Ilfs Application Form

DPID Stamp :

Group/Sub group code :_____________________

For Branch Use Only

Upfront Payment Details :

Amount (Rs.) :

Cheque No.

Cheque Dt.

Bank details.

Break-up of payment :

1-Maintenance :

2-Stamp Charges :

3-Others

Total :

Acceptance date

Accepted by :

Accepted by

(Sign):

For HO use only:

Client Id.:

Kit dispatch date:

Scanning:

DSA code :

DSA Auth.

Signatory:

Branch Manager/

Authorized official :

Inward date :

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NSDL Account Opening Form

DPID Stamp :

Branch Stamp HO Stamp

1

IL&FS House, Plot No. 14, Raheja Vihar, Chandivali, Andheri (E), Mumbai-400072Tel: 4249 3000 Fax: 2857 0948 Email: [email protected] Website : www.ilfsdp.com

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Form No. 2700055 Form No. 2700055

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Form No. 2700055

HELP CHECKLIST FOR FILLING THE DP ACCOUNT OPENING FORM

Account opening form

Name in the Account Opening form to be the same as name in PAN card (all holders)

Address for communication to be ticked

In case the type of account is “NRI”, overseas address to be mandatorily filled

Bank details duly filled

Page 5

Standing Instruction ticked

Account to be operated through POA - option ticked

Nature of Business / Financial details duly filled (all holders)

Page 6

General

Address to be in full and to match with the proof provided (all holders)

Occupation details duly filled (all holders)

PAN details to be filled (all holders)

All blanks struck off

Cancellations, if any, are authenticated by all the holders

Page 4

In case the sole holder is a Minor, guardian details to be mandatory filled

Tick here

*Valid Proof of address (all holders)-any one document as given in the list. In case both the correspondence

and permanent address are filled in the Account Opening Form, proof has to be provided for both

*Valid Proof of Identity (all holders) - any one document as given in the list

PAN card copy (all holders)

MICR Proof (photocopy of cheque)-should match with the Bank account details provided in the form

Rate sheet duly signed

DP Client Agreement duly executed

Agreement for receiving Bill and Transaction Statements by email (optional)

POA duly signed and completed

Documents to be submitted for opening a Demat Account :

Account Opening Form - completed in all respects as mentioned in the checklist

Voter ID card

Passport - should be valid on the date of submission

Driving License - should be valid on the date of submission

Bank passbook

Bank Statement - Original / Copy of bank statement on the stationery of the bank carries logo &

name of the bank alongwith cancelled copy of cheque. OR Original bank statement on a computer

generated stationery duly attested by the bank officials alongwith name and designation and

signed by the client alongwith cancelled original cheque.

The bank statement should be of the latest quarter

Electricity Bills-the bill date should not be more that two months old on the date of submission

Telephone Bills - the bill date should not be more than two months old on the date of submission.

This has to be a landline bill only and FWT / Mobile bills not accepted

Document typeAcceptable as

Proof of address

Acceptable as

Proof of Identity

Registered leave and license agreement-should be valid on the date of submission

Identity card / document with address issued by Professional Bodies such as ICAI, ICWAI, Bar

Council to their Members along with proof of membership

Photo credit card / debit card issued by Banks

Identity card/document with applicant 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 (this can be treated as valid only till the time the

Type / Sub type of account ticked

Signature on form to match with Signature on PAN card (all holders)

Photograph PASTED on the form (all holders)

Date of Birth to match with Date of Birth in PAN card

üüüü

ü

ü

ü

ü

ü

ü

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ü

ü

ü

Ration Card - should have the holders name in the list of members ü

üRegistered Agreement for sale

3

Application for Opening a Demat Account for INDIVIDUALS - ANNEXURE J

INSTRUCTIONS :

1. Please fill all the details in CAPITAL LETTERS only. 2. Strike off whichever is not applicable. 3. Provide document evidence as per options on

Date Client ID

TYPE OF ACCOUNTS (Please specify type correctly, change in type not allowed)

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

SOLE/FIRST HOLDER DETAILS (The name mentioned here will be treated as valid & correct. No claims will be entertained later for any disputes arising out names specified wrongly)

FULL NAME (Mr./Ms.)

as per pan card

STATE: TAMILNADU

PERSONAL DETAILS

PIN :

NAME OF FATHER/HUSBAND

CORRESPONDENCE ADDRESS Provide

proof of this address

(options listed on page2)

LOCAL/PERMANENT ADDRESS

Provide proof of this address

(Options listed on page 2)

TELEPHONE NO. (with STD code)

CITY: CHENNAI

FAX NUMBER

MOBILE NO.

