9. If Employed
________________________________________________________________________________________________
________________________________________________________________________________________________
11. Bank and Depository Account Details (through which transactions will generally be routed)
Branch: _________________________________________________________________________________________
Address: ________________________________________________________________________________________
Address: ________________________________________________________________________________________
Below Rs. 1,00,000/- | Rs. 1,00,000/- To Rs. 5,00,000/- | Rs. 5,00,000/- To Rs. 10,00,000/-
F3 Signature
2
Total:
(Sign):
3-Others
Form No.
Client Id.:
Scanning:
Signatory:
DSA Auth.
DSA code:
Cheque Dt.
Cheque No.
Accepted by
Bank details.
Inward date:
Amount(Rs.):
Accepted by:
1-Maintenance:
Acceptance date
Branch Manager/
Authorized official:
Branch Stamp
_____________
DPID Stamp:
Break-up of payment:
Upfront Payment Details:
For Branch Use Only
HO Stamp
____________
IL&FS House, Plot No. 14, Raheja Vihar, Chandivili, Andheri (E), Mumbai - 400 072.
Tel . : 2857 0965 Fax 2857 0948 Email ilfs-dp@issl.co.in Website : www.ilfsdp.com
1
Client Acknowledgment Copy
IL&FS Securities Services Limited
Form No.
Regd. Off. : IL&FS House, Plot No. 14, Raheja Vihar, Chandivili, Andheri (E), Mumbai - 400 072. Tel : 2857 0965 Fax 2857 0948 Email ilfs-dp@issl.co.in Website : www.ilfsdp.com
Form No.
2
Regd. Off. : IL&FS House, Plot No. 14, Raheja Vihar, Chandivili, Andheri (E), Mumbai - 400 072.
Tel . : 2857 0965 Fax 2857 0948
Email ilfs-dp@issl.co.in Website : www.ilfsdp.com
Form No.
INSTRUCTIONS :
1. Please fill all the details in CAPITAL LETTERS only. 2. Strike off whichever is not applicable. 3. Provide document evidence as per options on page 2
DATE Client ID
TYPE OF ACCOUNTS (Please specify type correctly, change in type not allowed)
Ordinary Resident HUF NRI Repatriable NRI Non-Repatriable Margin Promoter Others _____________
I/We request you to open a depository account in my/our name as per the following details.
PERSONAL DETAILS
SOLE/FIRST HOLDER DETAILS (The name mentioned here will be treated as valid & correct. No claims will be entertained later for any disputes arising out names specified wrongly)
NAME OF FATHER/HUSBAND
LOCAL/PERMANENT ADDRESS
Provide proof of this address
(options listed on page 2)
CORRESPONDENCE ADDRESS
Provide proof of this address
(options listed on page 2)
City : State : PIN
TELEPHONE NO. (with STD code) Fax Number
OCCUPATION
Service { Central Govt. State Govt. Public / Private Sector NGO Statutory Body }
Professional Business Student Housewife Retired Others (Specify)_____________
ADDRESS FOR
COMMUNICATION Local/Permanent Address Correspondence Address Foreign Address
FOREIGN ADDRESS
(Attestation Mandatory in proof)
Signature(s)
F1 S1 T1
Sole / First Holder Second Holder Third Holder
3
Form No.
NAME(Mr./Ms.)
as per pan card
ADDRESS OF GUARDIAN
PIN
SOLE/FIRST HOLDERS BANK ACCOUNT DETAILS (attach a cancelled / blank cheque leaf)
NAME OF BANK
PIN
SECOND HOLDER DETAILS (Joint holding not allowed in case any holder is (a) Minor or (b) if it is a HUF account )
NAME OF FATHER/HUSBAND
ADDRESS
Provide proof of this address
(options listed on page 2)
City : State : PIN
TELEPHONE NO.(with STD code) Fax Number
MOBILE NO. SMS Facility Yes No
Service { Central Govt. State Govt. Public / Private Sector NGO Statutory Body }
OCCUPATION
Professional Business Student Housewife Retired Others (Specify)_____________
THIRD HOLDER DETAILS (Joint holding not allowed in case any holder is (a) Minor or (b) if it is a HUF account )
FULL NAME (Mr./Ms.)
as per pan card
NAME OF FATHER/HUSBAND
ADDRESS
Provide proof of this address
(options listed on page 2)
City : State : PIN
TELEPHONE NO (with STD code) Fax Number
MOBILE NO. SMS Facility Yes No
Service { Central Govt. State Govt. Public / Private Sector NGO Statutory Body }
OCCUPATION
Professional Business Student Housewife Retired Others (Specify)_____________
Signature(s)
F2 S2 T2
Sole / First Holder Second Holder Third Holder
4
Form No.
