( Professional Self Employed Retired Housewife Student)

A- Passport Number

B- Voter ID Card

C- PAN Card

D- Driving Licence

E- UID (Aadhaar)

F- NREGA Job Card

Z- Others (any document notified by the central government)

New Update

Name* (Same as ID proof)

Maiden Name (If any*)

Father / Spouse Name*

Mother Name*

Date of Birth*

Gender*

Marital Status*

Citizenship*

CENTRAL KYC REGISTRY | Know Your Customer (KYC) Application Form | Individual

1. PERSONAL DETAILS

2. TICK IF APPLICABLE

3. PROOF OF IDENTITY (PoI)*

4. PROOF OF ADDRESS (PoA)*

ADDITIONAL DETAILS REQUIRED*ISO 3166 Country Code of Jurisdiction of Residence*

Tax Identification Number or equivalent (If issued by jurisdiction)*

Place / City of Birth*

RESIDENCE FOR TAX PURPOSES IN JURISDICTION(S) OUTSIDE INDIA

(To be filled by financial institution)

(Please refer instruction B at the end)

(Please refer instruction A at the end)

(Please refer instruction C at the end)

(Mandatory for KYC update request)

(Certified copy of any one of the following Proof of Identity[PoI] needs to be submitted)

(Please see instruction D at the end)

(Mandatory only if section 2 is ticked)

4.1 CURRENT / PERMANENT / OVERSEAS ADDRESS DETAILS

Important Instructions:

For office use only

A) Fields marked with ‘*’ are mandatory fields.

B) Please fill the form in English and in BLOCK letters.C) Please fill the date in DD-MM-YYYY format.D) Please read section wise detailed guidelines / instructions at the end.

E) List of State / U.T code as per Indian Motor Vehicle Act, 1988 is available at the end.F) List of two character ISO 3166 country codes is available at the end.G) KYC number of applicant is mandatory for update application.H) For particular section update, please tick ( ) in the box available before the section number and strike off the sections not required to be updated.

Married

Resident IndividualForeign National

Non Resident Indian

Unmarried

Account Type*

M- Male

Application Type*

KYC Number

F- Female T-Transgender

Signature / ThumbImpression

PHOTO

Prefix First Name Middle Name Last Name

S-ServiceO-OthersB-Business

ISO 3166 Country Code of Birth*

Identification Number

Passport Expiry Date

Driving Licence Expiry Date

( Private Sector Public Sector Government Sector )

IN- Indian Others (ISO 3166 Country Code )

Others

Person of Indian Origin

(Certified copy of any one of the following Proof of Address [PoA] needs to be submitted)

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

Occupation Type*

Residential Status*

S- Simplified Measures Account - Document Type code Identification Number

X- Not Categorised

Address Type*Proof of Address*

Line 2

State / U.T Code*

Residential / Business

Passport Driving Licence UID (Aadhaar)

Pin / Post Code*City / Town / Village*

ISO 3166 Country Code*

Voter Identity Card

Residential Registered Office

Address

please specify

Business

NREGA Job Card Others

Unspecified

District*

Line 1*

Line 3

Simplified Measures Account - Document Type code

Normal Simplified (for low risk customers) Small

Addition of Related Person Deletion of Related Person

5. CONTACT DETAILS

7. REMARKS (If any)

(All communications will be sent on provided Mobile no. / Email-ID) (Please refer instruction F at the end)

6. DETAILS OF RELATED PERSON (In case of additional related persons, please fill ‘Annexure B1’ ) (please refer instruction G at the end)

(If KYC number and name are provided, below details of section 6 are optional)

Tel. (Off)

FAX

Tel. (Res)

Email ID

Mobile

KYC Number of Related Person (if available*)

Guardian of Minor Assignee Authorized RepresentativeRelated Person Type*

Name*

PROOF OF IDENTITY [PoI] OF RELATED PERSON* (Please see instruction (H) at the end)

4.3 ADDRESS IN THE JURISDICTION DETAILS WHERE APPLICANT IS RESIDENT OUTSIDE INDIA FOR TAX PURPOSES* (Applicable if section 2 is ticked)