STATE: PIN : CITY:

EMAIL

OCCUPATION

Service {

SMS FACILITY

SEX

IN CASE OF NON-RESIDENT INDIAN:

FOREIGN ADDRESS

(Attestation Mandatory in proof)

Foreign Address

DATE OF BIRTH

MOTHER’S NAME

ADDRESS FOR

COMMUNICATION

PAN No. (Mandatory) : AKOPG7830Q

Local / Permanent Address Correspondence Address

YES NO

FEMALEMALE

Central Govt. State Govt. Public / Private Sector NGO Statutory Body}

Professional Others (Specify)______RetiredHousewifeStudentBusiness

RBI/AUTH DEALER REF. NO

FOREIGN CONTACT DETAILS TEL (RES): FAX: MOBILE :

RBI APPROVAL DATE :

Signature (s)

F1 S1 T1

qq q q q

q qþqqq

Regd. Off. : IL&FS House, Plot No. 14, Raheja Vihar, Chandivali, Andheri (E), Mumbai-400072

Tel: 4249 3000 Fax: 2857 0948

Email : [email protected] Website : www.ilfsdp.com

Form No. 2700055

qþ

q þ

18/05/1982

KALYAN CHAKRAVARTHY B.S.S

PARVEEN

þ q q

CITY:

600042

STATE : COUNTRY: PIN:

KANUPRIYA GUPTA

Others____________PromoterMarginNRI Non-RepatriableNRI RepatriableHUFOrdinary þ q q q q q q

9962589968

91-9962589968 -

FLAT F2, PLOT NO.2, SRIVARAAHA, 20TH STREET, TANSI NAGAR, VELACHERY

KANUPRIYA GUPTA

4

FULL NAME (Mr./Ms.)

as per pan card

STATE: PIN :


ADDRESS



CITY:

FAX NUMBER :

MOBILE NO.

EMAIL

OCCUPATION

SMS FACILITY

SEX

DATE OF BIRTH

MOTHER’S NAME

PAN No. (Mandatory) :

YES NO

FEMALEMALE

Signature (s)

MOB:

Date of Birth (of minor)

Proof MandatoryRELATIONSHIP

NAME (Mr./Ms.)

as per pan card

PAN No. (Mandatory) TEL: :

PIN :

ACCOUNT TYPE

GUARDIAN DETAILS (In case the Sole Holder is a Minor)

SOLE/FIRST HOLDERS BANK ACCOUNT DETAILS (attach a cancelled / blank cheque leaf)

SECOND HOLDERS DETAILS (Joint holding not allowed in case any holder is (a) Minor or (b) if it is a HUF account)

ADDRESS OF GUARDIAN

ACCOUNT NUMBER (As per cheque leaf)

NAME OF BANK

BRANCH ADDRESS (Bank’s Branch)

NON-MICR LOCATION

Savings

Yes No

Current Cash Credit Others

Cheque Leaf Attached Yes

9-DIGIT CODE MICR NUMBER OF THE BANK

AS APPEARING ON MICR CHEQUE LEAF.

No

FULL NAME (Mr./Ms.)

as per pan card

STATE: PIN :



CITY:

FAX NUMBER :

MOBILE NO.

EMAIL

OCCUPATION

SMS FACILITY

SEX

DATE OF BIRTH

MOTHER’S NAME

PAN No. (Mandatory) :

YES NO

FEMALEMALE

THIRD HOLDERS DETAILS (Joint holding not allowed in case any holder is (a) Minor or (b) if it is a HUF account)

CITY : STATE :

000201090819

ICICI BANK LTD

MG ROAD BANGALORE

þ q

qq q

qqqq

qq

qq

q þ

q

qqq

qq q

qq

qq

q

q þ

q q

Form No. 2700055

Others

Statutory Body}

Retired

NGOPublic / Private Sector

HousewifeStudent

State Govt.

Business

Central Govt.

Professional

Service {

Professional

Service { Central Govt.

