CLIENT REQUEST FORM

Request Number 1 2 3 4 5 6 7 8 9 10
UCC Reactivation Account Modification

To,
Date D D M M Y Y Y Y
JKB Financial Services Centre
___________________________ DP ID – IN302349 Client ID
Dear Sir, Trading Code PAN
Please reactivate/ change / add in my (our) client account as per details given below. (Please tick appropriate option to make necessary changes)
CHANGES TO BE EFFECTED IN Trading & Depository Account Trading Account Depository Account
Name of 1st Holder First Name Middle Name Surname
nd
Name of 2 Holder First Name Middle Name Surname
rd
Name of 3 Holder First Name Middle Name Surname

1. I/We wish to update Annual Income/Networth I/We confirm that the Income/Networth is not older than 1 year

Annual Income <1 Lac 1-5 Lac 5-10 Lac 10-25 Lac >25 Lac Networth___________________________________________ as on D D M M Y Y Y Y

2. CHANGE IN PERMANENT/CORRESPONDENCE ADDRESS (I/We request to make this change in CKYC/KRA also) Yes No
Permanent Address (Proof Required) Correspondence Address (Proof Required)

Address________________________________________________________________________ Address________________________________________________________________________
Landmark ______________________________________________________________________ Landmark ______________________________________________________________________
City _________________________________ State _________________________________ City _________________________________ State _________________________________
Tel. No_____________________________________________ PIN Tel. No_____________________________________________ PIN

3. I/We wish to update Contact Details 1St Holder 2nd Holder 3rd Holder

I hereby declare that the Mobile No belongs I hereby declare that the Mobile No belongs I hereby declare that the Mobile No belongs
New
to Self Spouse Children Parents to Self Spouse Children Parents to Self Spouse Children Parents
Mobile
+ 9 1 + 9 1 + 9 1

I hereby declare that the Email Id belongs to I hereby declare that the Email Id belongs to I hereby declare that the Email Id belongs to
New Self Spouse Children Parents Self Spouse Children Parents Self Spouse Children Parents
E Mail I wish to receive CAS over Email Y N I wish to receive CAS over Email Y N I wish to receive CAS over Email Y N
Email ID Email ID Email ID

4. I/We wish to avail the following facility Internet Based Trading Yes No MTF Yes No F&O Yes No

5. I/We wish to operate my/our account through BMLI & DDPI Yes No
Email ID Email ID Email ID
6. BANK DETAILS (Proof Required) Update the given Bank A/C as Default/Future Transactions
I/We wish to avail the following facility Internet Based Trading Y N MTF Y N F&O Y N
Old Details New Details
Bank Name__________________________ Type of A/C ______________ Bank Name__________________________ Type of A/C ______________
Account No ___________________________________________________ Account No ___________________________________________________
MICR Code_____________________ IFSC __________________________ MICR Code_____________________ IFSC __________________________
Branch Address _______________________________________________ Branch Address _______________________________________________

7. I/We wish to transfer my/our account: DEMAT TRADING From Branch _________________________ to __________________________

8. I/We wish to change signature(s) 1St Holder 2nd Holder 3rd Holder
1 Holder
St
OLD
SIGN

NEW
SIGN
DECLARATION: I/We confirm to have read & understood, acknowledged & agreed to MTF (Margin Trading Facility) Rights & Obligations as placed on JKBFSL website. I/We
confirm to have read Rights & Obligations of stock broker, sub broker & clients w.r.t IBT (Internet Based Trading), F&O (Futures & Options) from JKBFSL website. I/We hereby
declare that the details furnished above are true & correct to the best of my/our knowledge and belief. In case any of the above mentioned detail(s) is found to false, untrue,
misleading or misrepresenting I/We am/are aware that I/We may be held liable for it.

[Signature of First Holder] [Signature of Second Holder] [Signature of Third Holder]

NOTE: i) Form to be filled in BLOCK Letters & use Blue/Black Ball Point Pen only. ii) Please furnish proper supporting proofs for change in client master. iii) If
changes are to be done in DP Account, then all holders as per DP Account must sign the document(s).

FOR OFFICE USE ONLY:

Branch Stamp/HO Stamp

JKB Financial Services Limited

Main Road, Jawahar Nagar, Srinagar, J&K – 190008
CIN: U65990JK2008SGC002931 DP Regd No.: IN-DP-310-2017 SEBI Single Regd. No.: INZ00243934 DP-ID: IN302349
E: [email protected] W: www.jkbfsl.com T: +91 (0) 194 231 1512