IIFL Securities Limited

Account Opening Form (Individual) for Broking & Depository Services.

Customer Service Desk: (022) 40071000 | [email protected]
Channel : ONLINE | Sr. No. : | Lead ID : 2543273004158050437

IIFL Securities Limited, IIFL House, Sun Infotech Park, Road No. 16V, Plot No. B-23, MIDC, Thane Industrial Area, Wagle Estate ,
Thane 400 604 • Tel: (91-22) 3929 4000/ 4103 5000 • Fax: (91-22) 2580 6654

Rajkumari Agarwal User ID. AGARW821

INDEX OF DOCUMENTS

SECTION-A - MANDATORY DOCUMENTS SECTION-B - VOLUNTARY DOCUMENTS

AS PRESCRIBED BY SEBI AND EXCHANGES AS PROVIDED BY STOCK BROKER/ DEPOSITORY PARTICIPANT

Account Opening Form {Pg 1-9} Terms & Conditions cum Registration form for receiving
1. Part I - KYC form - Document captures the basic information SMS Alerts from Depository {Incuded in client copy}
about the constituent and an instruction / checklist. 1. Terms and Conditions-cum-registration / Modification form for
2. Part II - Document captures the additional information about the receiving SMS Alerts from CDSL/NSDL
constituent relevant to trading account and an instruction/check
list. For Distribution of Securities {Incuded in client copy}
3. Nomination Form for appointing a nominee to the client’s
1. Terms & Conditions for Distribution of Securities
account.
4. Client Declaration
Mutual Fund Trading Services {Incuded in client copy}
Tariff sheet {Pg 10} 1. Terms and Conditions for availing Mutual Fund Service System
(MFSS) facility and BSE StAR MUTUAL FUND offered by NSE and
1. Document detailing the rate/amount of brokerage and other BSE respectively
charges levied on the client for trading and demat account on the SIP in Mutual Fund & Security {Incuded in client copy}
stock exchange(s)/ depository.
Rights & Obligations of Stock Brokers, Sub-Broker 1. Terms and Conditions for availing systematice investment plan
& Clients {Incuded in client copy} in Mutual Fund and securities.
1. Document stating the Rights & Obligations of stock broker / Authorisation Letter {Pg 11-14}
trading member , sub-broker and client for trading on exchanges
(including additional rights & obligations in case of internet / A. Availing Mutual Fund Service System (MFSS) facility/ BSE StAR
wireless technology based trading). MUTUAL FUND (hereinafter jointly referred to “Mutual Fund
Transaction Facilities”)
Rights & Obligations of Beneficial Owner B. Authorization for Systematic Investment in Mutual Fund /
& Depository Participant {Incuded in client copy} Securities
1. Rights and Obligations of Beneficial Owner and Depository C. Running Account Authorisation
Participant as prescribed by SEBI and Depositories. D. Authorisation for Receipt of Contract Notes and Other
documents in Digital Mode
Risk Disclosure Document (RDD) {Incuded in client copy} E. Authorisation for Online Trading Software Password
1. Document detailing do’s and don’ts for trading on exchange, for Power of Attorney {Pg 16-19}
the education of the investors.
Guidance note {Incuded in client copy} 1. Voluntary and Limited purpose POA in favour of Broker for
operational requirements as per client athorization/instruction.
1. Document detailing risks associated with dealing in the securities a POA in favour of IIFL.
market.
Policies and Procedures {Incuded in client copy} PLEASE READ THIS DOCUMENT CAREFULLY BEFORE AGREEING
TO ITS CONTENTS AND ENSURE ALL THE DETAILS PROVIDED
1. Documents describing significant policies and procedures of IIFL
ARE CORRECT.
relateddocument:
eSigned to Trading Account of the client.
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PART-I- KNOW YOUR CLIENT APPLICATION FORM (KYC) - FOR INDIVIDUAL - 1st / Sole Holder
A. IDENTITY DETAILS (Please read instructions)
1. Name (As appearing in supporting Identification document)

Rajkumari Agarwal
Maiden Name :
Father/ Husband : MOHAN LAL AGARWAL
(a) Gender : Female (b) Marital Status : Married (c) Date of Birth : 11/02/1967
3. Nationality : INDIAN 4. Status : Resident
5. (a) PAN No : AEMPA4113J (b) Aadhar No :
6. Proof of identity : Copy of PAN CARD

B. ADDRESS DETAILS (Please read instructions)

1. Resident / Correspondance Address 3. Permanent Address of Resident Applicant if different from
B.1. Overseas address (Mandatory) for Non-resident Applicant
D 15 RAM MARG MITTAL COLONY BARI ROAD DHAULPUR D 15 RAM MARG MITTAL COLONY BARI ROAD DHAULPUR

328001DHOLPUR, RAJASTHAN, INDIA, DHOLPUR, RAJASTHAN, INDIA,328001

2. Proof of Resident Address provided by Applicant. 4. Proof of Permanent Address provided by Applicant.
Address Proof OTHERS Address Proof
Document No 113J Document No 113J
Place of Issue Place of Issue
Date of Issue NA Date of Issue NA
Date of Expiry NA Date of Expiry NA
Issuing Authority Issuing Authority
5. Contact Details: Mobile No : 0-9414413675 E-mail ID : [email protected]
DECLARATION
I hereby declare that the details furnished above including email and mobile no. are
true and correct to the best of my knowledge and belief and I undertake to inform you
of any changes therein , immediately.In case any of the above information is found to
be false or untrue or misleading or misrepresenting .
I am aware that I may be held liable for it.