Business Student

State Govt. Public / Private Sector

Housewife

NGO

Retired Others

Statutory Body}

þ q q q

ADDRESS


- -

- -

q

T2S2

KANUPRIYA GUPTA

F2

5

DECLARATIONSThe 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

Prevention of Money Laundering Act, 2002 (hereinafter referred to as “Act”) came into effect from July 1,2005 vide Notification No. GSR 436(E) dated July

1,2005 issued by Department of Revenue, Ministry of Finance, Government of India. Further, SEBI vide its circular reference number ISD/CIR/RR/AML/1/06

dated January 18, 2006 mandated that all intermediaries should formulate and implement a proper policy framework as per the guidelines on anti money

laundering measures and also to adopt a Know Your Customer (KYC) policy. The intermediaries may, according to their requirements specify additional

disclosures to be made by clients for the purposes of identifying, monitoring and reporting incidents of money laundering and suspicious transactions

undertaken by clients. SEBI also issued another circular reference no. ISD/CIR/RR/AML/2/06 dated March 20, 2006 advising all intermediaries to take

necessary steps to ensure compliance with the requirement of section 12 of the Act, inter-alia, maintenance and preservation of records and reporting of

DECLARATIONS RE : PREVENTION OF MONEY LAUNDERING

The investor(s) should ensure that the amount invested in the securities and represented as credit in their demat account is through legitimate sources only and

does not involve and is not designated for the purpose of any contravention or evasion of the provisions of the Income Tax Act, Prevention of Money Launder

ing Act, Prevention of Corruption Act and/or any other applicable law in force and also any laws enacted by the Government of India from time to time or any

To ensure appropriate identification of the customer (s) under its KYC policy and with a view to monitor transactions , ISSL DP reserves the right to seek

information, record customer’s telephonic calls and /or obtain and retain documentation for establishing the identity of the customer, proof of residence, source

of funds, etc. It may re- verify identity, seek and obtain any incomplete or additional information for this purpose.

I/We, hereby confirm that I/We will act on my/our own behalf and will continue to act on my/our own behalf unless otherwise communicated in writing.

NAME (S) OF HOLDER(S)

NAME AS IN PAN CARD / PAGE 3

SIGNATURE(S)

(Use Black Ink only)

SOLE/FIRST HOLDER (Mr./Ms.)

SECOND HOLDER (Mr./Ms.)

THIRD HOLDER (Mr./Ms.)

GUARDIAN(in case of minor)

(Mr./Ms.)

F3

S3

T3

I/We authorize you to receive credits automatically into my/our Demat account.

STANDING INSTRUCTION

No In case of a NRI account (RBI Approval)/Authorised Dealer Approval furnished

Yes (default) No

NoYes

No (default)YesAccount to be operated through Power of Attorney

NATURE OF BUSINESS

FIRST HOLDER

Financial Status

(Annual Income)

ADDITIONAL FINANCIAL DETAILS (Mandatory)

Income Range per annum:

Up to Rs.1Lakh

Rs.5 - 10 Lakh Rs.10 - 15 Lakh

Rs.1 - 2 Lakh

> Rs.15 Lakh


Signature (s)

Form No. 2700055

þ q q qq q q

KANUPRIYA GUPTA

NATURE OF BUSINESS

SECOND HOLDER

Financial Status

(Annual Income)


Up to Rs.1Lakh


Rs.1 - 2 Lakh

> Rs.15 Lakh


NATURE OF BUSINESS

THIRD HOLDER

Financial Status

(Annual Income)


Up to Rs.1Lakh


Rs.1 - 2 Lakh

> Rs.15 Lakh


q q q qq q q

q q q qq q q

q q

q q

q þ

T4S4

KANUPRIYA GUPTA

F4

HOUSEWIFE

6

Signature (s)

PHOTOGRAPHS OF ALL HOLDERS (Sign as per illustration provided)

IN PERSON VERIFICATION

SIGNATURE OF THE APPLICANT(S) SIGNED IN THE PRESENCE OF THE DP STAFF

NAME (S) OF HOLDER(S) SIGNATURE(S)




GUARDIAN(in case of minor)

(Mr./Ms.)