State* ZIP / Post Code* ISO 3166 Country Code*

Same as Current / Permanent / Overseas Address details Same as Correspondence / Local Address details

A- Passport Number

B- Voter ID Card

C- PAN Card

D- Driving Licence

E- UID (Aadhaar)

F- NREGA Job Card

Z- Others (any document notified by the central government) Identification Number

Passport Expiry Date

Driving Licence Expiry Date

D D M M Y Y Y Y

D D M M Y Y Y Y

Prefix First Name Middle Name Last Name

8. APPLICANT DECLARATION

9. ATTESTATION / FOR OFFICE USE ONLY

KYC VERIFICATION CARRIED OUT BY INSTITUTION DETAILS

Date : Place :

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changestherein, 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.

I hereby consent to receiving information from Central KYC Registry through SMS/Email on the above registered number/email address.

[Signature / Thumb Impression]

Signature / Thumb Impression of Applicant

Documents Received Certified Copies

Date

Emp. Name

Emp. Code

Emp. Designation

Emp. Branch

Name

Code

[Employee Signature][Institution Stamp]

D D M M Y Y Y Y

D D M M Y Y Y Y

4.2 CORRESPONDENCE / LOCAL ADDRESS DETAILS * (Please see instruction E at the end)

Same as Current / Permanent / Overseas Address details (In case of multiple correspondence / local addresses, please fill ‘Annexure A1’)

State / U.T Code* Pin / Post Code* ISO 3166 Country Code*District*

Line 2 City / Town / Village*

Line 1*

Line 3

Line 2 City / Town / Village*

Line 1*

Line 3

S- Simplified Measures Account - Document Type code Identification Number

(4)

M M D D

Empower Your Money

(ANNEXURE - 3) TRADING ACCOUNT RELATED DETAILS FOR INDIVIDUALS & NON-INDIVIDUALS

R.K. STOCKHOLDING (P) LTD. Regd. Office : R.K. House, Neelkanth Marg, Civil Lines, MORADABAD-244001 PH.: 0591-2415222, 2417222 Fax : 0591-2412282 Corporate Office : A-7, Block B-1, Mohan Co-operative Ind. Estate, Mathura Road, NEW DELHI-110044 PH.: 011-48564444 Fax : 011-48564444 • E-mail : enquiry@rkfml.com URL : www.rkfml.com

MANDATORY

Member : •National Stock Exchange of India Ltd. • Bombay Stock Exchange Ltd.•MCX Stock Exchange Ltd. SEBI Regn. No.: • NSE, BSE & MSEI – INZ000211932 MEMBER SHIP No.: NSE (12310), BSE (3052) & MSEI (33000) CLEARING MEMBER : GLOBE CAPITAL MARKIT LIMITED : SEBI REG. NO – INZ000177137 Compliance Officer: Chanchal Jain Principal Officer: Alok Kumar Jamuar CEO : R. K. Gupta Contact No. : 08802423669

E-mail ID:chanchal.jain@rkfml.com Contact No. : 09015666153

E-mail ID : alok.jamuar@rkfml.com Contact No. : 011-48564444

Email id:rk@rkfml.com The information is the sole property of the trading member / brokerage house and would not be disclosed to anyone unless required by law or except with the express permission of clients. In case of joint Account, each Client has to use one Registration Form. In case of joint names / Family members, please submit form for each person.

A. BANK ACCOUNT(S) DETAILS (Through which transactions shall generally be routed)

Bank Name Branch Address Account Number Account Type MICR Number IFSC Code Saving

Current Others -

in case of NRI / NRE / NRO

B. DEPOSITORY ACCOUNT(S) DETAILS (Through which transactions shall generally be routed)

Depository Participant Name

Name of Depository Beneficiary Name DP ID Beneficiary ID (BO ID)

NSDL CDSL

NSDL CDSL

NSDL CDSL

C. TRADING PREFERENCES Please sign in the relevant boxes where you wish to trade. The segment not chosen should be struck off by the client.