Place : Date : SIGNATURE OF APPLICANT

FOR OFFICE USE ONLY IPV Done þ On 31/03/2021

IIFL Securities Limited Staff name KAMLESH SINGAL Staff KAMLESH SINGAL
name
Code : C149861 Designation BRANCH COORDINATOR
Designation BRANCH COORDINATOR
(Original Verified) Self certifed
Documents copies received. Signature
þ
Signature
eSigned document: and Date

þRAJKUMARI AGARWAL
(Attested) True copies of Document recived.
and Date
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PART II - ACCOUNT OPENING FORM
1. DEPOSITORY SERVICE
I/We wish to open Depository Account with CDSL (CDSL:1301440003860187 as per the following details: )
Type of Account : Resident
A. ADDITIONAL INFORMATION TRADING ACCOUNT(Please fill this form in English and in BLOCK LETTERS)

1. TRADING PREFERENCE
STOCK EXCHANGE(S) & SEGMENT ON WHICH YOU WISH TO TRADE:
(Please sign in the relevant boxes where you wish to trade. The Segment not chosen should be struck off by you.)

Name of Segment / Exchange NSE BSE MCX NCDEX

Capital Market Segment N.A N.A
Futures and Options N.A N.A
Currency Derivatives N.A N.A
Debt N.A N.A
MFSS /BSE StAR N.A N.A
Commodity Futures & Options
If in future, you want to trade on any new segment/new exchange, separate authorisation letter should be submitted to
IIFL

2. PROOF OF FINANCIAL DETAILS(MANDATORY IN CASE OF DERIVATIVES/CURRENCY)

3. PAST ACTIONS
Details of any action/proceedings initiated/pending/ taken by SEBI/ Stock exchange/any other authority against the
applicant /constituent or its Partners/promoters/whole time directors/authorized persons in charge of dealing in
securities during the last 3 years:

Particular Name of Authority Month and Year of Action

4. COMTRACK ACCOUNT DETAILS :

CP Name & Address :
CP ID :
CMS (E) ID :
5. COMRIS ACCOUNT DETAILS :
eSigned document:
Comris Name
RAJKUMARI & Address :
AGARWAL
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6. DEALINGS THROUGH SUB-BROKERS/ AP AND OTHER STOCK BROKERS
If client is dealing through the sub-broker/ AP, provide the following details:
Sub Broker's/AP Name and Code
:
Registered office address :

SEBI/AP Registration number : Tel No. :

Website :
Authorised Person’s Code :
Name :
Address :

Whether dealing with any other stock broker/sub-broker/AP (if case dealing with multiple stock brokers/sub-
brokers/AP, provide details of all :
Name of stock broker :
Name of Sub-Broker/AP, if any :
Client Code : Exchange :
Details of disputes/dues pending from/to such stock broker/sub- broker :

7. DEPOSITORY ACCOUNT DETAILS (APPLICABLE IN CASE OF NON - IIFL DEMAT ACCONTS

Depository Participant :
Name and Address :
Depository Name :
DP ID : 1301440003860187 BO Account Number : 03860187
Benefciary Name :
Note : IIFL Demat Account will be default Demat Account for securities pay out.

8. ADDITIONAL DETAILS

Gross Annual Income / Networth Details

a) Income Range per Annum/Networth 500001-1000000
Whether you wish to receive : I wish to receive Electronic Contract Note (ECN)
Specify your Email id, : [email protected]
if applicable : Yes I wish to avail the facility of internet trading/wireless technology
Experience : Number of years of Investment/Trading Experience : 0
Any other information :
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B. COMMON DETAILS FOR BOTH TRADING & DEMAT ACCOUNT
1. BANK ACCOUNT DETAILS (FOR TRADING AND DEMAT ACCOUNT)
Bank Details
PUNJAB NATIONAL BANK Bank A/c No. : 1942000100884207
DHOLPUR, DHOOLKOT
DHOLPUR, RAJASTHAN, Pin Code : 328001 A/c Type : SAVING
IFSC Code : PUNB0194200
MICR Code : 328024003
C. FATCA / CRS DECLARATION / SELF CERTIFICATION FOR INDIVIDUAL
First/Sole Holder Second Holder (if any) Third Holder (if any)

Are you U.S. Person? ¨ Yes þ No ¨ Yes ¨ No ¨ Yes ¨ No

(Refer KYC Handout - Customer Copy)
Specify country of residence for tax þ India ¨ Other ¨ India ¨ Other ¨ India ¨ Other
purpose (Tax Residency)
Specify country of citizenship þ India ¨ Other ¨ India ¨ Other ¨ India ¨ Other

Note: If you are a U.S. person and/or if your tax residency/nationality/citizenship is other than India, then please
provide declaration/selfcertification under FATCA/CRS. This declaration form can be downloaded from
http://content.indiainfoline.com/ IIFLTT/DownloadForm Formats/downloads/Fatca_Declaration_Individual.pdf. or call
at centralized helpdesk at 022-41035000 or write to [email protected].
D. ADDITIONAL INFORMATION FOR DEMAT ACCOUNT (Please fill this form in ENGLISH and in BLOCK LETTERS)

CDSL DP ID: 13014400 Client ID (To be flled by IIFL) : 03860187

DETAILS OF ACCOUNT HOLDER(S)

Sole/First Holder Second Holder Third Holder
Client Name Rajkumari Agarwal Not Applicable Not Applicable
PAN AEMPA4113J Not Applicable Not Applicable
Occupation Private Sector Not Applicable Not Applicable
SIGNATURE Not Applicable Not Applicable

