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Modification Form

The document is a request form for adding, modifying, or deleting account details related to trading and depository accounts. It requires personal information such as name, Aadhaar number, PAN, and details of the requested changes, along with necessary documents for verification. The form must be signed and submitted with self-attested copies of required documents.

Uploaded by

Ameeth Vorra
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© © All Rights Reserved
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0 views1 page

Modification Form

The document is a request form for adding, modifying, or deleting account details related to trading and depository accounts. It requires personal information such as name, Aadhaar number, PAN, and details of the requested changes, along with necessary documents for verification. The form must be signed and submitted with self-attested copies of required documents.

Uploaded by

Ameeth Vorra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Account Details Addition/ Modification /Deletion RequestForm

LKP
Changes effected in Trading A/c Only Depository A/c Only Trading + Depository A/c

rst Holder DSecond Holder


Third Holder
Trading Code 2 $02002 DP BO id: 12030000

A Name of Applicant (Mandatory as per original KYC Records)


Tule Mr. Ms. Other: Aadhaar Number, if any: PAN

\de
Date of Birth L-

Cient Siatus Resident individua UNon Resident(Passport copy Mandatoryfor NRIs &Foreign Nationals)
we reuest au to
makethe fokowing additions /mocifkations/deletions to my/our account in your
recorts
Deteils (Please specify change of address,
bank details, mobile/phone number, sub
Tick Addition/Modification Existing Details New Details
/Deletion
status etc
(Please Specify)
Change of Address
Permanent CorrespondenceBoth
Phone / Mobile Number

Emal C

Signatue Change
Change ot Address in KRA
Permanent Correspondence Both

Charge of signature in KRA

Change of Name

Mother's Name on KYC

Documents Reauired: AddressProof - Passport, u Voter'siD,card Driving liecense L Rent Agreement J TolephoneBit Electricitybill not olderthan 2
months), Bank Statement /Passbook (not older than 2 months), Aadhaar Card

DProoff Submitted:
IncomeRange for
DpAN Card LPassport Voter sIDcard LDriving License Aadhaar Card
indviduals Below Rs. 1 Lac Rs. 1 Lac - Rs. 5 Lac Rs. 5 lac to Rs. 10 Lac
Rs. 10 Lac to Rs. 25 lac More than Rs. 25 lac
tricome Range for Non individuals- Below 20 Lac Rs. 20 Lac to Rs. 50 Lac
Rs. 50 Lac to Rs. 1 Crore More than Rs. 1
Only the mobile no./email id of your spouse, dependent children and O Self
Oependernt parents can be registered in your demat account
spouse
dependent parents Dependent chiidren
Oid Bank Details DefaultUY N New Bank Details Default OY JN

tVode of paymerit NEFT JCheque New Mode of payment NE FT cheque


Bank Name: Address: Bank Name
Account No: Type
BamK ob Mahayashtra Old City
Account No: Tyoe

FSC Code MICR


601265 S4278 Savinas
IFSC Code MICR

ocurents Submitted: ancel Cheque Bank Statement LBank Passbook


MAHB 00 0IS6
Adotional Depository (For Trading Only) Old Details New Details
DP D _Client iD ID: Client 1D_

DP Nome DP Name

DotumentsubmittedOP Clent master Staternent of ransactiosStatement of Holding


Date Application No P ID
Sole / First Holder Second Holder hrd HO.der

Name of Holder
ravin Wani
Signature
Modification requested for: [Specify reason

IPV Done on
Seal /Stamp of the intermediary should contain
Staff Namne Deslgnation:
Nane of the organiz ation
Signature /Date Stock Broker /Depository Participant Seal and Signature
Note:1.All documents should be self-attested
2. All doLuInents should be Verified against original
3.in case of no individual use separate PCR for
tradug A/t and
Deposr (y

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