central kyc registry | know your customer (kyc) … · 2019-05-06 · i/we request you to open a...

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1. PERSONALDETAILS (Please refer instruction A at the end) OTP Based E-KYC Small Simplified (for low risk customers) Normal (To be filled by financial institution) KYC Number (Mandatory for KYC update request) Account Type* Update New Application Type* For office use only CENTRAL KYC REGISTRY | Know Your Customer (KYC) Application Form | Individual Important Instructions: 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-YY Y Y Y 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. Name* (Same as ID proof) Maiden Name (If any) Father / Spouse Name Mother Name Date of Birth* Prefix First Name Middle Name Last Name Gender* Marital Status* M- Male Married F- Female Unmarried T-Transgender Others Citizenship* Residential Status* IN- Indian Resident Individual Foreign National Others (ISO 3166 Country Code ) Non Resident Indian Person of Indian Origin Occupation Type* S-Service ( O-Others ( B-Business Private Sector Professional Public Sector Self Employed Government Sector ) Retired Housewife Student) X- Not Categorised ADDITIONALDETAILS REQUIRED* (Mandatory only if section 2 is ticked) ISO 3166 Country Code of Jurisdiction of Residence* Tax Identification Number or equivalent (If issued by jurisdiction)* Place / City of Birth* (Certified copy of any one of the following Proof of Identity[PoI] needs to be submitted) 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) Passport Expiry Date Driving Licence Expiry Date Identification Number S- Simplified Measures Account - Document Type code Identification Number (Certified copy of any one of the following Proof of Address [PoA] needs to be submitted) Address Type* Proof of Address* Residential / Business Passport Voter Identity Card Residential Driving Licence NREGA Job Card Business UID (Aadhaar) Others Registered Office Unspecified Address Line 1* Line 2 Line 3 District* Simplified Measures Account - Document Type code 3. PROOF OF IDENTITY (PoI)* (Please refer instruction C at the end) D D M M Y Y Y Y 2. TICK IFAPPLICABLE RESIDENCE FORTAX PURPOSES IN JURISDICTION(S) OUTSIDE INDIA (Please refer instruction B at the end) 4.1 CURRENT / PERMANENT/ OVERSEASADDRESS DETAILS (Please see instruction D at the end) 4. PROOF OFADDRESS (PoA)* PHOTO Signature / Thumb Impression ISO 3166 Country Code of Birth* D D M M Y Y Y Y D D M M Y Y Y Y ple as e s pe cify City / Town / Village* Pin / Post Code* State / U.T Code* ISO 3166 Country Code*

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Page 1: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

1. PERSONALDETAILS (Please refer instruction A at the end)

OTP Based E-KYC Small Simplified (for low risk customers) Normal

(To be filled by financial institution) KYC Number (Mandatory for KYC update request)

Account Type*

Update New Application Type* For office use only

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

Important Instructions:

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-YY YYY 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.

Name* (Same as ID proof)

Maiden Name (If any)

Father / Spouse Name

Mother Name

Date of Birth*

Prefix First Name Middle Name Last Name

Gender*

Marital Status*

M- Male

Married

F- Female

Unmarried

T-Transgender

Others

Citizenship*

Residential Status*

IN- Indian

Resident Individual

Foreign National

Others (ISO 3166 Country Code )

Non Resident Indian

Person of Indian Origin

Occupation Type* S-Service (

O-Others (

B-Business

Private Sector

Professional

Public Sector

Self Employed

Government Sector )

Retired Housewife Student)

X- Not Categorised

ADDITIONALDETAILS REQUIRED*(Mandatory only if section 2 is ticked)

ISO 3166 Country Code of Jurisdiction of Residence*

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

Place / City of Birth*

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

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)

Passport Expiry Date

Driving Licence Expiry Date

Identification Number

S- Simplified Measures Account - Document Type code Identification Number

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

Address Type*

Proof of Address*

Residential / Business

Passport

Voter Identity Card

Residential

Driving Licence

NREGA Job Card

Business

UID (Aadhaar)

