Name & Address: To, DP & KYC Department Arch Finance ... · 1- Marriage Certificate. 2- Passport....
Transcript of Name & Address: To, DP & KYC Department Arch Finance ... · 1- Marriage Certificate. 2- Passport....
Name & Address: ______________________________
______________________________
______________________________
Date: _________________________
To,
Old Name New Name
Reason
Thanking You,
First / Sole Holder Second Holder Third Holder
Signature
Dear Sir,
I/We hereby request you to kindly name change in my Demat & Trading Account
Sub: Name Change in DP & Trading
DP & KYC DepartmentArch Finance Limited81, Darya Ganj, 1st Floor,New Delhi-110002Ph: 8595233233 | Fax: 011-43710055Email : [email protected] Web: www.archfin.com
This is inform you that I/We have operating demat & Trading account vide DP ID : IN303403 /& 12050500 Client ID _____________with Depository Participant Arch finance Limited and Trading account vide Client Code ________with Arch Finance Limited
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Please fill in ENGLISH and in BLOCK LETTERSApplication No. :
A. Identity Details (please see guidelines overleaf)
1. Name of Applicant (As appearing in support identification document).
Name
Father’s/Spouse Name
Mother’s Name
2. Gender Male Female B. Marital Status Single Married C. Date of Birth d d m m y y y y
3. Nationality Indian Other (Please specify)
4. Status Please tick () Resident Individual Non Resident Foreign National (Passport Copy Mandatory for NRIs & Foreign Nationals)
PHOTOGRAPH
Please affixthe recent passportsize photograph and
sign across it
5. PAN Please enclose a duly attested copy of your PAN Card
Aadhaar Number
6. Proof of Identity submitted for PAN exempt cases Please Tick ()
UID (Aadhaar) Passport Voter ID Driving Licence Others (Please see guideline ‘D’ overleaf
B. Address Details (please see guidelines overleaf)
1. Address for Correspondence
City/Town/Village
State
Pin Code
Country
City/Town/Village
State
Pin Code
Country
2. Contact Details
Tel. (Off.)
Mobile
E-Mail Id.
(ISD)
(ISD)
(STD)
(STD)
(ISD)
(ISD)
(STD)
(STD)
Tel. (Res.)
Fax
4. Permanent Address of Resident Applicant if different from above B1 OR Overseas Address (Mandatory) for Non-Resident / Foreign Nationals Applicant
3. Proof of address to be provided by Applicant. Please submit ANY ONE of the following valid documents & tick () against the document attached.
Passport Ration Card Registered Lease/Sale Agreement of Residence Driving License Voter Identity Card *Latest Bank A/c Statement/Passbook
*Latest Telephone Bill (only Land Line) *Latest Electricity Bill *Latest Gas Bill Others (Please Specify)
*Not more than 3 Months old. Validity/Expiry date of proof of address submitted d d m m y y y y
DECLARATION SIGNATURE OF APPLICANTI hereby declare that the details furnished above are true and correct to the best of my/our 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/we are aware that I/we may be held liable for it.
Place Date
Application Form (For Individuals Only)Know Your Client (KYC)ARCH FINANCE LTD.Regd. Office: 81, Darya Ganj, 1st Floor, New Delhi-110002Ph.: 8595233233 | Fax: 011-43710055E-mail : [email protected] | Website : www.archfin.com
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DECLARATION1. Ownership Declaration - Contact Detail (s)
A. E-mail-I hereby declare that the E-mail ID given by me belongs to Me or my family in case of family, the owner of E-mail ID is my Spouse Dependent children Dependent Parent
B. Mobile- I hereby declare that the Mobile given by me belongs to Me or my family in case of family the owner of Mobile is my Spouse Dependent children Dependent Parent2. Declaration for Electronic Communication Yes No
I wish to receive all future communication to me including but not limited to Contract note, Bills and Statement of Accounts to be sent to the above mentioned ID
Original Verified, Self Attested Documents & Certified copies received
ATTESTATION / FOR OFFICE USE ONLY
In person Verification (IPV) Details / KYC Verification Carried out by :Name of the person who has done the IPV:
Designation: Employee ID:
Name of the Organization: ARCH FINANCE LTD.
Date of IPV:Signature of the person who has done the IPV
Seal/Stamp of the Intermediary
Signature of the Authorised Signatory
Name of Sub-Broker/Authorised Person
Emp. Branch _______________________
Date D D M M Y Y Y Y
TM