ANNEXURE J
APPLICATION FOR OPENING AN ACCOUNT
(For Individuals Only)
Participant Name, Address & DP ID
(Pre-printed)
Date : Client –ID
(To be filled by Participant)
I/We request you to open a depository account in my/our name as per the following details:
(Please fill all the details in CAPITAL LETTERS only)
Type of Account
Ordinary Resident NRI-Repatriable Margin Promoter
HUF NRI-Non-Repatriable Others (please specify)
Sole/First Holder’s Details
Name (Mr./Ms.)
Name of
Father/Husband
Local / Permanent
Address
Correspondence
Address
Telephone No.
Fax Number
Occupation
Pin Code
Pin Code
Mobile No.
E-mail ID:
SMS Facility Yes No
Other Holder Details
Second Holder
Name (Mr./Ms.)
Name of
Father/Husband
Address
Telephone No.
Fax Number
Occupation
Pin Code
Mobile No.
E-mail ID:
SMS Facility Yes No
Third Holder
Name (Mr./Ms.)
Name of
Father/Husband
Address
Telephone No.
Fax Number
Occupation
Pin Code
Mobile No.
E-mail ID:
SMS Facility Y e s No
Address for communication /
Corporate Benefits (Default
option is Local Address)
Local / Permanent Address
Correspondence Address / Foreign Address
Guardian Details (In case the Sole Holder is a minor)
Name (Mr./Ms.)
Relationship (if any)
Address
Date of Birth
(of minor)
Pin Code
In Case of NRIs
Foreign Address
RBI Reference No.
Bank Sub-type
Bank Acoount No.
Bank Name
Branch Address
Financial Status (Annual Income)
Saving Account
D
D D M M Y Y Y Y
RBI Approval Date D M M Y Y Y Y
Bank Details
9-Digit Code Number of the Bank and branch appearing
on the MICR cheque issued by the Bank
Pin Code
Current Account
Sole/First Holder
Second Holder
Third Holder
Financial Details
Gaurdian (in case
of Minor)
P.A.N IT Circle / Ward / District No.
Additional Financial Details
Nature of Business
< Rs.5 Lakh Rs.5 – 10 Lakh Rs.10 – 15 Lakh > Rs.15 Lakh
I/We authorise you to receive credits automatically into my/our account.
Standing Instructions
Account to be operated through Power of Attorney (PoA)
Yes
Yes
No
No
Please attach recent passport size photographs in the space provided below:
Sole/First Holder Second Holder Third Holder
Signature
across
Photograph
Signature
across
Photograph
Signature
across
Photograph
Declaration
The rules and 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 also declare that the particulars
given by me/us are true to the best of my/our knowledge as on the date of making such application. I/We
further agree that any false / misleading information given by me or suppression of any material fact will
render my account liable for termination and further action.
Name(s) of holder(s) Signature(s)
Sole/First Holder
(Mr./Ms.)
Second Holder
(Mr./Ms.)
Third Holder
(Mr./Ms.)
Guardian (in case
of minor)
(Mr./Ms.)
I/We wish to make a nomination and do hereby nominate the following person in whom all rights and / or
amount payable in respect of securities held in the Depository by me / us in the said beneficiary owner
account shall vest in the event of my / our death.
Name of the Nominee
(Mr./Ms.)
Relationship with the
Applicant (if any)
Address of Nominee
NOMINATION
Date of Birth
(in case of minor)
Name of Guardian
(Mr./Ms.)
(in case Nominee is a minor)
Address of Guardian
Signature of Guardian
Pin Code
D D M M Y Y Y Y
Signature of
Nominee
Pin Code
I/We do not wish to make a nomination
Photograph
of Nominee
Signature of
Nominee
across
Photograph
Photograph of
Guardian
(in case of minor)
Signature of
Guardian across
Photograph
1.
Signature of two Witnesses
Name Address Signature with date
2.
Notes :
1. All communication shall be sent at the address of the Sole/First holder only.
2. 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.
3. As per NSDL Circular No. NSDL/PI/2004/1622 dated September 7, 2004 pursuant to SEBI Circular No. MRD/DoP/
Dep/Cir-29/2004 dated August 24, 2004 a copy of any one of the following documents may be accepted as proof of
identity / proof of address (local/correspondence/foreign address as the case may be):
Proof of Identity: Passport, Voter ID Card, Driving license, PAN card with photograph, Identity card/document with
applicant’s Photo, issued by a) Central/State Government and its Departments, b) Statutory/Regulatory Authorities, c)
Public Sector Undertakings, d) Scheduled Commercial Banks, e) Public Financial Institutions, f) Colleges affiliated to
Universities, g) Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to their Members; and h) Credit cards/
Debit cards issued by Banks.
Proof of Address: Ration card, Passport, Voter ID Card, Driving license, Bank passbook, verified copies of Electricity
bills (not more than two months old)/ Residence Telephone bills (not more than two months old)/ Leave and License
agreement / Agreement for sale, Self-declaration by High Court & Supreme Court judges, giving the new address in
respect of their own accounts, Identity card/document with address, issued by a) Central/State Government and its
Departments, b) Statutory/Regulatory Authorities, c) Public Sector Undertakings, d) Scheduled Commercial Banks, e)
Public Financial Institutions, f) Colleges affiliated to universities; and g) Professional Bodies such as ICAI, ICWAI, Bar
Council etc., to their Members.
Participants must verify the copy of the document with the original.
4. 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 non-resident Indian can be a Nominee, subject to the exchange controls in force, from
time to time.
(To be signed by the applicant only in case of nomination)
(Sole/First Holder) (Second Holder) (Third Holder)
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 favour of a Nominee shall be valid discharge by the depository 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 favour of the Nominee.
5. Strike off whichever is not applicable.
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Acknowledgement
Participant Name, Address & DP ID
Received the application from Mr/Ms___________________________ as the sole/first holder alongwith
_____________________________ and _______________________________ as the second and third
holders respectively for opening of a depository account. Your Client ID will be intimated to you shortly.
Please quote the DP ID & Client ID allotted to you in all your future correspondence.
Date : _________________
Participant Stamp & Signature