TRADING & DEMAT ACCOUNT OPENING FORM - NJ PMS

BANKMANDATEElectronicClearingService(DebitClearing)BSELimitedRegd.Office: Floor25, P.JTowers,DalalStreet,Fort,Mumbai– 400001,Maharashtra*CustomerReferenceNo:(UCC)TheManager*BankName:*MandateReferenceNo:UICode:*BranchName:*Address:TelephoneNo:I/weherebyauthorizeyoutodebitmy/ouraccount(ECSDebitclearing)formakingpaymenttoBSELimited(throughtheirserviceprovider)asperthedetails given as under.*Name of Account Holder:*MICR- 9DigitCodeNo.softheBank&Branch (AppearingontheMICRchequeissuedbythebank):* ModeofHolding:Single Joint EitherorSurvivor*AccountType: S.B.Account CurrentAccount CashCredit*Bank Account Number:*Account holder names (As per bank’s record):1st A/c Holder:2ndA/cHolder:3rd A/c Holder:Name of the Scheme *StartDate Periodicity *Amount(UpperLimit) *EndDateDailyI/Weherebydeclarethattheparticularsgivenabovearecorrectandcompleteinallrespects.Ifthetransactionisdelayedornoteffectedatallforreasonsofincompleteorincorrectinformation,I/wewouldnotholdtheuserinstitutionresponsible.Ihavereadtheoptioninvitationletterandagreetodischargetheresponsibilityexpectedofme/usasaparticipantunderthescheme.ThisistoinformthatI/WehaveregisteredfortheRBI’sElectronicClearingService(DebitClearing),andthatmy/ourpaymenttowardsmy/ourobligationinBSELtd.(thruitsserviceprovider)shallbemadefrommy/ourabovementionedbankaccountwithyourbank.I/WeauthorizetherepresentativecarryingthisECS(DebitClearing/StandingInstruction)mandateformtogetitverified&executed.I/Weherebyauthorizethebanktodebitmy/ouraccountforMandateverificationchargesifany.Signature(s)oftheaccountholder(s).(Asperbank’srecord)*Date: D D M M Y Y Y Y*Indicatesmandatoryfield.1. 2. 3.For Bank Use OnlyCertified that the particulars furnished above are correct and as per our records.Bank’sStampDate: D D M M Y Y Y YSignatureoftheAuthorizedofficialfromtheBank