer or face, as a consequence carrying out my instructions for orders placed verbally
2.ERRORS AND OMISSIONS
I understand and agree that inadvertent errors may occur, while executing orders placed by me. In such circumstances Zerodha
shall make all reasonable efforts to rectify the same and ensure that I am not put to any monetary loss. I understand and agree that
I shall not hold Zerodha responsible beyond this and claim additional damages/loss.I understand and agree that my request to
modify or cancel the order shall not be deemed to have been executed unless and until the same is confirmed by Zerodha.
3.NO MARKET MANIPULATION
I undertake not to execute transactions, either singly or in concert with other clients, which may be viewed as manipulative trades
viz. artificially raising, depressing or maintaining the price, creation of artificial volume, synchronized trades, cross trades, self
trades, etc or which could be termed as manipulative or fraudulent trades by SEBI/Exchanges. In case I am found to be indulging in
such activities, Zerodha has every right to inform the Exchange/SEBI/other regulatory authority of the same and suspend/close
my trading account.
4.NOT TO ACT AS UNREGISTERED SUB BROKER
I undertake not to act as unregistered Sub-broker and deal only for myself and not on behalf of other clients In case I wish to deal
for other clients also, I undertake to apply to SEBI through Zerodha to obtain a sub broker registration. In case Zerodha perceives
that I am acting as an unregistered sub broker, Zerodha has the right to immediately suspend my trading account and close all
open positions and adjust the credits (across all segments) against the dues owed by me to Zerodha without the requirement of
any notice from Zerodha. Further, Zerodha has the right to inform the concerned regulatory authorities about the same. In
aforesaid eventuality, I agree and undertake to indemnify Zerodha from any loss/ damage/claim arising out of such activity.
5.NOT DEBARRED BY ANY REGULATOR
I confirm and declare that there is no bar on me imposed by any Exchange or any regulatory and/or statutory authority to deal in
securities directly or indirectly. I agree to inform Zerodha, in writing, of any regulatory action taken by any Exchange or regulatory/
statutory authority on me in future. In case I fail to inform the same and Zerodha on its own comes to know of such action, Zerodha
has the right to suspend/close my trading account and refuse to deal with me. Also, Zerodha can at its sole discretion, close all the
open positions and liquidate collaterals to the extent of trade related debit balances, without any notice to me.
6. PMLA DECLARATION
I declare that I have read and understood the contents and the provisions of the PMLA Act, 2002, which were also explained to me
by Zerodha officials. I further declare that I shall adhere to all the provisions of PMLA Act, 2002.
I further undertake and confirm that;
a. I do not have any links with any known unlawful persons/institutions
b. I am a genuine person and not involved or indulge knowingly or assisted, directly or indirectly, in any process or activity
connected with the proceeds of crime nor I am a party to it. The investment money is derived from proper means and does not
involve any black or Hawala money in any manner.
7.INDEMNIFICATION I hereby indemnify and hold Zerodha, its Directors and employees harmless from and against all trade
related claims, demands, actions, proceedings, losses, damages, liabilities, charges and/or expenses that are occasioned or may
be occasioned to the Zerodha directly or indirectly, relating to bad delivery of shares/ securities and/ or third party delivery,
whether authorized or unauthorized and fake/forged/stolen shares/ securities/transfer documents introduced or that may be
introduced by or through me during the course of my dealings/ operations on the Exchange(s) and/ or proof of address, identity
and other supporting/ documents provided by me at the time of registration and/ or subsequently.
INDEMNITY OF JOINT HOLDINGS
I hereby agree to indemnify and hold Zerodha harmless from any trade related claims, demands, actions, proceedings, losses,
damages, liabilities, charges and/or expenses arising from transactions in securities held jointly by me with any other person or
persons, if any.
8. BSE StAR MUTUAL FUND FACILITY
I am interested in availing the StAR Mutual Fund facility of the Exchange for the purpose of dealing in the units of Mutual Funds
Schemes permitted to be dealt with on the StAR platform of the Exchange. For the purpose of availing the StAR Mutual Fund
facility, I state that “Know Your Client” details as submitted by me for the opening of Trading Account may be considered for the
purpose of StAR and I/we further confirm that the details contained in same remain unchanged as on date. I am willing to abide by
the terms and conditions as has been specified and as may be specified by the Exchange from time to time in this regard. I shall
ensure also compliance with the requirements as may be specified from time to time by Securities and Exchange Board of India
and Association of Mutual Funds of India (AMFI). I shall read and understand the contents of the Scheme Information Document
and Key Information Memorandum, addenda issued regarding each Mutual Fund Schemes with respect to which I choose to
subscribe/redeem. I further agree to abide by the terms and conditions, rules and regulations of the respective Mutual Fund
Schemes subscribed by me.
9.DELAYED PAYMENT CHARGES
I understand that in case my account is in debit balance and/or if I have insufficient funds to manage my trading positions, I will be
charged an interest of 0.05% per day as delayed payment charges. I confirm having read the rules & regulations pertaining to the
levy of such interest under the policies & procedures page on Zerodha's website.
10. NRI DECLARATION
I understand that if the sole/first applicant has or attains NRI Status, investments in scheme of mutual funds can be made only
upon providing Foreign Inward Remittance Certificate (FIRC) to Zerodha every time the investment is made.
11. THIRD-PARTY PAYMENTS
Zerodha shall have the prerogative to refuse payments received from any bank account where the client is not the first holder or
which is not mentioned in the KYC or which the client has not got updated subsequently by submitting a written request along with
adequate proof thereof as per proforma prescribed by Zerodha. Zerodha shall not be responsible for any loss or damage arising
out of such refusal of acceptance of payments in the situations mentioned above.
However, due to oversight, if any such third-party payment has been accepted by Zerodha and the credit for the same has been
given in the client's ledger, Zerodha shall have the right to immediately reverse such credit entries on noticing or becoming aware
of the same. In such a case, Zerodha reserves the right to liquidate any of the open positions and/or any of the collaterals received/
held on behalf of the client. Zerodha, its Directors and employees shall not be responsible for any consequential damages or
losses.
12. NO DEALINGS IN CASH
Zerodha as a policy neither accepts any funds for pay-in/margin in cash nor makes any payment or allows withdrawal of funds in
cash. No claim will be entertained where the client states to have made any cash payment or deposited cash with any Branch/Sub-
Broker/ Remisier/Employee/Authorised Person of Zerodha.
13. DISCLOSURE OF PROPRIETARY TRADING BY ZERODHA
Pursuant to SEBI Circular Number SEBI/MRD/SEC/Cir-42/2003 dated November 19, 2003, Zerodha discloses to its clients about
its policies on proprietarytrades. Zerodha does proprietary trades in the cash and derivatives segment at NSE & BSE.
14. DELIVERIES
The client shall ensure that the shares are properly transferred to the designated demat account of Zerodha, for effecting delivery
to the Exchange against the sale position of the client. Such transfers shall be entered by the client within the time specified by
SEBI/Exchanges/Zerodha. In case the client fails to transfer the shares on time to Zerodha, Zerodha shall not be responsible for any
loss/damages arising out of such delayed transfers.
15. SQUARING OFF OF POSITIONS & SALE /LIQUIDATION OF COLLATERAL MARGINS (to the extent of Settlement Margin
obligation)
The client shall settle the transactions, within the Exchange specified settlement time, by making the requisite payment of funds
and/or delivery of the shares. In case the client fails to settle the transactions within the settlement date, then Zerodha has the right
to square off the open and/or unpaid positions, at an appropriate time, as it deems fit, without any notice to the client. The client
shall not have any right or say to decide on the timing of closure of the open positions that needs to be closed. Zerodha, its
Directors and Employees shall not be responsible for any trade related loss or damages arising out of such square offs. All such
square off transactions shall have implied consent and authorization of the client in favour of Zerodha.
After such square off of open positions by Zerodha, as mentioned in above clauses, if there is a debit balance, the client shall pay
the same immediately. However, if the client does not clear off the debit balance, Zerodha shall have the right to liquidate the shares
and other securities of the client (kept as collateral/margin) to the extent of the debit balance, without any intimation to the client.
The client shall not have the right to decide on the timing of liquidation of shares and securities held in collateral/margin and the
shares and securities that needs to be sold or liquidated. Zerodha, its Directors and employees shall not be responsible for any
trade related loss or damages arising out of such selling.
(digio.in)
F6 Client Signature
Date: 2021-07-02 11:23:26 IST