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4. STANDING INSTRUCTIONS (FOR DEMAT ACCOUNT)

a.I/We would like to execute POA in favor of IIFSL for þ Demat A/C ¨ Bank A/C ¨ Bank & Demat A/C
b. As I/We have issued Power of Attorney in favour of IIFL Securities Limited for executing delivery instructions for
settlement of transactions executed through IIFL Securities Limited However, the DIS booklet should be issued to me/us
immediately on my/our request at any later date. The Delivery Instruction Slip (DIS) for the time being,. þRequired ¨Not
Required
c. SMS ALERT FACILITY On registered Mobile Number (Mandatory if you are giving Power Of Attorney (POA). Ensure that
the mobile number is provided in the KYC application form. þYes ¨No
d. I / We would like to instruct the DP to accept all the pledge instructions in my /our account without any other further
instruction from my/our end (If not marked, the default option would be ‘No’)þYes ¨No
e. Account Statement Requirement: ¨As per SEBI Regulations ¨Daily ¨Weekly ¨Fortnightly þMonthly
f.I/We would like to receive Statement of Account / Transaction-cum-Holding Statement / Daily Margin Statement and All
Other Statement at my email ID þYes ¨No
g. Whether you wish to receive: ¨Physical contract note þElectronic Contract Note
h. I/We would like to receive Annual Report in ¨Physical þElectronic ¨Both
i. EASI facility [Facility through CDSL’s website: www.cdslindia.com wherein a BO can view his ISIN balances, transactions
and value of the portfolio online.] þYes ¨No
a. I/We authorise you to receive credits automaticaly into my/our account þYes ¨No
b. Do you wish to receive dividend/interest directly to your bank account given herein through ECS? þYes ¨No
c. Account to be operated through Power of Attorney (PoA) þYes ¨No
j. I / We would like to share the email ID with the RTA þYes ¨No
k. I/We with to receive/Dividend/interest directly in to my bank account as given below through ECS (if not lt marked, the
default option would be "yes") þYes ¨No
(ECS is mandatory for location notified by SEBI from time to time)
l. I/We would like to maintain running account authorisation with IIFL Securities Ltd. þYes ¨No
If Yes, Funds & Securities settlement frequency þQuarterly ¨Monthly
r. I/We would like to receive Client Copy containing following¨Physical þElectronic
• Rights and Obligations of Stock Rights and Obligations of Stock Brokers, Sub-Broker /AP/APs and Clients as prescribed by
SEBI and
Exchanges
• Rights and Obligations of Beneficial Owner and Depository Participant as prescribed by SEBI and Depositories
• Risk disclosure Document for Capital, Currency, Stock and Commodity Derivatives Segment
• Guidance Note-Do’s and Don’ts forTrading on the Exchange (s) for Investors
• Policies and Procedures applicable to clients.

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17. NOMINATION DETAILS

¨I/We wish to make nomination

¨Single Nominee (100% as per details given below) ¨Multiple Nominee (Form available on website)
þI/We do not wish to make a nomination (strike of the nomination details below)
NOMINATION REGN. NO: DATE : DD/MM/YYYY
I/We wish to make a nomination and do here by nominate the following person in whom all rights and/ or amount payable
in respect of securities held in the Depository by me/us in the said beneficiary owner account shall vest in the event of
my/our death.
Name of the Nominee :
Relationship with the applicant (If any)
Address :

City: Pincode: State:

AADHAR: Saving Bank Account
Copy of Proof of Identity Document
Demat Account detail of Nominee
Contact Details:
Tel. (Off) Tel. (Res) Mobile No.
Fax: E-mail ID
PAN of Nominee
Signature of Nominee:

To be flled up only if Nominee is minor:

Date of Birth (in case of Minor Nominee)
Name of Guardian (Mr./ Mrs./ Ms)
Address of Guardian

City PIN Code State

Country Saving Bank Account
Copy of Proof of Identity Document
Demat Account detail of Guardian
Contact Details:
Tel. (Off) Tel. (Res) Mobile No.
Fax E-mail ID
Relation of Guardian with Minor: ____________________Guardian PAN No.

Signature of Guardian:
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PHOTOGRAPH OF NOMINEE PHOTOGRAPH OF GUARDIAN (In case of Minor nominee)

(Please sign (Please sign

accross the accross the
photograph) photograph)