Others

Registered Office Unspecified

Address

Line 1*

Line 2

Line 3

District*

Simplified Measures Account - Document Type code

3. PROOF OF IDENTITY (PoI)* (Please refer instruction C at the end)

D D

M M

Y Y Y Y

2. TICK IFAPPLICABLE RESIDENCE FORTAX PURPOSES IN JURISDICTION(S) OUTSIDE INDIA (Please refer instruction B at the end)

4.1 CURRENT / PERMANENT/ OVERSEASADDRESS DETAILS (Please see instruction D at the end)

4. PROOF OFADDRESS (PoA)*

PHOTO

Signature / Thumb

Impression

ISO 3166 Country Code of Birth*

D D

M M

Y Y Y Y

D D

M M

Y Y Y Y

ple as e s pe cify

City / Town / Village*

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

Page 2: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

Related Person Type* Guardian of Minor Assignee Authorized Representative

9. ATTESTATION / FOR OFFICE USE OLNY

[Employee Signature]

[Institution Stamp]

FARSIGHT SECURITIES LIMITED

M M D D

Line 1*

Line 2

Line 3

District*

Line 1*

Line 2

Line 3

State*

Tel. (Off)

FAX

Tel. (Res)

Email ID

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

Addition of Related Person Deletion of Related Person KYC Number of Related Person (if available*)

Name*

Prefix First Name Middle Name Last Name

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

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

A- Passport Number Passport Expiry Date D D

M M

B- Voter ID Card

C- PAN Card

D- Driving Licence Driving Licence Expiry Date D D

M M

E- UID (Aadhaar)

F- NREGA Job Card

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

S- Simplified Measures Account - Document Type code

Identification Number

8. APPLICANT DECLARATION

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 changes

therein, 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.

Date : Place :

Documents Received Certified Copies

KYC VERIFICATION CARRIED OUT BY

Date

Emp. Name

Emp. Code

Emp. Designation

Emp. Branch

INSTITUTION DETAILS

Name

Code

7. REMARKS (If any) Mobile no. / Email-ID) (Please refer instruction F at the end)

5. CONTACT DETAILS (All communications will be sent on provided

4.2 CORRESPONDENCE / LOCALADDRESS 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’)

4.3 ADDRESS INTHE JURISDICTION DEATILS WHEREAPPLICANTIS RESIDENTOUTSIDE INDIAFOR TAX PURPOSES* (Applicable if section 2 is ticked)

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

Mobile

Signature / Thumb Impression of Applicant

City / Town / Village*

Pin / Post Code*

State / U.T Code* ISO 3166 Country Code*

City / Town / Village*

ZIP / Post Code* ISO 3166 Country Code*

Y Y Y Y

Y Y Y Y

Y Y Y Y

I N B 0 2 4 2

Page 3: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

INSTRUCTIONS FOR AUTOMATIC PAY-IN (POA)

Know all men by these Present that I/We ____________________________________________ S/o / D/o / W/o __________________ ____________________________________ Aged _____________ years at present residing at _____________________________ __________________________________________________________________________________________________________

Whereas I/We am/are having Demat account number _____________DP ID IN301766/12056300 with Farsight Securities Ltd., Who is a stock broker registered with SEBI and member of recognized stock exchange/s and Depository participant of NSDL and CDSL.

And Whereas I/ we am/are desirous of appointing Farsight Securities Ltd. as my/ our constituted attorney to operate my/our beneficial owner account on my/our behalf for a limited purpose in the manner hereinafter appearing and subject to conditions as provided herein.

Now know you all and these presents witness that I/we do hereby nominate, constitute and appoint Farsight securities Ltd. (hereinafter referred to as “the stock broker”) as my true and lawful attorney and authorise it to perform the following functions on my behalf:

I. to transfer securities held in my/our aforementioned beneficial owner account(s) or any other account informed by me in writing to the stock broker from time to time to the following demat accounts of Farsight Securities Ltd maintained for the purpose of securities of trades and margin obligations arising out of trades executed by me/us on any recognized stock exchange through the stock broker or expected margin requirement from my request / order to trade.

ii. to pledge the securities in favour of the stock broker for the limited purpose of meeting my/our margin requirements on short fall in connection with the trades executed by me/us on any recognized stock exchange through the stock broker.

iii. to return to me/us, the securities or funds that may have been received by the stock broker erroneously or those securities or funds that the stock broker was not entitled to receive from me/us.

iv. to send consolidated summary of my/our scrip-wise buy and sell positions taken with average rates to me/us by way of SMS/email on a daily basis notwithstanding nay other document to be disseminated as specified by SEBI from time to time.

v. To apply for various products like Mutual Funds, Public Issues (shares as well as debentures) right, offer of shares, tendering shares in open offers etc pursuant to oral/written/electronic instructions given by me/us to the stock broker.