Running account authorization Voluntary
I/We are dealing through you as a client in Capital Market and/or Future & Option segment and/or Currency segment and/or
Interest Rate future Segment & in order to facilitate ease of operations and upfront requirement of margin for trade.
I/We authorize you as under:
1. I/We request you to maintain running balance in my account & retain the credit balance in any of my/our account and to
use the unused funds towards my/our margin/pay-in/other future obligation(s) of any segment(s) of any or all the
Exchange(s)/Clearing corporation unless I/We instruct you otherwise.
2. I/We request you to retain securities with you for my/our margin/pay-in/other future obligation(s) of any segment(s) of any
or all the Exchange(s)/Clearing Corporation, unless I/We instruct you to transfer the same to my/our account.
3. I/We request you to settle my fund and securities account (choose one option)
Once in a calendar Month
* Once in every calendar Quarter except the funds given towards collaterals/margin in form of Bank Guarantee and/or
Fixed Deposit Receipt
4. In case I/We have an outstanding obligation on the settlement date, you may retain the requisite securities/funds
towards such obligations and may also retain the funds expected to be required to meet margin obligation for next 5 trading
days, calculated in the manner specified by the exchanges.
5. I/We confirm you that I will bring to your notice any dispute arising from the statement of account or settlement so made
in writing preferably within 7 working days from the date of receipt of funds/securities or statement of account or statement
related to it, as the case may be at your registered office.
6. I/We confirm you that I can revoke the above mentioned authority at any time.
7. All accounts with credit balances of Rs. 10000/- or lesser shall be automatically retained and transfer of funds to the bank
account shall not be made as per SEBI circular MIRSD/SE/Cir-19/2009 & Exchange Circular Nos. NSE/INSP/24849 &
20091204-7.
8. This running account authorization would continue until it is revoked by me.
Yours faithfully,

(digio.in)
Date: F7
Date : 2021-07-02 Client Signature
2021-07-02 11:23:26 IST
Mobile declaration Voluntary

I____________________________________having EHOPR8794H
PAN______________________________ do hereby declare that my
mobile no. is _______________________________________

9738428508 Further, I authorize ZERODHA that the same may be used for
giving me any information/ alert/SMS.
I further declare the above mentioned statement is true and correct. Signed by: Karthik S R
(digio.in)
F8 Client Signature
Date: 2021-07-02 11:23:26 IST

Client defaulter declaration Voluntary

I _________________________________ EHOPR8794H
having PAN________________________do hereby declare that I have not been
involved in any unlawful activities and I have not been declared a defaulter or my name is not appearing in defaulter database as
per SEBI/ Various Exchange/ Regulatory bodies, etc. I further declare that the above mentioned declaration/ statement is true
and correct.