F6

S6

T6

NAME OF THE DP STAFF

SIGNATURE OF THE DP STAFF

& DP CODE

DATE WHEN ‘INPERSON’

VERIFICATION WAS CARRIED OUT

PLACE WHERE ‘INPERSON’

VERIFICATION WAS CARRIED OUT

NAME/DETAILS OF BRANCH/SERVICE CENTRE

Form No. 2700055

KANUPRIYA GUPTA

INSTRUCTION: Verify the photo with person; verify the originals of PAN card, other ID proofs and Address proof. Stamp the photocopies with Rubber stamps

provided; sign & date

T7S7

KANUPRIYA GUPTA

F7

DETAILS OF CLIENTS

NAME (S) OF HOLDER(S)

NAME AS IN PAN CARD/PAGE 3.SIGNATURE(S)

(Use Black Ink only)




F8

S8

T8

7

DETAILS OF NOMINEE

FORM FOR NOMINATION ANNEXURE JA

q I/We wish to make a nomination and do hereby

nominate the following person in whom all rights of

transfer and/or amount payable in respect of securities

held in the Depository by me/us in the said beneficiary

owner account bearing application no. as mentioned

Where a nomination is made please ensure that the following are present

o Photograph of the nominee, signed as illustrated on page 6

o Signature of the Nominee, Nominee PAN

o Signatures of two witnesses.

o In case of minor nominee, guardian to also sign across the minor

NAME OF NOMINEE (Mr./Ms.)

(Cannot be one of the holders)

RELATIONSHIP WITH THE APPLICANT (if any)

ADDRESS

PIN

SIGNATURE OF NOMINEE

PAN No.

IF NOMINEE IS MINOR

RELATIONSHIP WITH THE APPLICANT (if any)

ADDRESS OF GUARDIAN

PIN

SIGNATURE OF GUARDIAN

PAN No.

WITNESSES TO NOMINATION (MANDATORY)

SR.NO. NAME & COMPLETE ADDRESS (address is mandatory) SIGNATURE

1.

DATE

Form No. 2700055

KALYAN CHAKRAVARTHY BSS

SPOUSE

CITY: CHENNAI

KANUPRIYA GUPTA

2.

600042

þ I/WE DO NOT WISH TO MAKE A NOMINATION

GUARDIAN'S NAME (Mr./Ms.)

(in case Nominee is a minor)

DATE OF BIRTH

OF NOMINEE

PLOT NO2, SRIVARAAHA, 20TH STREET TANSI NAGAR VELACHERY

STATE : TAMILNADU

CITY : STATE :

8

Form No. 2700055

The nomination can be made only by individuals holding beneficiary owner accounts on their own behalf singly or jounlty. Non

indiciduals including society, trust body corporate, partnership firm, Karta of Hindu Undivided Family (HUF) Holder of power of

attorney cannot nominate. If the account is held jointly, all the joint holders must sign the nomination form.

The cancellation of Nomination can be made by the same persons who made the original nomination.

Non-individuals including society, trust, body corporate, partnership firm, karta of Hindu Undivided Family (HUF),

holder of power of attorney cannot cancel the nomination. If the beneficiary owner account is held jointly all joint

1.

2. Nomination can be made in favour of a Minor. In that event, the name and address of the Guardian of the minor nominee shall be

provided by the beneficial owner(s). Guardian should be someone other than the holders of the beneficiary account.

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 (NRI) can be a Nominee subject to the RBI Regulations in force, from time to

3.

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.

4.

5. Transfer of securities in favour of a nominee shall be valid discharge by the Depository or Depository Participant against the legal

heirs of the beneficial owner(s).

6.

On cancellation of nomination, the nomination shall stand rescinded and the Depository /Depository Participant shall not be under any

obligation to transfer the securities in favour of the Nominee.

In case you do not wish to nominate, we request you to tick the second option, i.e. ‘I/WE THE UNDERSIGNED DO NOT WISH TO

MAKE A NOMINATION IN RESPECT OF MY BO ACCOUNT’ in the nomination form duly signed by the account holder (s) and

forward it to us. Please also strike the nominee details.

7.

8. If the nomination details are not completed in all respects, the nomination will not be registered

9.

All communication shall be sent at the address of the Sole/First holder only. 1.

2. Thumb impressions and signatures other than English or Hindi or any of the other languages 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.

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 must be accepted as proof of identity / proof of address

(local / correspondence/ foreign address as the case may be) :

3.