DECLARATION
1. I/We hereby declare that the details furnished above are requests. In case Bank is not been mapped or Tagged to IIFL
true and correct to the best of my/our knowledge and belief Securities Limited (IIFL) as my registered broker, IIFL will not be
and I/we undertake to inform you of any changes therein, responsible for any defaults thereof.
immediately. In case any of the above information is found to 5. I/We hereby consent to receive information from central
be false or untrue or misleading or misrepresenting, I am / we KYC Registry through SMS/Email on the registered number /
are aware that I/we may be held liable for it. email address.
2. I/We confirm having received a copy of the following 6. I/We the undersigned, have taken cognizance of circulars
documents and further confirm having read and understood issued by SEBI / Commodity Exchanges from time to time on
the contents of these documents:- the guidelines for calculation of net open positions permitted
• Rights and Obligations of Stock Brokers, Sub-Brokers and in any commodity and/we hereby undertake to comply with
Clients as prescribed by SEBI and Stock Exchanges the same.
• Rights and Obligations of Beneficial Owner and Depository I/We hereby declare and undertake that I/We will not exceed
Participant as prescribed by SEBI and Depositories the position limits prescribed from time to time by Commodity
• Risk disclosure Document for Capital and Derivatives Exchanges or SEBI and such position limits will be calculated in
Segment accordance with the circulars on position limits as modified
• Guidance Note-Do’s and Don’ts for Trading on the Exchange from time to time. I/We undertake to inform you and keep you
(s) for Investors informed if I / any of our partners / directors / karta / trustee
• Policies and Procedures applicable to clients. or any of the partnership firms/companies / HUFs / Trusts in
I/We confirm having read/been explained and understood the which I or any of above such person is a partner / director /
contents of the document on policy and procedures of the karta / trustee, takes or holds any position in any commodity
stock broker, tariff sheet, voluntary & non voluntary forward contract / commodity derivative on Exchanges
documents. I/We do hereby agree to be bound by such through or through any other member(s) or Exchanges, to
provisions as outlined in these documents. I/We have also enable you to restrict our position limit as prescribed by the
been informed that the standard set of documents has been above referred circular of Exchanges as modified from time to
displayed for Information on stock broker’s designated time.
website, if any. I/We further understand that any change in the I/We confirm that you have agreed to enter order in
said documents including the “Policies and Procedures” shall commodity forward contracts / commodity derivatives for me
be made available on the website of IIFL and also intimated to / us as your clients on Commodity Exchanges only on the basis
me through circulars in internet trading platform/e-mails. I/We of our above assurances and undertaking. I/We further
shall keep myself updated of the same. undertake to bear any liable/penalty/charges levied by
3. I/We have read and understood the rules and regulations of Commodity Exchanges / SEBI.
the Depository and Depository Participants and I/We agree to 7. GST details furnished are true and genuine along with proof
abide and bind by the rules which are in force in force from of GST no. If no GST details furnished then, it shall be deemed
time to time pertaining to my/our account. Further in respect that you are unregistered under GST. In case there is any
of Government Securities (G-Sec), I/We will submit only those change in correspondence address, we will charge GST based
inter depository transfer instructions which are bonafide and on the address available on record, unless intimated to us. We
arising out of genuine trade or transfer transaction. would not be responsible for any non-receipt/short-receipt of
4. In case non-resident account, I/We also declare that I/We GST credit due to incorrect/inaccurate/ incomplete
have complied and will continue to comply with FEMA information provided and any loss, damage, cost and/or
regulation. I have informed the Bank that I will be trading expenses suffered/incurred by us due to non-reversal of GST
through IIFL Securities Limited (IIFL) and to honor all relevant credit, act, omission, false statement suppression of fact
eSigned document: and/or any breach would be borne by you.
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Name(s) of Account Holder(s) Signature of Holder
Sole/First Holder(in case of
Sole holder is Minor)(Mr./Ms.)

Second Holder (Mr./Ms.)

Third Holder (Mr./Ms.)

Guardian(in case sole holder is minor

) (Mr./Ms./Mrs.)

Signature of Witness for Nomination

Name of the Witness Address Signature of Witness

18. INTRODUCER’S DETAILS

Status Of Introducer ¨Sub-Broker ¨ Authorised Person ¨ Remisier ¨Existing Account Holder ¨ Bank Official ¨
IIFL Employee ¨ Any Other Person

Introducer’s Name:
Address

City Country
State PIN Code Tel.
Occupation PAN
DP ID Client ID Login ID
Designation PAN
Bank & Branch Name
Employee Code: Email Id

Signature of the Introducer

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TARIFF SHEET
SCHEDULE OF TRADING ACCOUNT CHARGES AND BROKERAGE
Plan name þ KARVIIFL
Account Opening Charges (one time) ₹ 0
First Year Annual Maintenance ₹ 0
Annual Maintenance (from 2nd year) ₹ 295 incl GST
Minimum Margin ₹ 0
Monthly subscription ₹0
Demat Charges
Credit transaction charges ₹0
Debit transaction charges ₹ 20
Margin Pledge initiation and Pledge release from Client to Stock Broker (Nil for Mutu ₹ 25
al Funds)
Margin Re-pledge initiation and Re- ₹1
pledge release from Stock Broker to Clearing Member (CM) (₹ 0 for Mutual Funds)

Margin Re-pledge initiation and Re-pledge release from CM to Clearing ₹ 1

Corporation (CC) (₹ 0 for Mutual Funds)

Margin Pledge Invocation charges by Stock Broker / CM /CC ₹ 25

Pledge creation (other than margin pledge) ₹ 59
Pledge Closure (other than margin pledge) ₹ 0
Demat/Remat Charges per certificate ₹ 18
Payment Gateway Charges ₹ 9
Conversion of MF units/De-statementization Per SOA ₹ 0

Reconversion of MF units in to SOA or Redemption/Re-statementization Per SOA ₹ 0

Re-issuance of (Additional) New DIS ₹ 118
Brokerage Charges
Equity Delivery ₹ 0.25%
Equity Intraday/ Futures ₹ 0.025%
Nifty Options (per Lot) ₹ 20 per Lot
Stock/Bank Nifty Options (per Lot) ₹ 20 per Lot
Commodity, currency trading ₹ 0.02%
Currency Options (per Lot) ₹ 10
Currency Futures (per Lot) ₹ 25
Commodity Options (per Lot)
Gold ₹ 20
Silver ₹ 20
Crude Oil ₹ 20
Copper
eSigned document: ₹ 20
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Zinc ₹ 20
Gold Mini ₹ 20
Other Charges
Delayed payment charge (p.a.) 18.00%
System & Risk square off ₹0
Call & Trade ₹0
Postal Charges for physical dispatch ₹ 40
Courier/ physical printing (when requested) ₹ 100
Auction Charges
Access to services
Research Report Yes
Intraday calls Yes
Market Guru seminars Yes
Trader Terminal EXE Yes
Dedicated RM Yes
Analyst/ Investment advisor meetings No