Stock Exchange Market Segment/s

NSE

Cash

F&O

CDS

BSE

Cash

F&O

CDS

MCX-SX

Cash

F&O

CDS

# If, in future, the client wants to trade on any new segment/new exchange, separate authorization/letter should be taken from the client by the stock broker. D. OTHER DETAILS

Gross Annual Income Details: Income Range per annum : Below Rs. 1 Lac Rs. 1 Lac to 5 Lac (please specify)

Rs. 5 Lac to 10 Lac Rs. 10 Lac to 25 Lac Rs. 25 Lac to 1 Crore >1 Crore

Net Worth (Net worth should not be older than 1 year) Amount Rs............................................................................................. as on (date) (Compulsory for Non-Individuals) Occupation : Private Sector Public Sector Government Service Business Professional (please tick any one and give brief details)

Please tick, if applicable :

Any other information :

Agriculturist Retired Housewife Student Others Please Specify

Politically Exposed Person (PEP) Related to a Politically Exposed Person (PEP)

.......................................................................................................................................................................

Y Y Y Y

Voluntary

To, Date: __/____/_________

M/s R.K. Stockholding Pvt. Ltd., A-7, Block-B-1, Mohan Co-operative Industrial Estate, Mathura Road, New Delhi-110044

Dear Sirs,

Sub: Authority for depositing/pledging my/our Securities with the Regulated Entity Ref: My/Our Client Code ………………………… with you

I/We am/are registered with R.K. Stockholding Pvt. Ltd. (hereinafter referred to as “RKSHPL”) for executing my/our trades/transactions through them from time to time on stock exchanges recognized under the Securities Contracts (Regulation) Act, 1956 (hereinafter referred to as the “Recognized Stock Exchanges”).

I/We hereby agree and authorize RKSHPL to offer and deposit/pledge any of my/our securities placed /lying with them from time to time (hereinafter referred to as “Securities”), as margin / collateral with the Recognized Stock Exchanges and/or the clearing corporation(s) of the Recognized Stock Exchanges and/or clearing member appointed by RKSHPL and/or any other entity regulated by SEBI (hereinafter collectively referred to as the “Regulated Entities” and individually each of the above are referred to as the “Regulated Entity”) towards its margin requirement for availing exposure limits on my/our behalf.

I/We hereby declare, agree and confirm the following with respect to the Securities as given/deposited/pledged by RKSHPL with the Regulated Entity as margin/collateral:

(i) That the Securities are in existence, owned by me/us and are and shall be free from any charge, lien or encumbrance, whether prior or otherwise save and except for the encumbrance created in RKSHPL favour.

(ii) That the Securities will be subject to the creation of pledge in favour of or for the benefit of the Regulated Entity and further that the Securities over which pledge may be created in future would be in existence and owned by me/us at the time of creation of such pledge and that the Securities to be given in future as margin/collateral to the Regulated Entity would likewise be my/our unencumbered, absolute and disposable property.

(iii) That RKSHPL and/or clearing member appointed by RKSHPL is authorized to do all such acts and things, sign such documents and pay and incur any such costs, debts and expenses as may be necessary under the deed of pledge executed by them in this regards and the same shall be subject to terms and conditions as contained therein.

(iv) That the Securities shall be subject to the first priority and lien in favour of the Regulated Entity to secure my/our obligations and that my/our rights or interests with respect to the Securities shall be subject and subordinate to the rights, claims and interests of the Regulated Entity in respect of the Securities.

(v) That the Regulated Entity may invoke the pledge without any reference to me/us or my/our permission and upon receipt of the Securities, the Regulated Entity may utilize the proceeds in meeting my/our obligations in such manner as it may deem fit and that such invocation of pledge will be final and irrevocable against RKSHPL, clearing member appointed by RKSHPL and me.

(vi) I/We shall not make any claims or demands for refund or any reimbursement in relation to the Securities from the Regulated Entity.

This authority will remain in force unless revoked by me/us in writing and accepted by RKSHPL.

Thank You,

Yours Faithfully

_____________________ Signature of the client

POWER OF ATTORNEY

POA FOR PAY-IN OF SECURITIES FOR THE PURPOSE OF SETTLEMENT

POWER OF ATTORNEY POA ID.........................................