Kindly read the following instructions before filling up Nomination Details

NOTES

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 Governments 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,

Proof of Address : Ration card, Passport, Voter ID Card, Driving license, Bank passbook, verified copies of Electricity bills (not more

that 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 Governments 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)

AGREEMENT WITH THE DEPOSITORY PARTICIPANT

Form No. 2700055

AGREEMENT BETWEEN THE DEPOSITORY PARTICIPANT AND THE PERSON SEEKING TO OPEN AN ACCOUNT WITH THE DEPOSITORY PARTICIPANT

(APPLICANT)

This Agreement made and entered into this __________________________ day of _____________________ (month) ____________________ (year) between

(hereinafter called “client“) and IL&FS Securities Services Limited situated at IL&FS House, Plot No. 14, Raheja Vihar, Chandivali, Andheri (E), Mumbai-400072.

(“hereinafter called “the Depository Participant“)

WHEREAS the Client has furnished to the Depository Participant the duly filled in application

form requesting therein to open an account with the Depository Participant NOW THEREFORE

in consideration of the Depository Participant having agreed to open account for the Client, both

the parties to the agreement hereby convenant and agreeas follows:-

WITNESSETH

IN WITNESS WHEREOF the Client and the Depository Participant has caused these presents to be executed as of the day and year first above written.

Signed and delivered for & on behalf of client

On Behalf of

IL&FS Securities Services Limited

Witness

Signature:_________________________________________

Signature:___________________________________________

Name: ___________________________________________

(Authorised Signatory)

Name: _________________________________________

Address: _________________________________________

_________________________________________

Applicant

9

Address: ________________________________________

_________________________________________

Name: _________________________________________

Witness

Signature:_________________________________________Signature: (1st Holder) : F10_________________________________

The Client shall pay such charges to the Depository Participant for the purpose of opening

and maintaining his account, for carrying out the instructions of the Client and for

rendering such other services as may be agreed to from time to time between the

Depository Participant and the Client as set out in Schedule A. The Depository Participant

shall reserve the right to revise the charges by giving not less than thirty days notice in

1.

The Client shall have the right to get securities which have been admitted on the Depository

dematerialized in the form and manner laid down under the Bye Laws and Business Rules.

The Depository Participant further undertakes that it shall not create or permit to subsist

any mortgage, charges or other encumbrances over all or any of such securities submitted

for dematerialisation except on the instructions of the Client

2.

The Depository Participant hereby undertakes that it shall maintain a separate account of its

own securities held in dematerialized form with the Depository and shall not commingle the

same with the securities held in dematerialized form on behalf of the Client

3.

The Depository Participant undertakes that a transfer to and from the accounts of the Client

shall be made only on the basis of an order, instruction, direction or mandate duly

authorised by the Client and that the Depository Participant shall maintain adequate audit

trail of such authorization.

4.

The Depository Participant agrees that the Client may give standing instructions with

regard to the crediting of securities in his account and the Depository Participant shall act

according to such instructions.

5.

The Depository Participant undertakes to provide a transaction statement including

statement of accounts , if any, to the Client at monthly intervals unless the Depository

Participant and the Client have agreed for provision of such statements at shorter intervals.

However, if there is no transaction in the account, then the Depository Participant shall

provide such statement to the Client atleast once a quarter.

6.

The Depository Participant shall have the right to terminate this agreement, for any reasons

whatsoever, provided the Depository Participant has given a notice in writing of not less

than thirty days to the Client as well as to the Depository. Similarly, the Client shall have the

right to terminate this agreement and close his account held with the Depository

Participant, provided no charges are payable by him to the Depository Participant. In such

an event, the Client shall specify whether the balances in its account should be transferred

to another account of the Client held with another Depository Participant or to rematerialise

the security balances held. Based on the instructions of the Client, the Depository

Participant shall initiate the procedure for transferring such security balances or

rematerialise such security balances within a period of thirty days, as per the procedure laid

down in the Bye Laws and Business Rules. Provided further, termination of this agreement

shall not affect the rights, liabilities and obligations of either party and shall continue to bind

the parties to their satisfactory completion.

7.

On the failure of the Client to pay the charges as laid out in clause (1) of this agreement

within a period of thirty days from the date of demand Depository Participant shall terminate

this agreement and close the account of the Client by requiring it to specify

8.