DECLARATIONS
The rules and regulations of the Depository and Depository Participants pertaining to an account which are in force now have been read by me/us and I/we have
understood the same and I/we agree to abide by and to be bound by the rules as are in force from time to time for such accounts. I/We also declare that the
particulars given by me/us are true to the best of my/our knowledge as on the date of making such application. I/We further agree that any false/misleading
information given by me or suppression of any material fact will render my account liable for termination and further action.
STANDING INSTRUCTION
I/We authorize you to receive credits automatically into my/our Demat account. Yes (default) No
In case of a NRI account (RBI Approval)/Authorised Dealer Approval furnished Yes No
NATURE OF BUSINESS
NATURE OF BUSINESS
NATURE OF BUSINESS
Signature(s)
F4 S4 T4
Sole / First Holder Second Holder Third Holder
5
Form No.
IN-PERSON VERIFICATION
SECOND HOLDER(Mr./Ms.) S6
INSTRUCTION: Verify the photo with person; verify the originals of PAN card, other ID proofs and Address proof. Stamp the photocopies with Rubber stamps provided; sign & date
Signature(s)
F7 S7 T7
Sole / First Holder Second Holder Third Holder
6
Form No.
DETAILS OF NOMINEE
NAME OF NOMINEE (Mr./Ms.)
(Cannot be one of the holders)
ADDRESS
IF NOMINEE IS MINOR
GUARDIAN ‘S NAME (Mr./Ms.)
(in case Nominee is a minor)
ADDRESS OF GUARDIAN
DETAILS OF CLIENTS
1.
2.
7
8
Form No.
AGREEMENT BETWEEN THE DEPOSITORY PARTICIPANT AND THE PERSON SEEKING TO OPEN AN ACCOUNT WITH THE DEPOSITORY PARTICIPANT
(APPLICANT)
Thi s Agreem ent made and ent ered int o thi s _______ _______ _______ ____day of _______ _______ _______ _( mont h) _______ _______ (year ) bet ween
residing at
(hereinafter called “client“) and IL &FS Securit ie s Servic es Limited situated at IL&FS house, Plot No. 14, Raheja Vihar, Chandivili, A ndheri (E), Mumbai - 400 072.
(“hereinafter called “the Depository Participant“)
WITNESSETH
WHEREAS the Client has furnished to the Depository Participant the duly filled in
application form requesting therein to open an account with the Depository Participant
Third Holder
whether the balances in its account be transferred to the account of the Client held with
NOW THEREFORE in consideration of the Depository Participant having agreed to open
another Participant or be rematerialised, in the manner specified in the Bye Laws and
account for the Client, both the parties to the agreement hereby convenant and agree
Business Rules.
as follows:-
9. The Client further agrees that in the event of the Client committing a default in the
1. The Client shall pay such charges to the Depository Participant for the purpose of
payment of any of the amounts provided in clause (1) within a period of thirty days from
opening and maintaining his account, for carrying out the instructions of the Client and
the date of demand, without prejudice to the right of the Depository Participant to close
for rendering such other services as may be agreed to from time to time between the
the account of the Client, the Depository Participant may charge interest @ not more
Depository Participant and the Client as set out in Schedule A. The Depository
than 24% p.a. or such other rate as may be specified by the Executive Committee from
Participant shall reserve the right to revise the charges by giving not less than thirty
time to time for the period of such default. In case the Client has failed to make the
days notice in writing to the client.
payment of any of the amounts as provided in clause ( 1 ) of this agreement, the
T9
2. The Client shall have the right to get securities which have been admitted on the Depository Participant shall have the right to discontinue the Depository services till
Depository dematerialized in the form and manner laid down under the Bye Laws and such time he makes the payment along with interest, if any, after giving two days notice
Business Rules. The Depository Participant further undertakes that it shall not create or to the Client.
permit to subsist any mortgage, charges or other encumbrances over all or any of such
10. The Depository Participant shall have a right to provide such information related to the
securities submitted for dematerialisation except on the instructions of the Client
Client’s account as may be requested by the National Securities Depository Ltd. from
3. The Depository Participant hereby undertakes that it shall maintain a separate account time to time
of its own securities held in dematerialized form with the Depository and shall not co-
11. The Client shall have the right to create a pledge of the securities held in the
mmingle the same with the securities held in dematerialized form on behalf of the Client
dematerialised form with the Depository Participant only in accordance with the
4. The Depository Participant undertakes that a transfer to and from the accounts of the procedure and subject to the restriction laid down under the Bye Laws and Business
Second Holder
Client shall be made only on the basis of an order, instruction, direction or mandate duly Rules.
authorised by the Client and that the Depository Participant shall maintain adequate
12. The Depository shall not be liable to the Client in any manner towards losses, liabilities
audit trail of such authorization.
and expenses arising from the claims of third parties and from taxes and other
5. The Depository Participant agrees that the Client may give standing instructions with governmental charges in respect of securities credited to the Client’s account.
regard to the crediting of securities in his account and the Depository Participant shall
13. The Client may exercise the right to freeze his account maintained with the Depository
act according to such instructions.