Notes

1. Customer is required to maintain a minimum balance of Rs.1000/- in his/ her ledger account.
2. Document handling charge of Rs. 50 /- shall be applicable:
- Customer who has opted for receiving documents by electronic mode: In case such customer also intends to receive
documents (contract notes and other related documents) by physical mode.
- Customer who has opted for receiving documents by physical mode: In case such customer intends to receive
additional/duplicate copies of documents (contract notes and other related documents) by physical mode. This charge
may be partly /fully waived off for high net worth /large customer at the discretion of IIFL.
3. lnter/settlement/ Beneficiary to pool transfer would be charged 0.04% (Minimum Rs.25 per scrip)
4. Charges quoted above are for the services listed. Any service not quoted above will be charged separately
5. No refund of account opening charges would be given if the account could not be opened due to non- submission of
complete documents by the client or due to lack of desired co-operation from the client.
6. Charges/service standards are subject to revision at sole discretion of IIFL Securities Limited and as informed by
communication sent by ordinary post/ E-mail.
7. Management reserves the right to freeze, discontinue or suspend any account if required
8. The above charges are exclusive of GST, statutory and other levies like Securities Transaction Tax, stamp duty and
other charges if any, being charges related to the execution and/or settlement of transactions shall be separately
chargeable as in force from time to time. The same shall be charged to the Client's account on actual basis

I/ We have understood and accepted the Schedule of Charges as stated here in above.
Sole/ First Holder Second Holder Third Holder

SIGNATURE

Branch Offcial Name: Branch Offcial Signature :

DateeSigned
: document: Place :
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AUTHORIZATION LETTER
To,
IIFL Securities Limited Date:
IIFLHouse, Sun Infotech Park, Road No. 16V, Plot No.B-23, _________________
Thane Industrial Area, Wagle Estate, Thane - 400 604
Sir,
A. Availing Mutual Fund Service System (MFSS) facility/ BSE funds shall be transferred from my Broking account to my
StAR MUTUAL FUND (hereinafter jointly referred to mutual fund transaction account as per this authority letter.
“Mutual Fund Transaction Facilities”) (Applicable in case I/We further agree and understand that such funds will be
opted) used by the Participant for applying for mutual fund units after
I/We am/are interested in availing the trading facility of the deducting the applicable brokerage, fees, charges and other
Exchanges for the purpose of transacting in the units of statutory levies. I/We agree and undertake to make good such
Mutual Funds Schemes permitted to be dealt with on shortfall immediately as may be informed by IIFL Securities
theMFSSand BSE StARMUTUALFUNDofNSEand BSE Limited from time to time.
respectively. In case of a redemption request, I/We agree and authorise IIFL
I/We therefore request you to register me/us as your client Securities Limited to debit my mutual fund transaction account
for participating in the Mutual fund transaction facilities to the extent of applicable brokerage, fees, charges and other
(MFSS and BSE StAR MUTUALFUND). statutory levies and further authorize to utilize the surplus
I/We are willing to abide by the terms and conditions as funds in my/our Broking account held with IIFL Securities
mentioned in theNSECircular dated 24/11/09, BSE Circular Limited in its capacity as a Stock Broker and transfer funds to
dated 02/12/2009 and further circulars as may be specified the extent of applicable brokerage, fees,
by the Exchanges from time to time in this regard. charges and other statutory levies (in case of both subscription
I/We shall also ensure compliance with the requirements as and redemption) and/or any other obligation to meet the debit
may be specified from time to time by Securities and in my/our Mutual fund transaction account.
Exchange Board of India and Association of Mutual Funds of
India (AMFI). For the said purpose of availing these facilities, B. Authorization for Systematic Investment in Mutual Fund /
I/We state that Know Your Client details Securities (Applicable in case opted)
as submitted by me/us for the stock broking may be I/We hereby authorize IIFL to execute an order in my/our
considered for the purpose and I/We further confirm that account held with IIFL for purchase of the securities and/or
the details contained in same remain unchanged as on date. mutual fund units under systematic investment plan on my/
I/We shall read and understand the contents of the Scheme our behalf as per my/our instructions.
Information Document and Key Information Memorandum, I/We further agree and understand that all the terms and
addenda issued regarding each Mutual Fund Schemes with conditions of the trading agreement/terms and condition
respect to which I/We choose to subscribe/redeem. I/We entered into/agreed with IIFL shall be also applicable to the
further agree to abide by the terms and conditions, rules and instructions for systematic investment in mutual fund units /
regulations of the Mutual Fund Schemes. securities and I/We hereby agree to abide by the same at all
With reference to my application for registering as a client times.
for Mutual Fund Transaction facilities offered by NSE and I/We understand that the instructions for systematic
BSE, I/We hereby undertake to provide funds to the investment can be given by me in writing or through the online
Participant equivalent to the subscription amount and facility provided by IIFL or over recorded telephone line. I/We
applicable brokerage/ fees/ charges before applying for hereby agree and understand that the said instructions shall be
mutual fund units through the Participant. valid and binding upon me/us until
For this purpose, I/We hereby authorize IIFL Securities modified and/or cancelled by me/us by giving valid instruction
Limited to utilize the surplus funds in my/our Broking to IIFL either in writing or through the online facility provided
account held with IIFL Securities Limited in its capacity as a by IIFL.
Stock Broker and transfer funds to the extent of subscription I/We hereby undertake to give an ECS mandate/ standing
amount and/or applicable brokerage, instruction in favor of IIFL towards my/our trade obligations
fees, charges and other statutory levies (in case of both arising out of this authorization or I/we hereby authorize IIFL to
subscription and redemption) and/or any other obligation to execute order under SIP on the basis of clear fund available in
meet the debit in my/ our Mutual fund transaction account. my ledger account and as per risk management policy.
My/our exposure limits in my trading account shall be I/We hereby authorize IIFL to debit my/our trading account
eSigned document:
reduced to the extent of the amount utilized for transacting held with IIFL towards my/our trade obligations and all the
in the mutualAGARWAL
RAJKUMARI fund units as per my instruction. fees, charges, taxes, brokerage etc due and payable by me/us.
In31.03.2021 11:09:50
case of subscription request, I/We hereby understand and I/We understand that this authorization can be revoked by
agree that based on my instruction, the amount will be me/us at any time by giving a written notice atleast 30 days in
debited in my Mutual fund transaction account and surplus advance to IIFL.

