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ASSIGNMENTS LIMITED Part I - Know Your Client (KYC) Application Form (For Non Individuals) ANNEXURE - K
A. IDENTITY DETAILS Photograph
Name Of The Applicant
Date of Incorporation
Date of commencement of business
Place of incorporation
PAN
Registration No. (e.g. CIN)
Status (Please tick any one)
B. ADDRESS DETAILS
Correspondence Address
City/ District/ Village
Pin Code State
Country
Tel. (Off.)
Tel. (Res)
Mobile
Fax
Email ID
Specify the proof of address submitted for Correspondence Address
Registered Address (If Different from above)
City/ District/ Village
Pin Code State
Country
Specify the proof of address submitted for Permanent Address
C. OTHER DETAILS
Gross Annual Income Details (Please Specify)
Income Rs
Net-worth as on Date
(Net worth should not be older then 1 year)
Name, PAN, residential address and photographs of Promoters/Partners/ Karta/Trustees and whole time directors
DIN / DPIN / UID of Promoters/Partners/LLP Partners and whole time directors:
Please Specify, As Applicable
D. DECLARATION
I / we hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief and I/we 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.
Name & Signature of the Authorised Signatory(ies) Date
FOR OFFICE USE ONLY
(Originals verified) True copies of documents received
(Self-Attested) Self Certified Document copies received
Signature of the Authorised Signatory
Date Seal/Stamp of the Intermediary
Details of Promoters/ Partners/ Karta/ Trustees and whole time directors forming a part of Know Your Client (KYC)Application Form for Non-Individuals
Sr. No. 1
Name
Relationship with Applicant(i.e. promoters, whole time directors etc.)
PAN
Residential / Registered Address
DIN/ UID
Photograph
Sr. No. 2
Name
Relationship with Applicant(i.e. promoters, whole time directors etc.)
PAN
Residential / Registered Address
DIN/ UID
Photograph
Sr. No. 3
Name
Relationship with Applicant(i.e. promoters, whole time directors etc.)
PAN
Residential / Registered Address
DIN/ UID
Photograph
Name & Signature of the Authorised Signatory(ies) Date
1. Identity of the applicant(s) is verified “in Person” a. Alankit Assignments Ltd. Intermediary ID - P2080 b. Branch / Service Centre _______________________________________ c. Staff Name __________________________________________________ Emp. Code _____________________ Signature ___________________ d. Date ___________________ Place _____________________
ALANKIT ASSIGNMENTS LIMITED PART II - ACCOUNT OPENING FORM (For Individuals)
ANNEXURE - K
Serial No. Receipt No. :............................................... Cash / Cheque No..................................... Rs.................................................................. OPENED BY............................................... VERIFIED BY.............................................
Client ID (To be filled by participant)
Date
A) Details of Account holder(s):
Sole / First Holder Name
PAN
Second Holder Name
PAN
Third Holder Name
PAN
B) Type Of Account
C) For HUF, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc. Although the account is opened in the name of the Karta, partner(s), trustee(es) etc., The name & PAN of the HUF, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., should be Mentioned below:
a. Name
b. PAN
D) In case of FIIs/ Others(as may be applicable)
RBI Approval Reference Number
RBI Approval date
SEBI Registration No. (For FIIs)
E) Bank Details
Bank Account Type
Bank Account Number
Bank Name
Branch Address
City/ District/ Village
Pin Code State
Country
MICR Number
IFSC Code
F) Clearing Member Details (to be filled up by Clearing Members only)
1. Name of the Stock Exchange
2. Name of Clearing Corporation/ Clearing House
3. Clearing Member ID
4. SEBI Registration Number
5. Trade Name
6. CM-BP-ID (to be filled up by Participant)
G) Standing Instruction
1. We authorise you to receive credits automatically into our account.
Yes
No
2. Account to be operated through Power of Attorney (PoA)
Yes
No
3. SMS Alert facility
First Holder
Yes
No
Second Holder
Yes
No
Third Holder
Yes
No
Declaration The rules and regulations of the Depository and Depository Participants pertaining to an account which are in force now have been read by us and we have understood the same and we agree to abide by and to be bound by the rules as are in force from time to time for such accounts. We here by declare that the details furnished above are true and correct to the best of my/our knowledge and belief and we 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, We are aware that we may be held liable for it. Authorised Signatories (Enclose a Board Resolution for Authorised Signatories)
Holder Name Signature(s)
First Holder
First Signatory ......................................................... ................................................
Second Signatory ......................................................... ...........................................
Third Signatory ......................................................... .............................................
Other Holder
Second Holder ........................................................... .........................................
Third Holder ........................................................... .........................................
Mode of Operation for Sole/First holder (In case of joint holdings, all the holders must sign)
Any one Singly
jointly by
As per resolution
Other (Please Specify)
NOTES:
1. In case of additional signatures, separate annexures should be attached to the applicationform.
2. Thumb impressions and signatures other than English or Hindi or any of the other languagenot contained in the 8th Schedule of the Constitution of India must be attested by a Magistrateor a Notary Public or a Special Executive Magistrate.
3. Strike off whichever is not applicable.
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