The Depository Participant and the Client shall abide by the arbitration and conciliation

procedure prescribed under the Bye Laws of National Securities Depository Ltd. and that

such procedure shall be applicable to any disputes between the Depository Participant and

the Client

whether the balances in its account be transferred to the account of the Client held with

another Participant or be rematerialised, in the manner specified in the Bye Laws and

Business Rules.

The Client further agrees that in the event of the Client committing a default in the payment

of any of the amounts provided in clause (1) within a period of thirty days from the date of

demand, without prejudice to the right of the Depository Participant to close the account of

the Client, the Depository Participant may charge interest @ not more than 24% p.a. or

such other rate as may be specified by the Executive Committee from time to time for the

period of such default. In case the Client has failed to make the payment of any of the

amounts as provided in clause ( 1 ) of this agreement, the Depository Participant shall have

the right to discontinue the Depository services till such time he makes the payment along

with interest, if any, after giving two days notice to the Client.

9.

The Depository Participant shall have a right to provide such information related to the

Client’s account as may be requested by the National Securities Depository Ltd. From time

to time

10.

The Client shall have the right to create a pledge of the securities held in the

dematerialised form with the Depository Participant only in accordance with the procedure

and subject to the restriction laid down under the Bye Laws and Business Rules.

11.

The Depository shall not be liable to the Client in any manner towards losses, liabilities and

expenses arising from the claims of third parties and from taxes and other governmental

charges in respect of securities credited to the Client’s account.

12.

The Client may exercise the right to freeze his account maintained with the Depository

Participant so as to lock the securities held with the Depository Participant in accordance

with the procedures prescribed in the Bye Laws and Business Rules.

13.

The Client may exercise the right to defreeze his account maintained with the Depository

Participant in accordance with the procedure and subject to the restrictions laid down under

the Bye Laws and Business Rules.

14.

17.

The Client shall notify the Depository Participant, within seven days, of any change in the

details set out in the application form submitted to the Depository Participant at the time of

opening the account or furnished to the Depository Participant from time to time

15.

The Depository Participant undertakes to resolve all legitimate grievances of the Client

against the Depository Participant within a period of thirty days.

16.

The Depository Participant and the Client further agree that all claims, differences and

disputes, arising out of or in relation to dealings on the Depository including any

transaction made subject to the Bye Laws or Business Rules of the Depository or with

reference to anything incidental thereto or in pursuance thereof or relating to their validity,

construction, interpretation, fulfillment or the rights, obligations and liabilities of the parties

thereto including any question of whether such dealings, transactions have been entered

into or not, shall be subject to the exclusive jurisdiction of the courts at Mumbai only

18.

Signature: (2nd Holder) : S10________________________________

Signature: (3rd Holder) : T10_________________________________

KANUPRIYA GUPTA residing at FLAT F2, PLOT NO.2, SRIVARAAHA, 20TH STREET, TANSI NAGAR, VELACHERY, CHENNAI, TAMILNADU - 600042

F9

KA

NU

PR

IYA

GU

PT

A

T9

S9

Name:

Name:

Name:

KANUPRIYA GUPTA

10

Form No. 2700055

Signature (s)

I/We agree to pay the charges as per following charge structure for our Demat account with ISSL

CHARGES FOR THE DEPOSITORY SERVICES

RATE SHEET

SCHEDULE- A

Client ID : _________________________________________________

Effective : ________ / _______ / 20 ________

Charge head Regular Scheme Refundable AMC Scheme

Annual Maintance

Charges

Rs. 150 per quarter to be paid at the beginning of every

quarter. At the time of new account opening AMC to be

paid upfront for two quarters NON-REFUNDABLE

An amount of Rs. 7000/- to be paid upfront. There would

be no AMC charged to the account for the duration this

scheme has been opted for. If the demat account holder

wishes to withdraw this amount at any point of time during

the operation of the account or on closure, the above

amount would be refunded after deducting Rs. 600/- i.e

Dematerialization

Charges

Rs. 2.00 per certificate plus courier charges of

Rs. 35 per demat request for every 500 gms.

Rs. 2.00 per certificate plus courier charges of

Rs. 35 per demat request for every 500 gms.

Transaction charges

Market/Off Market/

Interdepository Transactions

0.05% per debit instruction subject to a minimum of Rs .