Participant so as to lock the securities held with the Depository Participant in
6. The Depository Participant undertakes to provide a transaction statement including accordance with the procedures prescribed in the Bye Laws and Business Rules.
statement of accounts , if any, to the Client at monthly intervals unless the Depository
14. The Client may exercise the right to defreeze his account maintained with the
Participant and the Client have agreed for provision of such statements at shorter
Depository Participant in accordance with the procedure and subject to the restrictions
intervals. However, if there is no transaction in the account, then the Depository
laid down under the Bye Laws and Business Rules.
Participant shall provide such statement to the Client atleast once a quarter.
S9
15. The Client shall notify the Depository Participant, within seven days, of any change in
7. The Depository Participant shall have the right to terminate this agreement, for any
the details set out in the application form submitted to the Depository Participant at the
reasons whatsoever, provided the Depository Participant has given a notice in writing
time of opening the account or furnished to the Depository Participant from time to time
of not less than thirty days to the Client as well as to the Depository. Similarly, the Client
shall have the right to terminate this agreement and close his account held with the 16. The Depository Participant undertakes to resolve all legitimate grievances of the Client
Depository Participant, provided no charges are payable by him to the Depository against the Depository Participant within a period of thirty days.
Participant. In such an event, the Client shall specify whether the balances in its 17. The Depository Participant and the Client shall abide by the arbitration and conciliation
account should be transferred to another account of the Client held with another procedure prescribed under the Bye Laws of National Securities Depository Ltd. and
Depository Participant or to rematerialise the security balances held. Based on the that such procedure shall be applicable to any disputes between the Depository
IN WITNESS WHEREOF the Client and the Depository Participant has caused these presents to be executed as of the day and year first above written.
Signed and delivered for & on behalf of client F9
On Behalf of
Witness
IL&FS Securities Services Limited
Signature:
Signature:
Name:
Name:
(Authorised Signatory)
Address:
Applicant Witness
Signature(1st Holder): F10
Signature:
Name:
Name:
Signature(2nd Holder): S10
Name: Address:
Signature(3rd Holder): T10
Name:
9
Form No.
Date :
The Manager
IL&FS Securities Services Limited
IL&FS House, Plot No.14
Raheja Vihar, Chandivali
Andheri (East)
Mumbai 400 072
I/We refer to the DP-Client Agreement (“the Agreement”) entered into between me/us
and IL&FS Securities Services Limited (ISSL) for opening the abovementioned
Demat Account.
I/We are aware that the DP, in terms of the NSDL Circular, agreed to provide
monthly/quarterly Bills and Transaction Statements and other notices by email or on
website on the terms and conditions annexed hereto(overleaf).
I/We intend to avail the facility of receiving monthly / quarterly Bills and Transaction
statements and other intimations / notices by email or on website for the captioned
demat account on the terms and conditions annexed hereto. I / We request you to
register the following email ID(s) for the same :
_________________________________________________________________
All other terms and conditions of the Agreement remain the same. This letter shall
form part and parcel of the Agreement
________________
F13 ________________
S13 _________________
T13
12
Form No.
Terms & Conditions for receiving Bills, Transaction Statements and other
intimations / notices by email or on website
1. The client agrees not to receive Bills and Transaction statements and any other intimations
/ notices in paper form from the DP. Provided however that, in case when the DP is not
able to provide such Bills and Transaction statements and intimations / notices to its clients
through website / email due to any unforeseen problems, the DP should ensure that the
same reaches me/us in physical form to the address as registered in the captioned demat
account
2. The client shall take all the necessary steps to ensure confidentiality and secrecy of the
login name and password of the internet/email account
3. The client is aware that the Bills and Transaction statement and any other intimation /
notices may be accessed by other entities in case the confidentiality / secrecy of the login
name and password is compromised
4. The client shall immediately inform the DP about change in email address, if any,
5. The client shall confirm the validity of the email address atleast once in a year
6. The client and the DP shall have the right to terminate this agreement after giving a notice of
at least 10 days in advance to the other party
Client Id:
13