I/We further agree and confirm that the powers and authorities conferred by this Power of Attorney shall continue until it is revoked (without notice) in witting by me/us. That the said revocation shall be effective from the date on which the revocation notice is received by the stock broker in his office at Karol Bagh. However, the revocation shall not absolve me / us from pay-in obligation and margin obligation undertaken prior to receipt of notice by the attorney and revocation shall be effective only after the existing obligations have been discharged in full in all respects.

IN WITNESS WHEREOF, I/We the above mentioned do hereby-set my/our hands hereon at _________________ on this ______________ day of the month of ___________ in the year _________ in the presence of the following witness:

WITNESS (1): ______________________________________________

NAME ______________________________________________

SIGNATURE ______________________________________________

ADDRESS ______________________________________________

______________________________________________

WITNESS (2): ______________________________________________

NAME ______________________________________________

SIGNATURE ______________________________________________

ADDRESS ______________________________________________

______________________________________________

ACCEPTEDFor Farsight Securities Ltd.

Authorised Signatory

Sl No. Client/CM BP ID DP ID DP Name A/c Type

1 IN558205 IN301766 Farsight Securities Ltd NSDL NSE Pool

2 IN666177 IN301766 Farsight Securities Ltd NSDL BSE Pool

3 10122040 IN301766 Farsight Securities Ltd Margin A/c

4 1205630000000097 Farsight Securities Ltd CDSL NSE Pool

5 1205630000003288 Farsight Securities Ltd CDSL BSE Pay-out a/c

6 1205630000003292 Farsight Securities Ltd CDSL BSE Pay-in a/c

ADDITIONAL KYC FORM FOR OPENING A CDSL DEMAT ACCOUNT ( FOR INDIVIDUAL)

(To be filled by the applicant in BLOCK LETTERS in English)

(To be filled by the Depository Participant)

I/We request you to open a demat account in my/our name as per the following details

Holders Details

PAN

UID

PAN

UID

PAN

UID

Sole/First HolderName

Second Holder Name

Third HolderName

* In case of Firms, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., although the account is opened in the name of the natural persons, the name of the Firm, Association of Persons (AOP), Partnership Firm,Unregistered Trust, etc., should be mentioned above.

Name *

Details of Guardian (in case the account holder is minor)

Guardian’s Name

PAN Relationship with the applicant

Type of Account (Please tick whichever is applicable)

Individual

NRI

Foreign National

Status Sub - Status

Individual Resident

Individual HUF / AOP

Individual Margin Trading A/c (MANTRA)

NRI Repatriable

Foreign National

NRI Non-Repatriable Promoter

Others (specify)____________

NRI Non-Repatriable

Foreign National Depository Receipts

NRI-Depository Receipts

NRI Repatriable Promoter

Others (specify)____________

Individual - Director

Individual Promoters

Individual Director’s Relative

Minor

Others (specify)____________

I/We instruct the DP to receive each and every credit in my/our account(If not marked, the default option would be ‘Yes’)I/We would like to instruct the DP to accept all the pledge instructions inmy/our account without any other further instruction from my/our end(If not marked, the default option would be ‘No’)

[Automatic Credit] Yes No

Yes No

I/We wish to receive dividend / interest directly in to my bank account as given below through ECS (If not marked, the default option would be ‘Yes’) [ECS is mandatory for locations notified by SEBI from time to time]

YesNo

Account Statement Requirement

I/We request you to send Electronic Transaction-cum-Holding Statement at the email ID ________________________________________________________________________________________________

As per SEBI Regulation Daily Weekly Fortnightly Monthly

Yes No

I/We would like to share the email ID with the RTA Yes No

I/We would like to receive the Annual Report(Tick the applicable box. If not marked the default option would be in Physical)

Physical / Electronic /

Both Physical and Electronic

Application No.

DP Internal Reference No.