25 plus depository charges at actuals.

0.05% per debit instruction subject to minimum of Rs. 30

plus charges depository at actuals.

Same day execution

and payin.

Same day execution charges Rs.50 per

transaction or 0.05% which ever is higher..

Same day execution charges Rs.50 per

transaction or 0.05% which ever is higher..

SLB Charges

For Security Borrowing : Rs.25 plus

Depositories charges

For Security Lending : Rs.25 plus


For Security Borrowing : Rs.25 plus


For Security Lending : Rs.25 plus


Pledge Charges

Creation/Closure and

Confirmation of both

0.02% of the transaction charges subject to a

minimum of Rs.50 plus depository charges at

actuals.


minimum of Rs. 50 plus depository charges at

actuals.


minimum of Rs. 50

0.05% of the transaction charges subject to

minimum of Rs. 50

Pledge Charges for Invocation

Rs. 25 per certificate or 0.05% of the value

whichever is higher plus depository charges as actuals

Rs. 25 per certificate or 0.05% of the value

whichever is higher plus depository charges as actuals.

Rematerialization

Charges

Rs. 50 per transactionRs. 50 per transactionFailed / Rejected

Transactions

Demat Rejection

Charges

Rs. 35 per rejection for every 500 gms Rs. 35 per rejection for every 500 gms

Adhoc / Non periodic

statement requests

Rs. 25(Rs 500 for Foreign address) per request upto 10

pages. Every additional 5 pages or a portion thereof will

be charged at Rs. 5 PLUS courier charges.

Rs. 25(Rs 500 for Foreign address) per request upto 10

pages. Every additional 5 pages or a portion thereof will be

charged at Rs. 5 PLUS courier charges.

Cheque Bounce Charges Charges will be applied based on charges as

determined by our bankers

Charges will be applied based on charges as

determined by our bankers

Tick Appropriate Scheme : Regular Scheme q Refundable AMC Scheme q

In case scheme is not ticked, the default scheme selected would be ‘Regular Scheme’.

Note :

It is mandatory that the rate sheet is signed by the applicant(s); and in case of special rate sheets, it should be attached to account

opening form with signatures of applicants & DP executive

I/We understand that the above charges are subject to revision by ISSL after providing a notice period of 30 days. Such revisions will be

notified by ordinary post / courier.

(Pls. Sign on the Reverse too)

T11S11

KANUPRIYA GUPTA

F11

Form No. 2700055

Signature (s) :

11

Client ID : _________________________________________________

OTHER POINTS :

● Annual Maintenance Charges are non-refundable

● All charges would attract the service tax/cess/levies and /other such taxes as applicable from time to time

● All payments have to be made favouring IL&FS Securities Services Limited. You can pay by Cheques or

Demand Drafts payable at the local branch where the account is opened, outstation cheques will not be

accepted.

● All the percentages in the above structure would be applied on the value of the transaction as computed by

NSDL/ CDSL.

● Out of Pocket expenses incurred on the Dispatch of securities for Dematerialisation and communication

charges incurred on out-station calls/faxes made specifically on request of the client will be charged on

actual.

● Charges quoted above are for the services listed. Any services not listed above will be charged separately.

IMPORTANT NOTE :

● DP bills should be paid on or before the due date. Interest shall be levied @2% per month on outstanding

amount for non payment from the bill due date. Pursuant to Clause 9 of the Client-DP Agreement, in case of

non-payment of DP Charges within the due date, DP reserves the right to discontinue operation of the demat

account till such time that the payment is received

● For all purposes the Bill date shall be construed as the date of demand and the bill will be considered as the

Bill cum Notice for payment and, ISSL reserves the right to “Freeze Depository account for debit

transactions”, in case of non payment of charges after two days from the Bill due date.

T12S12

KANUPRIYA GUPTA

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Form No. 2700055

Client ID :

(This Form needs to be certified by Bank)

Client Name :

Particulars of Bank Account S.B. Current Cash Credit

9-Digit code number of the bank and branch

(Appearing on the MICR cheque issued by the bank)

(Please attach a photocopy of a cheque or a blank

ELECTRONIC CLEARING SERVICE (DEBIT CLEARING) FORM

A/c Holder(s) Name(s)

ISSL Copy

Name of the Bank

q q q

Name of the Branch

Address

Ledger and Ledger folio number :

Account number (as appearing on the cheque book)

I hereby instruct you to debit my account on 25th day of every billing month.