(digio.in)
F9 Client Signature
Date: 2021-07-02 11:23:26 IST
To
Zerodha
Sub: Acknowledgement
This is to acknowledge the receipt of following documents. I further state and confirm that I have read and understood
all the clauses of aforesaid documents.
Sl. No Brief significance of the Document
1 Duly Executed Copy of KYC
2 Rights and Obligations
3 Risk Disclosure document (RDD) for Capital, Derivatives, and Currencies Segments
4 Guidance Note - Do's and Dont's for trading on the Exchange(s) for investors
5 Zerodha Tariff Sheet
6 Policies and Procedures Document pursuant to the SEBI circular dated December 03, 2009
7 General Terms & Conditions governing securities trading and broking services of Zerodha
8 Running account authorisation, Mobile declaration & Client defaulter declaration
I also confirm that I have received the relevant clarifications, if any, wherever required from the officials of Zerodha
Yours faithfully,
Client Name : ______________________________________
KARTHIK SOLLEPURA RAMANNA F10
(digio.in) Client Signature
Date: 2021-07-02 11:23:26 IST

Zerodha Broking Ltd.
153/154, 4th Cross, 4th Phase, JP Nagar, Dollars Colony,
Opp. Clarence School, Bangalore - 560078
Additional KYC Form for Opening a Demat Account
For Individuals
(To be filled by the Depository Participant)
Application No Date 2021-07-02 DP Internal Reference No
DP ID 12081600 Exchange NSE/BSE UCC EM3776 Client ID 85153061
(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:-
Holder Details
Sole / First Holder’s Name KARTHIK SOLLEPURA RAMANNA
PAN EHOPR8794H UID
Second Holder’s Name
PAN UID
Third Holder’s Name
PAN UID
*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)
Status Sub – Status
* Individual * Individual Resident Individual-Director
Individual Director’s Relative Individual HUF / AOP
Individual Promoter Minor
Individual Margin Trading A/c (MANTRA) Others(specify)
NRI NRI Repatriable NRI Non-Repatriable

NRI Repatriable Promoter NRI Non-Repatriable Promoter
NRI – Depository Receipts Others (specify)
Foreign National Foreign National Foreign National - Depository Receipts Others (specify)
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 [Automatic Credit] * Yes No
(If not marked, the default option would be ‘Yes’)
I / We would like to instruct the DP to accept all the pledge instructions in my /our account without Yes * No
any other further instruction from my/our end (If not marked, the default option would be ‘No’)
Account Statement Requirement * As per SEBI Regulation Daily Weekly Monthly Fortnightly
I / We request you to send electronic transaction-cum-holding statement at the following * Yes No
Email ID [email protected]
I / We would like to share the email ID with the RTA * Yes No
I / We would like to receive the Annual Report Physical * Electronic Both Physical and Electronic
(Tick the applicable box. If not marked the default option would be in Physical)

I/We would wish to avail the following facility:
Basic Service Demat Account facility (BSDA)
Yes * No
Nomination details (Please tick the appropriate options)

I / We do wish to nominate (Fill Annexure 1A)
* I / We do not wish to nominate
I/We wish to receive dividend/interest directly in to my bank account as given below through ECS. * Yes No
(If not marked, the default option would be ‘Yes’) [ECS is mandatory for locations notified by SEBI from time to time ]
Bank Details [Dividend Bank Details]
Account type Saving * Current Others (specify)
Bank Code (9 digit MICR code) 571240502 IFS Code (11 character) HDFC0002567
Account number 50100385488275
Bank Name HDFC BANK LTD
Branch Name NO 1121 5D GROUND FLOOR
Bank Branch Address MANDYA KARNATAKA
City ---- State ----
Country ---- PIN code ----
(I) Photocopy of the cancelled cheque having the name of the account holder where the cheque book is issued, (or)
(ii) Photocopy of the bank statement having name and address of the BO
(iii) Photocopy of the passbook having name and address of the BO, (or) (iv) Letter from the Bank.
*In case of options (ii), (iii) and (iv) above, MICR code of the branch should be present/mentioned on the document.
Other Details
Gross Annual Income Details (please specify): Income Range per annum
Below Rs 1 Lakh 1-5 Lakh * 5-10 Lakh 10-25 Lakh 25 Lacs to 1 Cr >1Cr
Or Net-worth as on ________________date___________________ (Net worth should not be older than 1year)
Occupation :_______________________________________________________________________________________
Others
Please tick, if applicable: Politically Exposed Person (PEP) Related to Politically Exposed Person (RPEP)
Any other information:________________________________________________________________________________
SMS Alert Facility

MOBILE NO. +91 _____________________________
9738428508
Refer to Terms &
Conditions given in [Mandatory, if you are giving Power of Attorney (POA)]
Annexure - 2.4 (if POA is not granted & you do not wish to avail of this facility, cancel this option).
Transactions Using I wish to avail the TRUST facility using the Mobile number registered for SMS Alert Facility. I have
Secured Texting Facility read and understood the Terms and Conditions prescribed by CDSL for the same.
(TRUST). Refer to Terms I/We wish to register the following clearing member IDs under my/our below mentioned BO ID
and Conditions registered for TRUST
Annexure – 2.6
Yes * No
Stock Exchange Name/ID Clearing Member Name Clearing Member ID (Optional)
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.

153/154, 4th Cross, 4th Phase, JP Nagar, Dollars Colony,
Opp. Clarence School, Bangalore - 560078
Schedule-A Tariff Structure

