TRADING & DEMAT ACCOUNT OPENING FORM - NJ PMS

ADDITIONAL DETAILS FOR OPENING TRADING ACCOUNTI/We request you to open a Trading Account in my/our name as per the following details:Depository Account DetailsBeneficiary NameDP NameDP AddressDP IDTrading PreferencesClient IDDepository Name(Please sign in the relevant boxes where you wish to trade. The segment not chosen should be struck off by the Client)BSE SegmentCashF&OSTAR MFCurrency DerivativeNSE SegmentCashF&OMFSSCurrency DerivativeSignature(*If, in future, the Client wants to trade on any new segment/new exchange, separate authorization/letter should be takenfrom the client by the stock broker.)Past ActionsSignature1(a)/211(b)/211(c)/211(d)/21Please give the details of any action taken by SEBI/Stock Exchange/ any other authority for violation of SecuritiesLaws/ other economic offences specifically indicating any action taken during the previous 3 years.2(a)/212(b)/212(c)/212(d)/21Dealings through Sub-brokers and other Stock BrokersWhether dealing through the sub-broker, provide the following details:Sub-broker's Name:SEBI Registration number:Registered office address:Telephone:Website:Fax:Whether dealing with any other stock broker/sub-broker (if case dealing with multiple stock brokers/sub-brokers,provide details of all)If Yes, Stock Broker's Name:Client Code:Name of the Exchange:Details of disputes/dues pending from/to such stock broker/sub- broker: _________________________________7