DP ID

Date

Client ID

D D M M Y Y Y Y

1 2 0 5 6 3 0 0

CDSL

FARSIGHT SECURITIES LTD.Depository Participant : DP-CDSL, DP - ID - 12056300SEBI Regn No. : IN-DP-CDSL-442-200817-A/55, Triveni Plaza, Gurudwara Road, Karol Bagh, New Delhi–110005EAPBX: 011-4504-4444 (30 Lines) Fax: 011-45044434 | E-mail : [email protected]

Second Holder

D 2.2

Third holder

D 2.3

First Holder

D 2.1

Page 4: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

CDSL Bank Details [Dividend Bank Details] ( * 9 digit MICR Code ) (

# 11 Character )

MICR Code* IFSC Code#

Bank A/c No. Bank A/c Type Saving Current Others Pl. Specify

Bank Name Branch Name

Bank Branch Address

City/town/village PIN Code

State Country

(I) Photocopy of the cancelled cheque having the name of the account holder where the cheque book is issued, (or) (ii) Photocopy of the Bank Statement having name and address of the BO (iii) Photocopy of the Passbook having name and address of the BO, (or) (iv) Letter from the Bank.

In case of options (ii), (iii) and (iv) above, MICR code of the branch should be present / mentioned on the document.

Other Details

Gross Annual Income Details

Income Range per annum Up to Rs. 1,00,000 Rs. 1,00,001 to Rs. 5,00,000 Rs. 5,00,001 to Rs. 10,00,000 Rs. 10,00,001 to Rs. 25,00,000 More than Rs. 25,00,001

Net worth as on (Date) / /20 Rs. [Net worth should not be older than 1 year]

Occupation Private / Public Sector Govt. Service Business Professional Agriculture Retired Housewife Student Others (Specify)

Please tick, if Applica ble Politically Exposed Person (PEP) Related to Politically Exposed Person (RPEP)

Any other information

SMS Alerts Facility Mobile No. + 9 1

Refer to Terms & Conditions given as

Annexure 2.4

[(Mandatory , if you are giving Power of Attorney ( POA)]

(If POA is not granted & you do not wish to avail of this facility, cancel this option).

Transactions Using Secured Texting Facility (TRUST) Refer to Terms and Conditions Annexure - 2.6

I wish to avail the TRUST facility using the Mobile number registered for SMS Alert Facility. I have read and

understood the Terms and Conditions prescribed by CDSL for the same. Yes No

I/We wish to register the following clearing member IDs under my/our below mentioned BO ID registered for TRUST

Stock Exchange Name / ID Clearing Member Name Clearing Member ID (Optional)

To register for easi, please visit our website : www.cdslindia.com Easi allows a BO to view his ISIN balances, transactions and value of the portfolio online.

Declaration

I/We have received and read the Rights and Obligations document and terms & conditions and agree to abide by and be bound by the same and by the Bye Laws as are in force from time to time. I / We declare that the particulars given by me/us above are true and to the best of my/our knowledge as on the date of making this application. I/We agree and undertake to intimate the DP any change(s) in the details / Particulars mentioned by me / us in this form. I/We further agree that any false / misleading information given by me / us or suppression of any material information will render my account liable for termination and suitable action.

I hereby declare that the Mobile No. Email ID given KYC Form / Demat Account Opening Form belongs to

me or my family member (spouse, dependent children and dependent parents.)

First/Sole Holder or Guardian (in case of Minor)

Second Holder Third Holder

Name

Signature

(Signatures should be preferably in black ink ).

Page 5: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

COMMON NOMINATION FORM

Nomination Option

[I/We wish to make a nomination.

[As per details given below]

I/We do not wish to make a nomination.

[Strike off the nomination details below]

NOMINATION DETAILS

I/We wish to make a nomination and do hereby nominate the following person(s) who shall receive all securities held in the Depository by me / us in the said beneficiary owner account in the event of my / our death.

Nomination can be made upto Details of 1st Nominee Details of 2nd Nominee Details of 3rd Nominee

three nominees in the account

1 Name of the nominee(s) (Mr./Ms.)

2 Share of each Nominee

Equally [If not equally, please specify percentage]

% % %

Any odd lot after division shall be transferred to the first nominee mentioned in the form.

3 Relationship With the Applicant (If Any)

4 Address of Nominee(s)

PIN Code

5 Mobile/Telephone No. of Nominee(s)

6 Email ID of Nominee(s)

7 Nominee Identification details :

[Please tick any one of following and provide details of same]

Photograph & Signature

Photograph of 1st nominee

Signatue

Photograph of 2nd nominee

Signatue

Photograph of 3rd nominee

Signatue

PAN

Aadhaar

Saving Bank Account No.