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User Id.: AGARW821
I/We understand that such revocation shall be effective from within the period of settlement of my account (Securities and
the date of receipt of confirmation of the same from IIFL. Funds) as opted by me.
I/We agree and undertake to fulfill all my/our obligations as g) The Securities lying in client beneficiary account on my/our
per the instructions for systematic investment arising in my/ behalf and/or credit balances lying in my/our ledger account of
our account before the effective any segments of any Exchanges can be considered as margin for
date of such revocation. the any segments of any Exchanges.
I/We agree to abide by the Terms and Conditions applicable h) I/We understand that this authorization shall remain valid
for Systematic Investment in Mutual Fund and/or Securities until revoked by me/us. I/we undertake to clear all my dues
and any amendments thereto at all times. arising during the validity of this authorization else the member
I/We undertake to indemnify and keep indemnified IIFL and shall recover all my/our dues in my/our ledger till date. I also
its directors / officers for all trades executed on my / our undertake to clear all my dues to you before serving revocation
behalf as per the instructions given by me/us. of this authorisation else the member will recover all my dues
in my ledger till date and then effect the revocation.
C. RUNNINGACCOUNTAUTHORISATION (Applicable in case I) I /We further wish to have settlement of my account (funds
opted) and securities) on quarterly / monthly basis as opted by me/us
Authorisation to IIFL Securities Limited here in before.
As per clause 2 of the circular, the provisions with regard to I /We understand that settlement amount shall be subject to
running account settlement of clients’ funds and securities retention of requisite securities/ funds towards outstanding
specified in SEBI Circulars MIRSD/ SE /Cir-19/2009 dated obligations and margins in my account calculated in the manner
December 03, 2009 and SEBI/HO/MIRSD/MIRSD2/CIR/P specified by SEBI/ Exchange and details mentioned in the
/2016/95 dated September 26, 2016 shall stand modified and “Statement of Account” at the time of settlement. I /We
the said circulars shall be applicable only as guidelines for authorise you to send the statement of account on funds and
running account settlement of clients’ “funds” only. securities as on the date of settlement to my internet trading
However, it will be ensured that excess securities, so held in account or e-mail id registered with you. I /We understand that
“Client Collateral/Collateral” account are released to clients I /We can obtain a copy of the same from any of your Branch
along with their funds’ settlement (i.e. once in every 30/90 offices.
days) after making necessary retention. I /We understand and authorize that you will not release the
a) I would like to keep securities purchased by me with you as payout in case the balance after necessary retention is upto
collateral for giving me exposure limits in my trading Rs.10000/- or any other sum as specified by Exchanges from
account/margin obligation. I authorize you not to transfer time to time in any of the quarters, till my revocation in writing
shares/securities purchased by me to my demat beneficiary as I /We will be doing regularly trading with you.
account and keep them with yourselves. I also authorise you I also undertake to bring any dispute arising from Statement of
to pledge these shares/ securities with the Clearing Member/ accounts or settlement so made to your notice within seven
Exchange/Custodian, at your discretion. In case any of the working days from the date of receipt of funds/securities or
shares/securities are sold in subsequent settlements, you Statement as the case may be. So kindly maintain my account
may take this as a standing instruction to as a running account basis for funds and securities.
adjust against my previous purchase positions in any of
Exchanges. D. AUTHORISATION FOR RECEIPT OF CONTRACT NOTES AND
b) Whenever I require delivery of any shares/securities, I shall OTHER DOCUMENTS IN DIGITAL MODE (Applicable in case
send you a written request. I understand that such payout of opted)
securities will be made subject to your risk management I/We hereby consent to receive from IIFL Securities Limited the
policies. digital contract notes, bills, ledgers, transaction statements,
c) In case there is a debit balance in my account, you are demat statement of accounts/ holding statement(s)/bills/other
authorized to sell at any point of time the shares/ securities statements, notices, circulars, amendments and such other
held by me/ held on my behalf, at your sole discretion. Any correspondence documents, records by whatever name called
profit or loss made on such transactions will be to my in electronic form duly authenticated by means of a digital
account as it would have occurred on normal purchase/sale signature as specified in the Information Technology Act 2000
made by me. I also agree to pay the balance amount, if any and the rules made thereunder to my registered email id. I/We
after deducting credit of sale of shares. further hereby agree that the IIFL
d) I also request you not to issue cheques /make payments Securities Limited shall fulfill the legal obligation, if the above
settlement wise unless specifically demanded by me, as payin documents are sent electronically to the said e-mail id and I/We
and payout are very close and therefore exchange of cheque am/are aware that I/we will not receive the statements /
becomes unnecessary paper work.
eSigned document: documents in paper form. In this regard, I/we further confirm
e) RAJKUMARI
I/We understand and agree that no interest will be payable and agree that:
AGARWAL
to31.03.2021
me/us on11:09:50
the amounts or securities so retained with you. (i) The above is my/ our personal E-mail id. I/We shall take all
f) I further authorise you to set off/ adjust any of my necessary steps to ensure confidentiality and the secrecy
debits/dues in any segment of any Exchange with credits of of the login and password of the abovementioned e-mail
any other segment(s) of any Exchange(s) in my account account. IIFL shall not be liable to or responsible for any
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 User Id.: AGARW821
breach of secrecy. I/We am/are aware that the statements/ • Though the Member is required to deliver physical contract
documents may be accessed by other entities in case the note, I/We find that it is inconvenient for me/us to receive
confidentiality/secrecy of the login name and physical contract notes. Therefore, I/We am/are voluntarily
password is compromised. I/We will be solely responsible for requesting for delivery of electronic contract note pertaining to
the security of the information provided on my/ our all the trades carried out / ordered by me/us.
aforesaid e-mail id. • I/We have access to a computer and am/are a regular internet
(ii) E-mails sent to any of the above mentioned e-mail user, having sufficient knowledge of handling the email
account, which have not bounced back, shall be deemed to operations.
be duly delivered to the me/us. • My email id is [email protected] This has
(iii) IIFL shall not take cognizance of out-of -office/ out been created by me/us and not by someone else.
ofstation auto replies and I/We shall be deemed to have • I/We am/are aware that this declaration form should be in
received such electronic mails. English or in any other Indian language known to me/us.
(iv) Such Statements shall be deemed to have been delivered • I am aware that non-receipt of bounced mail notification by
on the day when the e-mail is sent by IIFL. member shall amount to delivery of the contact note at the
(v) I/We further agree that IIFLmay at its sole discretion also above email id.
provide / discontinue such statements in physical form. [The above declaration has been read and understood by
(vi) IIFL shall not be liable or responsible for any statement me/us. I/We am/are aware of the risk involved in dispensing
received from frauds or impostors or any consequences with the physical contract note, and do hereby take full
thereof. responsibility for the same]
(vii) IIFL shall not be liable for any problem, which arises at
my/our computer network because of my/our receiving any E. AUTHORISATION FOR ONLINE TRADING SOFTWARE
Statement from IIFL. PASSWORD(Applicable in case opted)
(viii) I/We shall inform IIFL by way of a letter in writing duly I wish to use onlineTrading Software in this regards Following:-
signed by me or inform through internet platform if there is I. Please send my system-generated, internet account first time
any change in the Email given above. as well as subsequent, password on the registered mobile
(ix) I/We undertake to check the Statement and bring the numbers. Also, if I ever need to reset the Password later, the
discrepancies to your notice within the time period as same should also be sent by SMS on the above given mobile
specified under the relevant agreements entered into with number.As soon as I receive the systemgenerated Password, I
IIFL. My/Our non-verification or not accessing the Statement shall login and change it for security reasons. I am aware that
on regular basis shall not be a reason for disputing the same system-generated
at any time. Password will automatically expire in 72 hours from the time of
(x) I/We shall inform in writing in prescribed format to IIFL to sending.
discontinue the said facilities. I/We and IIFL shall have the II. In the event that I do not receive the Password on SMS within
right to terminate such service provided a written notice is 24 hours of opening of account or request for reset of
given atleast 10 days in advance to the other party. Password, I shall contact the Customer Service Department of
I/We shall immediately inform IIFL about change in email the IIFL immediately and request for re-setting of my Password.
address, if any. I/We further agree that IIFL will not be III. I have been explained that I shall set my new Password as
responsible for nonreceipt of documents sent via electronic may be easy to remember for me, but should not be easy to
delivery due to change in/incorrect email decipher for anybody else and should be preferably alpha-
address/correspondence address as mentioned or any other numeric and not my or any family member's name/ surname.
reason which inter alia include technical reasons or IV. I am fully aware of the risk of electronic loss/ theft and agree
malfunction of my/our computer system/server/internet to be solely liable and responsible for the same as well as for
connection etc. Further I/We agree and undertake to any unauthorized use/ misuse of the Password. I understand
indemnify IIFL and its group companies, that they will not be IIFLwill not be responsible or liable in any manner whatsoever
held liable/ responsible for any losses, claims for the same.
damages, cost and liabilities etc. caused to me/us due to
misuse of this information or pursuant to any litigation cases, F. Availing IIFL Distribution Services (Applicable in case opted)
complaints, actions, etc that may arise in future on account I/We understand that:
of my/ our above authorization request. (a) IIFL Securities Limited (herein after referred as IIFL), its
• I/We am/are aware that the Member has to provide associates and subsidiaries of IIFL Holdings Ltd. are engaged in
physical contract note in respect of all the trades placed by providing various financial services including distribution and
me/us unless
eSigned I/We myself/ourselves want the same in the
document: execution services of various financial products.
electronic form.
RAJKUMARI AGARWAL Accordingly, for providing said services IIFL and its associates
• I/We am/are
31.03.2021 aware that the Member has to provide
11:09:50 may earn fees (including arranger fees) or commission from
electronic contract note for my/our convenience on my/our issuers of mutual funds, alternative investment funds, venture
request only. capital funds, debt instruments etc.