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons

of incomplete or incorrect information, I would not hold ISSL DP responsible, I have read the option invitation letter and agree to discharge

the responsibility expected of me as a beneficiary under the scheme.

1.

2.

3.

Date :____________________

TO BE CERTIFIED BY CLIENT’S BANK

Certified that the particulars furnished above are correct as per our records.

Bank’s Stamp

Date :

Name :___________________________________

Signature :________________________________

(Ma

nd

ato

ry)

(Ma

nd

ato

ry)

Encl: Cheque leaf

12

KANUPRIYA GUPTA

Form No. 2700055

Client ID :

(This Form needs to be certified by Bank)

Client Name :

Particulars of Bank Account S.B. Current Cash Credit

9-Digit code number of the bank and branch

(Appearing on the MICR cheque issued by the bank)

(Please attach a photocopy of a cheque or a blank

ELECTRONIC CLEARING SERVICE (DEBIT CLEARING) FORM

A/c Holder(s) Name(s)

Bank Copy

Name of the Bank

q q q

Name of the Branch

Address

Ledger and Ledger folio number :

Account number (as appearing on the cheque book)

I hereby instruct you to debit my account on 25th day of every billing month.

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons

of incomplete or incorrect information, I would not hold ISSL DP responsible, I have read the option invitation letter and agree to discharge

the responsibility expected of me as a beneficiary under the scheme.

1.

2.

3.

Date :____________________

TO BE CERTIFIED BY CLIENT’S BANK

Certified that the particulars furnished above are correct as per our records.

Bank’s Stamp

Date :

Name :___________________________________

Signature :________________________________

(Ma

nd

ato

ry)

(Ma

nd

ato

ry)

Encl: Cheque leaf

12

KANUPRIYA GUPTA

13

Form No. 2700055

Date :

Re : Demat Account no. / Form No. 2700055

DPID : IN300095

I/We refer to the DP-Client Agreement (“the Agreement”) entered into between me/us and IL&FS Securities Services

Limited (ISSL) for opening the abovementioned Demat Account.

I/We are aware that the DP, in terms of the NSDL Circular, agreed to provide monthly /quarterly Bills and Transaction

Statements and other notices by email or on website on the terms and conditions annexed hereto(overleaf).

I/We intend to avail the facility of receiving monthly / quarterly Bills and Transaction statements and other

intimations / notices by email or on website for the captioned demat account on the terms and conditions annexed

hereto. I / We request you to register the following email ID(s) for the same :

The Manager

IL&FS Securities Services Limited

IL&FS House, Plot No.14

Raheja Vihar, Chandivali

Andheri (East)

All other terms and conditions of the Agreement remain the same. This letter shall form part and parcel of the

Agreement

T13S13KANUPRIYA GUPTA

F13

Form No. 2700055

15

Terms & Conditions for receiving Bills, Transaction Statements and other

intimations / notices by email or on website

Signed and delivered by

Second Holder

First Holder

Third Holder

F14

Client email id/web-based id:

Client Id:

S14

T14

Signed and delivered by

(For and on behalf of Participant)

Name: IL&FS Securities Services Limited

Authorised Signatory

IL&FS House, Plot No. 14, Raheja Vihar, Chandivali

Andheri (E), Mumbai-400072

1. The client agrees not to receive Bills and Transaction statements and any other intimations / notices in paper form

from the DP. Provided however that, in case when the DP is not able to provide such Bills and Transaction

statements and intimations / notices to its clients through website / email due to any unforeseen problems, the DP

should ensure that the same reaches me/us in physical form to the address as registered in the captioned demat

account

2. The client shall take all the necessary steps to ensure confidentiality and secrecy of the login name and password of

the internet/email account

The client is aware that the Bills and Transaction statement and any other intimation / notices may be accessed by

other entities in case the confidentiality / secrecy of the login name and password is compromised

3.

The client shall immediately inform the DP about change in email address, if any,4.

5. The client shall confirm the validity of the email address atleast once in a year

The client and the DP shall have the right to terminate this agreement after giving a notice of at least 10 days in

advance to the other party

6.

Ilfs Application Form

Documents

Transcript of Ilfs Application Form