Proof of Identity

Demat Account ID

Sr. Nos. 8-14 should be filled only if nominee(s) is a minor:

8 Date of Birth {in case of minor nominee(s)} D D M M Y Y Y Y D D M M Y Y Y Y D D M M Y Y Y Y

9 Name of Guardian (Mr.Mrs.) {in case of minor nominee(s)}

10 Address of Guardian

PIN Code

11 Mobile/Telephone No. of Guardian

12 Email ID of Guardian

13 Relationship of Guardian with Nominee

Page 6: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

14 Guardian Identification details :

[Please tick any one of following and provide details of same]

Photograph & Signature

Photograph of 1st Guardian

Signatue

Photograph of 2nd Guardian

Signatue

Photograph of 3rd Guardian

Signatue

PAN

Aadhaar

Saving Bank Account No.

Proof of Identity

Demat Account ID

Name(s) of Holder(s) Signature(s) of holder

Sole/ First Holder/ Guardian (in case sole holder is minor) (Mr./Ms.)

Second Holder (Mr./Ms.)

Third Holder (Mr./Ms.)

Signature of Witness for Nomination

Name of the Witness Address Signature of Witness

Date D D M M Y Y Y

Notes : 1. All communication shall be sent at the address of the Sole/First holder only. 2. Thumb impressions and signatures other than English or Hindi or any of the other

language not contained in the 8th Schedule of the Constitution of India must be attested by a Magistrate or a Notary Public or a Special Executive Magistrate.

3. Instructions related to nomination, are as below: I. The nomination can be made only by individuals holding beneficiary owner

accounts on their own behalf singly or jointly. Non- individuals including society, trust, body corporate and partnership firm, karta of Hindu Undivided Family , holder of power of attorney cannot nominate. If the account is held jointly, all joint holders will sign the nomination form.

II. A minor can be nominated. In that event, the name and address of the Guardian of the minor nominee shall be provided by the beneficial owner.

III. The Nominee(s) shall not be a trust, society, body corporate, partnership firm, karta of Hindu Undivided Family or a power of Attorney holder. A non-resident Indian can be a Nominee, subject to the exchange controls in force, from time to time.

IV. Nomination in respect of the beneficiary owner account stands rescinded upon closure of the beneficiary owner account. Similarly, the nomination in respect of the securities shall stand terminated upon transfer of the securities.

V. Transfer of securities in favour of a Nominee(s) shall be valid discharge by the depository and the Participant against the legal heir.

VI. The cancellation of nomination can be made by individuals only holding beneficiary owner accounts on their own behalf singly or jointly by the same persons who made the original nomination. Non- individuals including society, trust, body corporate and partnership firm, karta of Hindu Undivided Family , holder of power of attorney cannot cancel the nomination. If the beneficiary owner

account is held jointly, all joint holders will sign the cancellation form. VII. On cancellation of the nomination, the nomination shall stand rescinded and the

depository shall not be under any obligation to transfer the securities in favour of the Nominee(s).

VIII. Nomination can be made upto three nominees in a demat account. In case of multiple nominees, the Client must specify the percentage of share for each nominee that shall total upto hundred percent. In the event of the beneficiary owner not indicating any percentage of allocation/share for each of the nominees, the default option shall be to settle the claims equally amongst all the nominees.

IX. On request of Substitution of existing nominees by the beneficial owner, the earlier nomination shall stand rescinded. Hence, details of nominees as mentioned in the FORM 10 at the time of substitution will be considered. Therefore, please mention the complete details of all the nominees.

X. Copy of any proof of identity must be accompanied by original for verification or duly attested by any entity authorized for attesting the documents, as provided in Annexure D.

XI. Savings bank account details shall only be considered if the account is maintained with the same participant.

XII. DP ID and client ID shall be provided where demat details is required to be provided.

4. For receiving Statement of Account in electronic form: I. Client must ensure the confidentiality of the password of the email account. II. Client must promptly inform the Participant if the email address has changed. III. Client may opt to terminate this facility by giving 10 days prior notice. Similarly,

Participant may also terminate this facility by giving 10 days prior notice. 5. Strike off whichever is not applicable.