For individuals/HUF/corporates
Details POA Clients
Option-1
Stamp charges payable upfront Rs.50/-
Annual Maintenance Charges (charged quarterly)
a. Individuals/Non Individual (except Corporate) Rs.300/- + GST
b. Non Individual - Corporate Rs.1000/- + GST
Transaction Charges : (Market Trades)
Buy(Receive) / Sell (Debit) Nil / Rs.8/- + Rs 5.50/- (CDSL Charges)
Transaction Charges : (Off-Market Trades)
Buy(Receive) / Sell (Debit) Nil / 0.03% or Rs.25/- whichever is higher
Demat (Per certificate) Rs. 150/- per certificate
Rs. 150/- per certificate
Remat (Per certificate)
+ CDSL Charges
Courier charges per Demat/Remat/Demat Rejn./CMR Rs. 100/-
Pledge Request Rs. 20/- + Rs. 12 per request (CDSL Charges)
Unpledge Request Rs. 20/- + Rs. 12 per request (CDSL Charges)
Pledge invocation Rs. 20/-
Margin Pledge Rs. 9 + Rs. 5 per request (CDSL Charges)
Margin Unpledge Rs. 9 + Rs. 5 per request (CDSL Charges)
Margin Repledge Rs. 2/- (CDSL charges)
Periodic Statement
By Email / Physical Free / Rs. 50/- (+Courier charges at actual)
Adhoc / Non Periodic Statement Requests
a. By Email Rs.10/- per request
Rs. 50 per request upto 10 pages. Every additional page
b. Physical
at Rs. 5 (+Courier charges at actual)
Delivery instruction
a. First Delivery Instruction Book Free (10 Leaves)
b. Every Addl Booklet (10 Leaves) Rs.100/-
Cheque Bounce Charges Rs. 350/-
Failed Transactions Rs. 50 per ISIN
Modification in CML Rs. 25/- per request
KRA Upload / Download Rs. 50/-
NOTE :
For all purposes the bill date shall be construed as the date demand and the bills will be considered as the bill cum notice for
payment and Zerodha Broking Ltd. reserves the right to freeze depository account for debit transaction in case of non
payment of charges after two days from the bill date.
The above tariff is subject to change. Changes if any will be intimated 30 days in advance Annual Maintenance Charge
(AMC) is non refundable. GST is applicable on all above charges except stamp charges.
First/Sole
Signed by: Karthik S R Holder
or Guardian
(digio.in)
F11 (in case S1 Second Holder T1 Third Holder
Date: 2021-07-02 of Minor)
11:23:26 IST

Date : 2021-07-02
To,
Dear Sir,
Sub : Requesting for bill/transaction/holding statement through email.
I/We request you to send me/us bill, transaction and holding statement of my CDSL Demat account no. 12081600__________
85153061
________at following email address: [email protected]

____________________________________________________________________
I/We fully agree and are aware of following Terms and Conditions mentioned below.
(a) that I/We will not receive the bill, transaction and holding statements in paper form.
(b) that I/We will take all the necessary steps to ensure confidentiality and secrecy of the login name and password of the
internet/email account.
(c) that I/We am/are aware that the bill, transaction and holding statements may be accessed by other entities in case the
confidentiality /secrecy of the login name and password is compromised.
(d) that I/We in case bill, transaction and holding statements are sent by email, I/We will immediately inform the Zerodha
Broking. about change in email address, if any.
In case, the Zerodha Broking is not able to provide bill/transaction statement to its Clients by email or on website due to any
reason (including bounced emails), Zerodha Broking Ltd. will ensure that the transaction statement is provided to me/us in
paper form as per the time schedule stipulated in the Bye Laws & Business Rules of CDSL.
I/We hereby request you to send the statements:

Daily Fortnightly Weekly Monthly *
Yours faithfully,
First/Sole
or Guardian
(digio.in)
F12(a) (in11:23:26
Date: 2021-07-02 case of Minor)
IST S2(a) Second Holder T2(a) Third Holder
Declaration
I/We have received and read the Rights and Obligations documents and terms & conditions and agree to abide by and be bound
by the same and the Bye Laws as are in force from time to time. I/We declare that the particulars given by me/us above are true
to the best of my/our knowledge as on the date of making this application.
I/We agree and undertake to intimate the DP of 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
(digio.in) or Guardian
Date: F12(b) (in 11:23:26
2021-07-02 case of Minor)
IST S2(b) Second Holder T2(b) Third Holder

Annexure E
Option form for issue of DIS booklet Voluntary

Date : 2021-07-02
DP ID 12081600 Client ID 85153061
First Holder Name KARTHIK SOLLEPURA RAMANNA
Second Holder Name
Third Holder Name
To,
Dear Sir,
I/We hereby state that: [select one of the option given below]
Option 1:
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) in favour of Zerodha Broking Ltd. for executing delivery instructions for
settling stock exchange trades (Settlement related transactions) effected through such Clearing Member.
Option 2: OR
I/We do not require the Delivery Instruction Slip(DIS)for the time being, Since I/We have issued a POA in favour of Zerodha
Broking Ltd. for executing the delivery instructions for settling stock exchange trades [settlement related transaction]
effected through such Clearing Member. However, the Delivery Instruction Slip (DIS) booklet should be issued to me / us
immediately on my / our request at any later date.
I/We hereby select Option 1 Option 2 *

First/Sole
or Guardian
(digio.in)
Date: F15 S5 T5
(in 11:23:26
case of Minor) Second Holder Third Holder
2021-07-02 IST
Client E-mail ID Optional

[email protected]
Client Mobile Number

9738428508
Declaration
I hereby declare that the mobile no./email ID mentioned in the Account opening form/ request for change in mobile no./email
ID is my own
Request letter for registration of mobile no./email ID of person belonging to the client's family
Please note that the mobile no./email id/both mentioned in the Account opening form/ request for change in mobile no./email ID
belongs to Mr/Mrs./Ms. ______________________________________________________________________ who is my
______________________________ [relationship with the client]
First/Sole
or Guardian
(digio.in)
F16 (in case
Date: 2021-07-02 of Minor)
11:23:26 IST
[Only the mobile no./email id of your spouse, dependent children and dependent parents can be registered in your demat account]

Date: 2021-07-02 11:23:26 IST
Date: 2021-07-02 11:23:26 IST
Date: 2021-07-02 11:23:26 IST
Date: 2021-07-02 11:23:26 IST
Page No .: 1
Account Branch : MANDYA

Address : NO. 1121/5-D, GROUND FLOOR,
ASHOK NAGAR,
B M ROAD,
MR KARTHIK S R City : MANDYA 571401
State : KARNATAKA
NO 1999/A 1ST FLOOR 3RD CROSS Phone no. : 9945863333
SUBASH NAGAR MANDYA CITY OD Limit : 0.00
. Currency : INR
Email : [email protected]
MANDYA 571401 Cust ID : 156445608
KARNATAKA INDIA Account No : 50100385488275 OTHER
A/C Open Date : 16/12/2020
JOINT HOLDERS : Account Status : Regular
RTGS/NEFT IFSC: HDFC0002567 MICR : 571240502
Branch Code : 2567 Product Code : 113
Nomination : Registered
From : 01/01/2021 To : 30/06/2021 Statement of account