13
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 User Id.: AGARW821
(b) Apart from above, investment may be made in securities informed of any change in my mobile number immediately
of associates, investment transaction may be done with IIFL, for updating the same in databases. I am aware that without
its associates and group companies of IIFL as counterparties intimation for change in mobile number, IIFL would not be able
and IIFL, including its subsidiaries and associates may receive to send my Password over new mobile number and also would
various form of remuneration linked to distribution services not be able to update in records and databases.
offered to the Client. iii. I am aware that in case of change in my mobile number
I/We hereby agree to avail services like distribution of anytime after opening of this account, it is mandatory for me to
securities / financial products including but not limited to submit the photocopy of a latest/last two months Mobile bill
following offered by IIFL Distribution Services. for postpaid connection. If I have prepaid connection then I
• Initial PublicOffer/Followon PublicOffer /Offer for sale have to visit personally to the Branch/FANs alongwith my ID
• Mutual Funds proofs (E.g.: Pan Card or Driving License) and get the
• Bonds,Debentures documents verified by the branch officials.
• NPS iv. I will be solely responsible for the security of the information
• Other financial products provided on my aforesaid mobile number. Further,
1. I/We hereby give my/our consent to execute new Power v. I agree and undertake to indemnify IIFLand its group
ofAttorney in favour of IIFLand enable IIFL to my investments companies, that they will not be held liable/responsible for any
& redemptions losses, claims, damages, cost and liabilities etc. caused to me
relating to IIFL Distribution Services being availed by me. due to misuse of this information or pursuant to any litigations,
2. I/ We hereby authorize IIFL and its associates to disclose, non-litigation cases, complaints, actions, etc. that may arise in
share, remit in any form, mode or manner, all / any of the future on account of my above authorization request.
information provided by me/ us, including all changes, vi. I/We confirm having received a hard copy of the following
updates to such information as and when provided by me/ us documents and further confirm having read and understood the
to associates of IIFL Group, issuers, brokers, Mutual Funds, contents of these documents.
AIFs, banks and other relevant parties ('the Authorized • SMSAlerts Facility by depository : I/We consent to CDSL /
Parties') or any Indian or foreign governmental or statutory NSDL providing to the service provider such information
or judicial authorities / agencies including but not limited to pertaining to account/ transactions in my/ our account as is
the Financial Intelligence Unit-India (FIU-IND), the tax / necessary for the purposes of generating SMSAlerts by service
revenue authorities in India or outside India wherever it is provider, to be sent to the said mobile number. I/We have read
legally required and other agencies without any obligation of and understood the terms and conditions mentioned above and
advising me/ us of the same. agree to abide by them and any amendments thereto made by
3. I/We hereby declare that there is no action pending the depository from time to time. I/We further undertake to
against me/us by any regulatory authority for violation of any pay fee/ charges as may be levied by the depository from time
law. There are no unpaid fines/penalties levied on me/us. to time. I/ We further understand that the SMS alerts would be
I/We have not violated any law applicable to us or sent for a maximum four ISINs at a time. If more than four
circular/regulations issued under any law as on date. I/We debits take place, the BOs would be required to take up the
have no legal or regulatory proceedings pending against matter with theirDP.
me/us for any financial crimes or violation of Securities • Terms &Conditions ForDistribution of Securities.
laws initiated be SEBI/RBI/Banks or any other financial • Terms and Conditions for availing Mutual Fund Service System
institution. (MFSS) facility and BSE StAR MUTUALFUND offered by NSE and
Pursuant to my/our instructions, I/We hereby authorize IIFL, BSE respectively.
to invest the balance lying in the my/our ledger account, • Terms andCondition for availing systematic investment in
demat account and/or bank account, in the units of mutual Mutual fund/Securities
fund and/or in such other financial products of as specified vii. I/We declare and confirm that the authorisation will not be
above and redeem in part or full as and when to meet my applicable for the product / services not opted by me/us
account obligations with IIFL. viii. “I/We hereby authorise the representatives/employees of
IIFL or its group companies to give call on my/our registered
DECLARATION mobile number and send any messages & emails on my
i. I amaware that the mobile number shall be updated in all registered mobile number & Email ID as mentioned in the
your records and databases including trading and demat account opening form to share any information/alert
account. /message including but not limited to research data, trading
ii. I declare that the registered ismy personalmobile number calls, marketing and promotional messages/calls with reference
and is always
eSigned inmy safe custody. I shall keep IIFL
document: to any products, promotions etc."
RAJKUMARI AGARWAL
31.03.2021 11:09:50 Sole/First Holder (Mr./Ms.) Second Holder (Mr./Ms.) Third Holder (Mr./Ms.)
SIGNATURE