Empower Your Money IN FAVOUR OF BROKER FOR OPERATIONAL REQUIREMENTS AS PER CLIENT INSTRUCTION

TO ALL TO WHOM THESE PRESENTS SHALL COME I/WE. ................................................................................... ,

R/o.............................................................................................................................................................India, Indian

inhabitant SEND GREETINGs.

Whereas I/ We am a/ are investor(s) engaged in buying and selling of securities through R. K. stockholding (P) Ltd. (a

member of BSE, bearing SEBI registration no. INB 011231033, member NSE bearing SEBI registration no. INB

231231037 & member MSEI bearing SEBI registration no. INB 261231030) hereinafter referred as “RK STOCK”.

Whereas I/ We am / are HOLDING a Beneficiary account no. 12041800. ................................................ through R. K.

stockholding (P) Ltd. and due exigency & paucity of time I/We wish to appoint an agent/attorney to operate the aforesaid

beneficiary account.

NOW KNOW WE ALL AND THESE PRESENTS WITNESSTH THAT I THE ABOVENAMED DO HEREBY NOMINATE,

CONSTITUTE/AND APPOINT “RKSTOCK” as my true and lawful attorney (hereinafter referred to as the attorney) for

me and on my behalf and in my name and at my/our cost and expense to do the following acts, deeds or things:

1. To do instruct the aforesaid depository Participant to debit securities and/or to transfer securities from the aforesaid

beneficiary account for the purpose of meeting margin/ delivery obligations of the recognized stock exchange

towards any segment arising out of the trades executed by me/us through them.

2. To instruct DP to transfer the share to RKSTOCK Margin account number 1204180000121428 and/ or

1204180000121354 for pledge/ unpledged the same with NSE/BSE/MSEI or clearing member as margin deposit

in connection with the trades executed by me/us through RKSTOCK.

3. To instruct the DP to debit securities to the said BO account and/ or transfer securities from the said account to

RKSTOCK NSE CM account no. DP ID IN513262 10489215, 1204180000001915, 1100001100016225 and/ or

BSE CM account no. DP ID IN630529 10434604, 1204180000000356, 1100001000015303 and/ or MSEIL CM

account no. DP ID IN472469, 1204180000096409, 1100002800001893 to the extent share sold by me/ us for pay-

in obligations towards any stock exchange.

4. Unless specifically instructed by me/us within the reasonable time, to apply for various products like shares &

securities, Public Issue (shares as well as debenture), subscription to rights, offers of shares, tendering shares in

open offers, mutual fund, etc.

5. To transfer charges levied in my BO account to my trading ledger account of NSE/BSE/MSEI.

6. To do all such things and give all such instructions as mentioned above concerning the said account as I/we myself/

ourselves could give if I/we was/ were personally present.

That the RKSTOCK would liable to return back all the securities that may have been transferred erroneously.

This authority is restricted to the margin/ delivery obligations arising out of the transactions of trades executed by me/us

through RKSTOCK and I/We ratify the instructions given by aforesaid Clearing Member to the Depository Participant

named hereinabove in the manner specified herein.

That powers and authorities conferred by this Power of Attorney can be revoked at any point of time, without any notice.

Witness whereof I/we have executed this Power of Attorney on this ……… day of…………, 20……….

SIGNED AND DELIVERED BY:

Sole/First Holder Second Holder Third Holder

Name of A/c Holder

Sign of A/c Holder

5

In the presence of (name & address of witness)

Name of witness: …………………………………………………………

Address of witness: ………………………………………………………

……………………………………………………………………………..

Date: ……………………………. Place: ……………………………….

I/ We Accept

……………………………………………………………………

R. K. Stockholding (P) Ltd

A-7 Block-B1, MCIE, Mathura Road, New Delhi-110044

(26)

Declaration

Date………………………

I/ We hereby declare that I/ We do not want to open my/our demat account under Basic Service Demat Account (BSDA).

I/ We confirm that I/ We have understood contents of BSDA Policy and procedures laid down by SEBI.

I/ We authorized R. K. Stockholding (P) Ltd. to open my/ our demat account under Normal Category and we further acknowledge that I/ We do not want to open a BSDA account

………………………………………………..

(Signature of Client)

Client Name …………………………………..

Client BOID …………………………………..