QRC No CHANGE /MODIFICATION REQUEST FORM Date
QRC No CHANGE /MODIFICATION REQUEST FORM Date
QRC No CHANGE /MODIFICATION REQUEST FORM Date
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<strong>QRC</strong> <strong>No</strong> ________________ <strong>CHANGE</strong> /<strong>MODIFICATION</strong> <strong>REQUEST</strong> <strong>FORM</strong><br />
The Manager,<br />
RELIANCE CAPITAL LTD<br />
MBC Centre, Ground Floor, 143A, Ghodbunder Road,<br />
Opp. Cine wonder Cinema, Kapurbavdi, Thane West 400607<br />
Dear Sir,<br />
Client ID<br />
DP ID BO ID<br />
<strong>Date</strong>:________________<br />
I/We also authorize to deduct Rs 40 (plus taxes) as processing fees for this Change Request.<br />
Account Holder’s Details<br />
Name of First/ Sole Holder<br />
Name of Second Holder<br />
Name of Third Holder<br />
I request you to effect the following changes in client details. I understand that the change(s) is / are being carried out at<br />
my/ our request and will affect all accounts held by me viz DP/ EQUITY/ COMMODITIES/ FX/ AMCs/RTAs, under<br />
the captioned client code. I/ We submit the necessary documents (for Address Change requests and Name Change<br />
requests) in original and photocopy required for effecting the same.<br />
Details (pl. Specify Addition/Modification/ Existing Details New Details<br />
change of address, Deletion (please<br />
bank details, change of<br />
signature, telephone<br />
number, etc)<br />
specify)<br />
Pls update your Mobile no. ____________________________________________<br />
First/Sole Holder Second Holder Third Holder<br />
Name<br />
Signature<br />
Please also arrange to make the following changes in the records of<br />
RELIANCE COMMODITIES LTD RELIANCE SECURITIES LTD<br />
AMCs/RTAs (Asset Management Companies/Registrar and Transferring Agent), for my holdings<br />
FOR OFFICE USE ONLY (Mandatory to be filled by branch official)<br />
=============================(please Tear Here)==========================================<br />
Received Account Details Addition / Modification / Deletions request as per details given below :<br />
Client ID: _________________________________ <strong>Date</strong>: ________________________________________________<br />
Name: ________________________________________________Branch Name: _____________________________<br />
Signature: ________________________________________
RELIANCE CAPITAL LTD<br />
Following are the terms/ instructions for change of request<br />
• Changes requested above would be effected within a period of 4 to 5 working<br />
days from the date of receipt at the Branch and the said changes would be<br />
effective in the systems from that date only.<br />
• The fresh/ new Signature(s) and/ or DP Operating Instructions would be valid<br />
once the changes are updated in the system. The company will not be responsible<br />
for return/ dishonor of any such old outstanding/ unpaid cheques/ debits/ requests<br />
and which are still in transit and yet to be received/ actioned by the Reliance<br />
Money and not in conformity with the fresh/ new Signature(s) and/ or Operating<br />
Instructions Change request.<br />
• I/ We have read, understood and are agreeable to the terms mentioned above.<br />
• It is compulsory to give acknowledgment copy to the client<br />
Documents requirements are:<br />
Change in Address<br />
• CRF duly signed by all the holders.<br />
• Proof of Address (Electricity bill, Telephone bill, Bank verification letter, Bank<br />
statement with latest transaction, original cancelled cheque).<br />
• Identity Proof ( Pan card, Election card, Valid Driving license, Valid Passport)<br />
Change in Bank details<br />
• CRF duly signed by all the holders<br />
• Proof of bank (Bank Statement with transaction , original cancelled cheque, Bank<br />
passbook with latest transaction)<br />
• Power of attorney duly signed By All Holders.<br />
• Identity Proof ( Pan card, Election card, Valid Driving license, Valid Passport)<br />
Signature:<br />
Signature should be same as client had signed in AOF<br />
Change in <strong>No</strong>mination<br />
• CRF duly signed by all the holders<br />
• <strong>No</strong>mination change request Letter<br />
Change in Signature:<br />
Client should personally visit to the branch with Proof of identity and bank<br />
attestation.<br />
FOR OFFICE USE ONLY (Mandatory to be filled by branch official)<br />
Branch Name:___________________________________________<br />
Received on : __________________________________________<br />
Customer Signature Verified by (sign): _______________________________________<br />
Name of Staff __________________________________Employee ID:______________<br />
(For CBO use only)<br />
Updated by _________________________ Authorised by _____________________<br />
Employee ID _________________<br />
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