Date Narration Chq./Ref.No. Value Dt Withdrawal Amt.using Aadhaar
eSigned Deposit Amt.
(digio.in) Closing Balance
Date: 2021-07-02 11:23:26 IST
01/01/21 UPI-S S FUEL NETWORK-PAYTM-54909881@PAYT 0000100111790755 01/01/21 200.00 16,035.00
M-PYTM0123456-100111790755-UPI
01/01/21 UPI-PURUSHOTHAMA 0000100112354328 01/01/21 300.00 15,735.00
G-PURUSHOTHAM88841PURU@
OKAXIS-CNRB0000033-100112354328-UPI
OKAXIS-CNRB0000033-100112383595-UPI
01/01/21 UPI-KRUPASHREE SR-DHANVI327-1@OKAXIS-CIT 0000100113753931 01/01/21 500.00 15,035.00
I0000004-100113753931-UPI
01/01/21 UPI-MOHAMMED AZEEM-AZEEM10786-2@OKSBI-C 0000100117836183 01/01/21 220.00 14,815.00
NRB0000033-100117836183-UPI
01/01/21 UPI-KRUPASHREE SR-DHANVI327-1@OKAXIS-CIT 0000100119326716 01/01/21 5,000.00 9,815.00
I0000004-100119326716-UPI
I0000004-100119490945-UPI
02/01/21 UPI-GOOGLEPAY-GOOG-PAYMENT@OKAXIS-UTIB00 0000100201932960 02/01/21 5.00 2,320.00
00553-100201932960-REWARDED FOR PAYIN
M-PYTM0123456-100211995702-UPI
02/01/21 UPI-RAZORPAY-RAZORPAY@ICICI-ICIC0000001- 0000100212449776 02/01/21 10.00 2,210.00
100212449776-PV TEARS PRIVATE L
03/01/21 UPI-NARMADA SERVICE STAT-PAYTMQR28100505 0000100309495098 03/01/21 200.00 2,010.00
01011PARP0RJCEKQ@PAYTM-PYTM0123456-10030
9495098-UPI
05/01/21 UPI-PURUSHOTHAMA 0000100513725182 05/01/21 1,000.00 1,010.00
OKAXIS-CNRB0000033-100513725182-UPI
24/01/21 UPI-S S FUEL NETWORK-PAYTM-54909881@PAYT 0000102411399199 24/01/21 100.00 910.00
M-PYTM0123456-102411399199-UPI
HDFC BANK LIMITED

*Closing balance includes funds earmarked for hold and uncleared funds
Contents of this statement will be considered correct if no error is reported within 30 days of receipt of statement.The address on this statement is that on record with the Bank as at the day of requesting
this statement.
State account branch GSTN:29AAACH2702H1ZW
HDFC Bank GSTIN number details are available at https://www.hdfcbank.com/personal/making-payments/online-tax-payment/goods-and-service-tax.
Registered Office Address: HDFC Bank House,Senapati Bapat Marg,Lower Parel,Mumbai 400013
Page No .: 2

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

24/01/21 UPI-PRATHAP B P-AMZN0004604132@APL-SBIN 0000102412079098 24/01/21 15.00
eSigned using Aadhaar (digio.in) 895.00
Date: 2021-07-02 11:23:26 IST
0007965-102412079098-UPI
26/01/21 EAW-416021XXXXXX4758-LWCW7961-MANDYA 0000000000005275 26/01/21 300.00 595.00
29/01/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL JAN 21 CHASA21028281855 29/01/21 25,825.00 26,420.00
COGNIZANT TECHNOLOGY SOLUTION-KARTHIK S
R-CHASA21028281855
I0000004-103015677041-UPI
03/02/21 UPI-BHUVANESHWARI MEDICA-PAYTMQR28100505 0000103413195544 03/02/21 335.00 6,085.00
010114YE1J0AQN0C@PAYTM-PYTM0123456-10341
3195544-UPI
I0000004-103421638711-UPI
I0000004-103516260521-UPI
04/02/21 UPI-PURUSHOTHAMA 0000103522990750 04/02/21 4,000.00 2,085.00
OKAXIS-CNRB0000033-103522990750-UPI
OKAXIS-CNRB0000033-103720531489-UPI
00553-103720310827-REWARDED FOR PAYIN
08/02/21 UPI-VINUTHA S K-VINUTHAINMANDYA-1@OKHDFC 0000103909078043 08/02/21 10,000.00 11,921.00
BANK-KARB0000902-103909078043-VINUTHA
12/02/21 POS 416021XXXXXX4758 AMARAVATHI FUEL 0000104302880909 12/02/21 200.00 11,721.00
12/02/21 POS 416021XXXXXX4758 RELIANCE TRENDS 0000000000000143 12/02/21 3,949.06 7,771.94
13/02/21 UPI-JAGDISH-PRATAP10164-1@OKSBI-CNRB0000 0000104414154727 13/02/21 160.00 7,611.94
033-104414154727-UPI
15/02/21 CRV POS 416021******4758 HPCL 0.75% CASH 000000000000000 15/02/21 1.50 7,613.44
18/02/21 UPI-SRIRANGA B K-PUTTASRIRANGA@OKAXIS-IO 0000104916897299 18/02/21 4,800.00 2,813.44
BA0002836-104916897299-UPI
HDFC BANK LIMITED