Page 7: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

FATCA & CRS DECLARATION (FOR INDIVIDUAL)

Do you have any non-indian Country(ies) of Birth / Citizenship / Nationality and Tax Residency? Yes No

Sole/First Holder/Guardian Yes No Second Holder Yes No Third Holder Yes No

Country of Birth

Country of Birth

Country of Birth

Country of Citizenship/ Nationality

Country of Citizenship/ Nationality

Country of Citizenship/ Nationality

Are you a US Specified Person?

Yes No Please provide Tax Payer Id

Are you a US Specified Person?

Yes No Please provide Tax Payer Id

Are you a US Specified Person?

Yes No Please provide Tax Payer Id

Country of Tax Residency* (Other then India) Taxpayer Identification No.

Country of Tax Residency* (Other then India) Taxpayer Identification No.

Country of Tax Residency* (Other then India) Taxpayer Identification No.

1.

1.

1.

2.

2.

2.

3.

3.

3.

*Please indicate all countries in which you are a resident for tax purpose and associated Taxpayer identification number.

FATCA - CRS Terms and Conditions

I have read and understood the information requirements and the Terms & Conditions mentioned in this Form (read along with FATCA &

CRS instructions) and hereby confirm that the information provided by me on this Form is true, correct and complete. I hereby agree and

confirm to inform Farsight Securities Ltd for any modification to this information promptly.

I further agree to abide by the provisions of the scheme related documents inter alia provisions of FATCA & CRS on Automatic Exchange of

Information (AEOI).

Signatures

First Holder

Second Holder

Third holder

Declaration - Authority Letter for Activation of same E-mail ID or same mobile number for Multiple Clients

Please refer to the Trading/DP accounts opened with you, for the purpose of dealing in NSE / BSE/MCX/NSDL/CDSL. We all belong to

same family or having common director

COMMON EMAIL ID ………………………………………………………….

MOBILE NUMBER .…………………………………………………………

Code/Client ID Name Relationship Signature of Family Members

Signatures

First Holder

Second Holder

Third holder

AADHAAR AUTHENTICATION CONSENT

“I/we hereby state that I/we have no objection in authenticating myself/ourselves with Aadhaar based authentication system through NSDL e-Governance Infrastructure Limited / CDSL Ventures Limited and give my/our consent to provide my Aadhaar Number, OTP, Demographic details or Biometric for Aadhaar based authentication. I/we also authorize NSDL e-Governance Infrastructure Limited / CDSL Ventures Limited to share the authentication details with Farsight Securities Limited for the purpose of carrying Aadhaar authentication as required by PMLA guidelines, which shall not be further shared.”

Signatures

First Holder

Second Holder

Third holder

Page 8: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

PART II – ACCOUNT OPENING FORM

FARSIGHT SECURITIES LTD. Depository Participant : NSDL, DP - ID - IN301766 Depository Participant : CDSL, DP - ID - 12056300 SEBI Regn No. : IN-DP-CDSL-442-2008 7-A/55, Farsight Triveni Plaza, Gurudwara Road, Karol Bagh, New Delhi–110005 EAPBX: 011-4504-4444 (30 Lines) Fax: 011-45044434 | E-mail : [email protected]

TARIFF FOR NSDL/CDSL ACCOUNT

Sl. No. PARTICULARS CORPORATE INDIVIDUAL/HUF

A B C BSDA

1. Account Opening NIL NIL NIL NIL NIL

2.

(i) Annual Maintenance

500/- Per Annum 1000/-

Per Annum 300/- Per

Annum

1st Year 999 Subsequent

year NIL

NIL

(ii) Maintenance Charges By Depositories 500/- Per Annum NIL NIL NIL NIL

3.

Transaction Charges

Delivery In-coming NIL NIL

Delivery Out-going (through Speed- E, POA) Rs. 18/- per Trxn NIL 18/- per Trxn

18/- per Trxn

30/- per Trxn

4. KRA/CKYC Modification 250/- per modification 100/- per modification

5. Dematerialisation 20/- Plus 3/- per Certificate (Postage Charges 30/- Extra)

6. Rematerialisation 20/- per certificate or 20/- for every certificate every 100 securities which ever is higher (Postage Charges 30/- Extra)

