AUTHORISED PERSON APPROVAL FORM

(To be filled by the introducer/Franchisee coordinator in consultation with the prospective business associate)

SEGMENTS NSE CASH NSE F&O BSE CURRENCY MCX

Please tick YES YES YES YES YES
APPLICANT PARTICULARS
Name of Business Associate: SUJATA DILIP GANDHI
Type of Entity: ​(Please tick) [ * ] Individual [ ] Proprietor [ ] Partnership [ ] Company
Contact Person SUJATA DILIP GANDHI
Name Middle Name Last Name
Registered Office Address:
FLAT NO.9 SHANTVAN
SOCIATY 47/3 RG TAWARE
ROAD TAWARE COLONY
PARWATI

City: PUNE State:

MAHARASHTRA Pin code:
411 009
Land Tel No.:
020-24221701 Mobile no.:
9370383661/9403191708
Email id.:
DILIPGANDHI14@YAHOO.
CO.IN

AGREED TERMS

1. SECURITY DEPOSIT AND

REGISTRATION FEES DETAILS

Registration Fees Chq (Amount)

6618/-

DETAILS OF SECURITIES (​In case of

collateral​)

Script

*NOTE :_ REMANING 25000/-

DEPOSITE PAID BY BROKRAGE WITH
IN FIVE MONTH FROM DATE OF
FRANCHISEE ACTIVATION
2. BROKERAGE
OPTION I Keynote Capital 80% ASSOCIATE 20%

REVENUE SHARING (Pls. mention base slab below)

OPTION II KEYNOTE CAPITALS will charge the following brokerage to the business associate.
Brokerage charged over and above the following slab would be passed on to the
FIXED BROKERAGE SHARING business partner

(Pls. mention base slab below)

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Signat
ure of
Busine
ss
Associ
ate

APPR
OVAL
PA NAME SIGN
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Ke ABHIJEET KULKARNI
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As MOHIT JAIN
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Vi RAMNARESH PIPPAL
ce
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