this statement.
Page No .: 3

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

21/02/21 UPI-REDBUSIN-REDBUS.PAYU@AXISBANK-UTIB00 0000105219787678 21/02/21 1,600.00
eSigned using Aadhaar (digio.in) 1,213.44
Date: 2021-07-02 11:23:26 IST
00000-105219787678-UPI
OKAXIS-CNRB0000033-105308059054-UPI
22/02/21 UPI-BAKE POINT BAKERY-GPAY-11169523222@O 0000105317534424 22/02/21 300.00 1,513.44
KBIZAXIS-UTIB0000000-105317534424-UPI
25/02/21 UPI-PURUSHOTHAMA 0000105612066903 25/02/21 640.00 873.44
OKAXIS-CNRB0000033-105612066903-UPI
OKAXIS-CNRB0000033-105614981807-UPI
25/02/21 UPI-BHARATPE MERCHANT-BHARATPE9020023500 0000105616916454 25/02/21 80.00 1,433.44
8@YESBANKLTD-YESB0000105-105616916454-VE
RIFIED MERCHANT
26/02/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL FEB 21 CHASA21056833458 26/02/21 25,825.00 27,258.44
R-CHASA21056833458
26/02/21 NWD-416021XXXXXX4758-03916004-MANDYA 0000105718007382 26/02/21 10,000.00 17,258.44
28/02/21 NWD-416021XXXXXX4758-0426W009-MANDYA 0000105916000132 28/02/21 500.00 13,258.44
28/02/21 UPI-SANGEETHA MOBILES MA-Q09985382@YBL-Y 0000105917291378 28/02/21 400.00 12,858.44
ESB0YBLUPI-105917291378-UPI
03/03/21 UPI-AVINASH L M-AVINASHAVI9739-1@OKICICI 0000106210233931 03/03/21 150.00 12,708.44
-UCBA0002904-106210233931-UPI
03/03/21 UPI-A V T JUICE CENTER-PAYTMQR2810050501 0000106214798771 03/03/21 50.00 12,658.44
01C3TOT27R8ADH@PAYTM-PYTM0123456-1062147
98771-UPI
04/03/21 UPI-N C MANJUNATH-MANJUNATHNC9986@OKAXIS 0000106319371094 04/03/21 461.00 12,197.44
-KKBK0008270-106319371094-UPI
05/03/21 UPI-AVINASH L M-AVINASHAVI9739-1@OKICICI 0000106407754181 05/03/21 2,000.00 10,197.44
HDFC BANK LIMITED

this statement.
Page No .: 4

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

-UCBA0002904-106407754181-UPI eSigned using Aadhaar (digio.in)
Date: 2021-07-02 11:23:26 IST
M-PYTM0123456-106610086806-UPI
09/03/21 UPI-BHUVANESHWARI MEDICA-PAYTMQR28100505 0000106820692178 09/03/21 270.00 9,727.44
010114YE1J0AQN0C@PAYTM-PYTM0123456-10682
0692178-UPI
-UCBA0002904-107312648460-UPI
14/03/21 UPI-SHRINIDHI M J-SRINIDHI1151418GTTC-1@ 0000107320241117 14/03/21 300.00 8,427.44
OKICICI-ICIC0001721-107320241117-UPI
15/03/21 NEFT CR-CHAS0INBX01-INDIA INC 2020 COGNI CHASB21071272884 15/03/21 1,200.00 9,627.44
ZANT TECHNOLOGY SOLUTIONS INDI-KARTHIK S
R-CHASB21071272884
17/03/21 NWD-416021XXXXXX4758-13234003-MANDYA 0000107612006857 17/03/21 600.00 9,027.44
21/03/21 UPI-VISHWAKANTHA J L-VISHWAKANTH55@OKSBI 0000108015595219 21/03/21 100.00 9,127.44
-KARB0000912-108015595219-2LTS WATER
-UCBA0002904-108219254326-UPI
31/03/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL MAR 21 CHASB21089687272 31/03/21 25,825.00 35,952.44
R-CHASB21089687272
01/04/21 CREDIT INTEREST CAPITALISED 000000000000000 31/03/21 48.00 36,000.44
02/04/21 UPI-VISHWAKANTHA J L-VISHWAKANTH55@OKSBI 0000109212116679 02/04/21 300.00 36,300.44
-KARB0000912-109212116679-ENJOY
-ICIC0000159-109218095776-UPI
03/04/21 NWD-416021XXXXXX4758-ID148901-MANDYA 0000109312370173 03/04/21 10,000.00 26,600.44
03/04/21 NWD-416021XXXXXX4758-ID148901-MANDYA 0000109312370174 03/04/21 10,000.00 16,600.44
13/04/21 UPI-BHARATPE MERCHANT-BHARATPE.905202539 0000110318655809 13/04/21 155.00 15,345.44
2@FBPE-FDRL0001382-110318655809-VERIFIED
MERCHANT
HDFC BANK LIMITED

this statement.
Page No .: 5

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

15/04/21 UPI-BHARATPE MERCHANT-BHARATPE.905202539 0000110512365775 15/04/21 107.00
Date: 2021-07-02 11:23:26 IST
MERCHANT
16/04/21 UPI-PRATHAP B P-AMZN0004604132@APL-SBIN 0000110619094624 16/04/21 165.00 15,073.44
0007965-110619094624-UPI
MERCHANT
17/04/21 UPI-NARMADA SERVICE STAT-PAYTMQR28100505 0000110709179616 17/04/21 250.00 14,768.44
01011PARP0RJCEKQ@PAYTM-PYTM0123456-11070
9179616-UPI
17/04/21 NWD-416021XXXXXX4758-13234003-MANDYA 0000110710026838 17/04/21 200.00 14,568.44
17/04/21 UPI-RAVI DONNE BIRIYANI -GPAY-1116948326 0000110714585899 17/04/21 190.00 14,378.44
3@OKBIZAXIS-UTIB0000000-110714585899-UPI
17/04/21 UPI-LAKSHMANA-PAYTMQR28100505010181NYQTY 0000110719643597 17/04/21 70.00 14,308.44
EHKF3@PAYTM-PYTM0123456-110719643597-UPI
18/04/21 UPI-LAKSHMANA-BHARATPE90200234938@YESBAN 0000110809135284 18/04/21 180.00 14,128.44
KLTD-YESB0000105-110809135284-VERIFIED M
ERCHANT
18/04/21 UPI-MAHADEVAMMA-7353906535@BARODAMPAY-BA 0000110818627203 18/04/21 70.00 14,058.44
RB0VJCHKA-110818627203-VERIFIED MERCHANT
18/04/21 UPI-RAZORPAYREDBUS-REDBUS-PAYMENT@ICICI- 0000110820841145 18/04/21 1,800.00 12,258.44
ICIC0000001-110820841145-UPI
0007965-110909674381-UPI
-UCBA0002904-111011424471-UPI
00553-111011708156-UPI
00553-111011719174-EARNED FOR USING G
HDFC BANK LIMITED

