TRADING & DEMAT ACCOUNT OPENING FORM - NJ PMS

Depository Account DetailsBeneficiary NameDP Name N J I n d i a I n v e s t P r i v a t e L i m i t e dDP Address 9 t h F l o o r B T o w e r U d h n a U d y o g n a g a rS a n g h C o m m e r c i a l C o m p l e x C e n t r a l R o a dN o . 1 0 , U d h n a , S u r a t - 3 9 4 2 1 0 .DP ID 1 2 0 6 4 2 0 0 Client IDTrading Preferences(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 ActionsADDITIONAL DETAILS FOR OPENING TRADING ACCOUNTI/We request you to open a Trading Account in my/our name as per the following details:Signature1(a)/211(b)/211(c)/211(d)/21Depository Name C D S LPlease 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