Rsec Crf Form

Reliance Securities Limited 11th Floor, R-Tech IT Park, Western Express Highway, Goregaon (East), Mumbai 400063.

Equities - Change Request Form (for Individuals Only)Please fill details in BLOCK LETTERS in English

Date DP ID: 13041400 BO IDTrading Client Code

I/We request you to update the following details in your client master. I/We understand that the change(s) is / are being carried out at my/ our request and will affect in accounts held by me/us with Reliance Securities Ltd., under the captioned client code / BO ID.

1. Bank Details Addition/Modification for Trading & Demat Account

Add / Modify New Bank Details Existing Bank Details

Bank Name

Bank Branch

Bank A/c No

A/c Type

MICR Code

IFSC Code (compulsory)

Bank Name

Bank Branch

Bank A/c No

“Delete Existing Secondary bank details(Please tick, if required)Primary bank details can never be deleted”

Please tick any one of 'a' or 'b'

a) Make above new bank details as bank (This new bank details to be used for Funds Payin, Payout & Dividend credit.

Existing bank details, if any will be marked as Secondary bank account)

b) Make above new bank details as bank (This new bank details to be used for Funds Payin only )

Primary/Default

Secondary

Bank details provided in the POA executed by me/us, shall stand modified with the bank details provided under this request form

For Change in Bank details: ? Copy of Cheque with name printed, copy of bank passbook, Copy of bank statement of Accounts duly stamped and attested by bank Authorities, Not older than 3 Months.

2. KYC details updation in Trading, Demat account & KRA updation

Change of Address details

Change of Contact Details (Email id and Phone number )

“Change in Gross Annual Income Details / Occupation detail

(Please fill and sign the attached "KYC details change form" and submit along with this form dully signed)

3. Running Account Authorisation - Settlement Preference

Once in a calendar Quarter (Tick any one) Once in a calendar month This authorisation shall remain valid until it is revoked by me/us

4. Exchange Segment Addition Deletion

NSE F&O ______________________________________ BSE F&O MCX-SX F&O

NSE Currency MCX-SX Currency MCX-SX Cash Derivatives _____________________________________ Derivatives ____________________________________ Segment _____________________________________

_____________________________________ _________________________________

For Derivative segment activation (any one required) Copy of ?ITR Acknowledgment ?Annual Accounts ?Form 16 in case of salary income ?Net-worth certificate ?Salary Slip ?Bank Account Statement for last 6 months reflecting income.

First/Sole Holder Second Holder Third Holder

Name

Signature @ @ @

RSL accepting branch should affix rubber stamp of “ l” & “ ” seal on Proofs, pages should be signed by branch official.

Branch Name:_________________________________ Received on

Verified with Origina In Person Verification

Name of Staff

Employee ID: QRC No. : (Sign): ________________________

Customer Signature Verified by

(For CBO use only)

Updated by Authorized by

Employee ID Employee name

Important Instructions:- a) Applicant has to bring the original documents for verification of the proofs, and all photo copies should be self attested b) Copy of PAN, dully signed by customer should be submitted along with CRF for all changes requested.

(Tick any one)

@

@

@ @

Acknowledgment Receipt for CustomerDate QRC NO

Trading Client Code Name of the First applicant

Type of Request’s

Tear Off

Reliance Securities Limited CRF/Ver 2.7/Feb 2013Page 1 of 3

I/ We have read, understood and are agreeable to the changes as filled, signed and attached

@ @

Mandatory to be filled by branch official

Reliance Securities Limited CRF/Ver 2.7/Feb 20133