this statement.
Page No .: 6

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

0007965-111107461653-UPI eSigned using Aadhaar (digio.in)
Date: 2021-07-02 11:23:26 IST
0007965-111207622400-UPI
22/04/21 UPI-SANTHOSH KUMAR B R-PAYTMQR2810050501 0000111219895177 22/04/21 40.00 11,948.44
0116S7AX6EJJBZ@PAYTM-PYTM0123456-1112198
95177-UPI
23/04/21 UPI-PAYTM-PTMUPF@PAYTM-PYTM0123456-11139 0000111393005664 23/04/21 1.88 11,950.32
3005664-CASHBACK RECEIVED
23/04/21 UPI-EURONETGPAY-EURONETGPAY.PAY@ICICI-IC 0000111310702301 23/04/21 20.00 11,930.32
IC0000001-111310702301-UPI
IC0000001-111312207777-UPI
23/04/21 UPI-SURYA MEDICALS AND G-PAYTMQR28100505 0000111319269299 23/04/21 270.00 11,611.32
0101103DRWKNJAH9@PAYTM-PYTM0123456-11131
9269299-UPI
0007965-111319342369-UPI
0007965-111519168176-UPI
0007965-111719964011-UPI
-UCBA0002904-111807924175-UPI
0007965-111808067596-UPI
29/04/21 POS 416021XXXXXX4758 ADGP RECRUITMENT 0000111944044378 29/04/21 500.00 8,672.32
30/04/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL APR 21 CHASC21119133787 30/04/21 25,825.00 34,497.32
R-CHASC21119133787
-ICIC0000159-112011105189-UPI
30/04/21 NWD-416021XXXXXX4758-0426W007-MANDYA 0000112018014306 30/04/21 10,000.00 26,497.32
HDFC BANK LIMITED

this statement.
Page No .: 7

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

30/04/21 NWD-416021XXXXXX4758-0426W007-MANDYA 0000112018014418 30/04/21 8,200.00
Date: 2021-07-02 11:23:26 IST
01/05/21 UPI-RAKSHITH ARADHYA M G-RAKSHITHARADHYA 0000112109145245 01/05/21 1,000.00 17,297.32
1424@OKHDFCBANK-HDFC0002567-112109145245
-UPI
00553-112109161035-UPI
0007965-112211594607-UPI
09/05/21 UPI-NAGARAJU M -NAGARAJU7653@OKSBI-SBIN 0000112908590516 09/05/21 500.00 16,753.32
0040035-112908590516-UPI
0007965-113007215224-UPI
0101FKZ7ED34GGB8@PAYTM-PYTM0123456-11310
8233026-UPI
16/05/21 UPI-K T R FUEL STATION-PAYTMQR2810050501 0000113608886815 16/05/21 200.00 16,218.32
011T2PL3E02690@PAYTM-PYTM0123456-1136088
86815-UPI
-UCBA0002904-113817117349-UPI
20/05/21 UPI-ANILKUMAR H J-Q77120431@YBL-CNRB000 0000114008346836 20/05/21 402.00 15,666.32
0000-114008346836-UPI
22/05/21 UPI-BILLDESKTEZ-BILLDESK.PREPAID-MOBILE@ 0000114211649724 22/05/21 349.00 15,317.32
ICICI-ICIC0000555-114211649724-UPI
0007965-114309525205-UPI
-UCBA0002904-114817366829-UPI
29/05/21 UPI-BILLDESKTEZ-BILLDESK.PREPAID-MOBILE@ 0000114910690200 29/05/21 49.00 15,095.32
ICICI-ICIC0000555-114910690200-UPI
29/05/21 UPI-RAGHAVA T-RAGANARAGANA234@OKSBI-SBI 0000114918788971 29/05/21 25.00 15,070.32
N0003916-114918788971-UPI
HDFC BANK LIMITED

this statement.
Page No .: 8

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

30/05/21 UPI-RELIANCE FRESH-RELIANCEFRESH.2707656 0000115007765717 30/05/21 89.84
Date: 2021-07-02 11:23:26 IST
8@HDFCBANK-HDFC0000001-115007765717-UPI
30/05/21 UPI-GOUTHAM PROVISIONS-GPAY-11167490349@ 0000115007826531 30/05/21 320.00 14,660.48
OKBIZAXIS-UTIB0000000-115007826531-UPI
30/05/21 UPI-LAKSHMANA-PAYTMQR28100505010181NYQTY 0000115007878986 30/05/21 100.00 14,560.48
EHKF3@PAYTM-PYTM0123456-115007878986-UPI
31/05/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL MAY 21 CHASC21148762072 31/05/21 25,825.00 40,385.48
R-CHASC21148762072
02/06/21 UPI-UDAYAKUMAR HM S O 0000115308290474 02/06/21 19,500.00 20,885.48
CH-UDAYAKUMARHM292
9@OKHDFCBANK-BARB0VJMAMA-115308290474-UP
IC0000001-115718997246-UPI
07/06/21 UPI-INDIAN OIL PETROL PU-Q85347539@YBL-Y 0000115810329356 07/06/21 200.00 20,633.48
ESB0YBLUPI-115810329356-UPI
08/06/21 UPI-SHANKARANANDA M-9481171557@YBL-HDFC0 0000115918485213 08/06/21 400.00 20,233.48
002567-115918485213-UPI
MERCHANT
MERCHANT
09/06/21 UPI-SRINIVASA DIAGNOSTIC-SRINIVASADIAGNO 0000116017978047 09/06/21 2,600.00 15,337.48
STICS.28111045@HDFCBANK-HDFC0000001-1160
17978047-UPI
-UCBA0002904-116316007096-UPI
15/06/21 UPI-MS SHIVALEELA ENTERP-PAYTMQR150926@P 0000116610200747 15/06/21 100.00 15,088.48
HDFC BANK LIMITED