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User Id.: AGARW821
CHECKLIST FOR THE DOCUMENT TO BE COLLECTED FROM CLIENT
Below are the documents which needs to be collected based on the selection done by client during online data entry

Sr No. Client details selection Type of documents to be collected

1 PAN CARD Copy of Pancard

2 ID Proof Copy of PAN CARD

3 Correspondence Address OTHERS

4 Permanent Address

5 Bank Details Original Cancel Cheque + Bank Passbook or Bank Statement

6 Income Proof

7 Payment Details A/c Opening Fee:- 0.00 / Margin Amount:- 0.00 / Total Amount:- 0.00

8 Mode of Payment Cheque

* All Documents /Copies should be self certified by client

* If Correspondance and Permanent Address is same then only one copy of address proof to be collected

SUBMISSION CHECKLIST
1. Complete Documentation Received No
Yes If no, give Details __________________
2. “Verified with Original” Stamp affixed on proofs Yes No

3. Is Client KYC Verified First Holder :- No Second Holder :- Third Holder :-

Tieup Bank Details
Introducer Details (E1) Serviced By (E2)

Employee Name IIFLKARVY IIFLKARVY Bank:

Employee Code D2329 D2329 Branch:

Designation Financial Advisory Network Member Financial Advisory Network Member Customer Id:

Date EmpCode:

Signature EmpName:

3. “PAN verified” stamp with Employee Name & signature affixed on Proof Yes No

4. Risk Categarization Low

5. Margin Money Collected Yes No

Amount in Rs. 0.00 Rs. (In words :)

Chq. /CMS No._________________ Chq./CMS. Date _____________ Bank Name ______________________________________

Form Version : Version:2.00/January/2015

eSigned document:
RAJKUMARI AGARWAL
31.03.2021 11:09:50

15
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eSigned document:
RAJKUMARI AGARWAL
31.03.2021 11:09:50