this statement.
Page No .: 9

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

AYTM-PYTM0123456-116610200747-UPI eSigned using Aadhaar (digio.in)
Date: 2021-07-02 11:23:26 IST
18/06/21 UPI-SRINIDHI N-RAJENIDHI194@OKAXIS-KARB0 0000116916450726 18/06/21 150.00 14,938.48
000586-116916450726-UPI
18/06/21 UPI-SRINIDHI N-RAJENIDHI194@OKAXIS-KARB0 0000116916583956 18/06/21 104.00 14,834.48
000586-116916583956-UPI
IC0000001-117025932531-UPI
19/06/21 UPI-K B KAVITHA-HARISHGOWDA1981@OKAXIS-U 0000117028510314 19/06/21 100.00 14,385.48
TIB0000796-117028510314-UPI
21/06/21 UPI-BHARATPEMERCHANT-BHARATPE.9100061702 0000117246482845 21/06/21 80.00 14,305.48
@ICICI-ICIC0000001-117246482845-VERIFIED
MERCHANT
0101103DRWKNJAH9@PAYTM-PYTM0123456-11735
9231826-UPI
0007965-117359298174-UPI
-UCBA0002904-117462859854-UPI
24/06/21 UPI-K T R FUEL STATION-PAYTMQR2810050501 0000117577067789 24/06/21 100.00 13,598.48
0190GCMDTE0ZPR@PAYTM-PYTM0123456-1175770
67789-UPI
24/06/21 UPI-KAVERY FASHION-GPAY-11167629477@OKBI 0000117577183383 24/06/21 220.00 13,378.48
ZAXIS-UTIB0000000-117577183383-UPI
24/06/21 UPI-KAVERY FASHION-GPAY-11167629477@OKBI 0000117577224199 24/06/21 60.00 13,318.48
ZAXIS-UTIB0000000-117577224199-UPI
30/06/21 NEFT CR-CHAS0INBX01-COGNIZANT SAL JUN 21 CHASD21180323084 30/06/21 25,825.00 39,143.48
R-CHASD21180323084
01/07/21 CREDIT INTEREST CAPITALISED 000000000000000 30/06/21 123.00 19,266.48
HDFC BANK LIMITED

this statement.
Page No .: 10

ASHOK NAGAR,
B M ROAD,
State : KARNATAKA
. Currency : INR
MANDYA 571401 Cust ID : 156445608
A/C Open Date : 16/12/2020

Date: 2021-07-02 11:23:26 IST
STATEMENT SUMMARY :-
Opening Balance Dr Count Cr Count Debits Credits Closing Bal
16,235.00 109 25 171,257.90 174,289.38 19,266.48
Generated On: 02-Jul-2021 10:14 Generated By: Requesting Branch Code: NET
156445608
This is a computer generated statement and does
not require signature.
HDFC BANK LIMITED

this statement.
Date: 2021-07-02 11:23:26 IST

Instructions / Checklist For Filling KYC Form

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Instructions / checklist for filling KYC form

B. Proof of Identity (POI)

C. Proof of Address (POA)

D. Exemptions/clarifications to PAN (*Sufficient documentary evidence in support of such claims to be collected.)

E. List of people authorized to attest the documents

F. Additional documents in case of trading in derivatives segments - illustrative list:

Copy of ITR Acknowledgement Copy of Annual Accounts

Undertaking Contains voluntary undertakings by the client with respect to Zerodha's

For office use only (To be filled by the financial institution)

Tick if applicable Residence for tax purposes in jurisdiction(s) outside India

5a. PAN EHOPR8794H

FOR OFFICE USE ONLY

Date Signature of the Authorized Signatory

3 Sign wherever you see

City/Town District Pin Code

Others (any document notified by the Central Govt.) Identification No

Trading account related details

In what capacity do you trade commodities?

4 Sign wherever you see

D. Depository account(s) details

E. Dealings through other stock brokers

F. Introducer details (optional)

G. Trading preferences / experience

NSE Signed by: Karthik S R

I. Nomination details (Please tick the appropriate options)

* I / We do not wish to nominate

Client Name ___________________________________________

6 Sign wherever you see

For office use only

Signature of the Authorised Signatory Seal/Stamp of the stock broker

7 Sign wherever you see

9 Sign wherever you see

Once in a calendar Month

8. This running account authorization would continue until it is revoked by me.

Signed by: Karthik S R

Mobile declaration Voluntary

mobile no. is _______________________________________

giving me any information/ alert/SMS.

10 Sign wherever you see

KARTHIK SOLLEPURA RAMANNA

Signed by: Karthik S R

all the clauses of aforesaid documents.

Sl. No Brief significance of the Document

1 Duly Executed Copy of KYC

2 Rights and Obligations

5 Zerodha Tariff Sheet

8 Running account authorisation, Mobile declaration & Client defaulter declaration

11 Sign wherever you see

NRI NRI Repatriable NRI Non-Repatriable

Details of Guardian (in case the account holder is minor)

12 Sign wherever you see

Nomination details (Please tick the appropriate options)

* I / We do not wish to nominate

SMS Alert Facility

13 Sign wherever you see

Schedule-A Tariff Structure

14 Sign wherever you see

________at following email address: [email protected]