7. Instruction Booklet 25/- for 10 Leaves (Postage charges 30/- extra)

8. Pledge Creation/ Closure/ Invocation 50/- per Transaction

N. B. : • Any other services not specified above shall be charged extra. • Rejection charges on failure of instruction 20/ per instruction shall be charged. • Non - execution of delivery instruction due to any problem / error 30/- per communication / dispatch. • Physical DIS execution charges 10/- per slip extra. • Charges / Services standards are subject to revision at Depository Participants discretion after giving 30 days notice. • In case of Demat rejection postage shall be charged @ 30/- for dispatch to the Client for removal of objection. • In case of Non-Payment of the bill within 30 days from the date of bill, Interest @ 1.5% p.m. will be charged. • The depository services are liable to be discontinued on such default. The renewal charges will be 100/-. • Statements of accounts will be mailed by ordinary post only, at free of cost. Statements can be provided by courier with extra charges of

30/- per dispatch. • Amount charged by NSDL/CDSL for CAS will be charge extra. • Client Master Charge 20/- Per Request. • Taxes and other government levies extra as applicable from time to time. • Charges for transaction value from 5 to 20 lac 50/- and transaction value above 20 lac 80/- per Instruction extra. • DP reserves the right not to execute the delivery instruction in case where service charges are outstanding. • Client will maintain minimum 200/- as an advance payment which will be adjusted against future bills. • 10/- per page for holding / transaction / financial accounts for extra statements. • Please Place my /our Account under Scheme A /B /C /BSDA HOLDER'S SIGNATURES

First Holder Second Holder Third holder

For Farsight Securities Ltd

(Authorised Signatory)

Received Copy

Client(s) Signature

Page 9: CENTRAL KYC REGISTRY | Know Your Customer (KYC) … · 2019-05-06 · I/We request you to open a demat account in my/our name as per the following details Holders Details PAN UID

INSTRUCTIONS FOR AUTOMATIC PAY-IN (POA)

Know all men by these Present that I/We S/o / D/o / W/o Aged years at present residing at

Whereas I/We am/are having Demat account number DP ID IN301766/12056300 with Farsight Securities Ltd., Who is a stock broker registered with SEBI and member of recognized stock exchange/s and Depository participant of NSDL and CDSL.

And Whereas I/ we am/are desirous of appointing Farsight Securities Ltd. as my/ our constituted attorney to operate my/our beneficial

owner account on my/our behalf for a limited purpose in the manner hereinafter appearing and subject to conditions as provided herein.

Now know you all and these presents witness that I/we do hereby nominate, constitute and appoint Farsight securities Ltd. (hereinafter

referred to as “the stock broker”) as my true and lawful attorney and authorise it to perform the following functions on my behalf:

I. to transfer securities held in my/our aforementioned beneficial owner account(s) or any other account informed by me in writing to the stock broker from time to time to the following demat accounts of Farsight Securities Ltd maintained for the purpose of securities of trades and margin obligations arising out of trades executed by me/us on any recognized stock exchange through the stock broker or expected margin requirement from my request / order to trade.

Sl No. Client/CM BP ID DP ID DP Name A/c Type

1 IN558205 IN301766 Farsight Securities Ltd NSDL NSE Pool

2 IN666177 IN301766 Farsight Securities Ltd NSDL BSE Pool

3 10122040 IN301766 Farsight Securities Ltd Margin A/c

4 1205630000000097 Farsight Securities Ltd CDSL NSE Pool

5 1205630000003288 Farsight Securities Ltd CDSL BSE Pay-out a/c

6 1205630000003292 Farsight Securities Ltd CDSL BSE Pay-in a/c

ii. to pledge the securities in favour of the stock broker for the limited purpose of meeting my/our margin requirements on short fall in connection with the trades executed by me/us on any recognized stock exchange through the stock broker.

iii. to return to me/us, the securities or funds that may have been received by the stock broker erroneously or those securities or funds that the stock broker was not entitled to receive from me/us.

iv. to send consolidated summary of my/our scrip-wise buy and sell positions taken with average rates to me/us by way of SMS/email on a daily basis notwithstanding nay other document to be disseminated as specified by SEBI from time to time.

v. To apply for various products like Mutual Funds, Public Issues (shares as well as debentures) right, offer of shares, tendering shares in open offers etc pursuant to oral/written/electronic instructions given by me/us to the stock broker.

I/We further agree and confirm that the powers and authorities conferred by this Power of Attorney shall continue until it is revoked (without notice) in witting by me/us. That the said revocation shall be effective from the date on which the revocation notice is received by the stock broker in his office at Karol Bagh. However, the revocation shall not absolve me / us from pay-in obligation and margin obligation undertaken prior to receipt of notice by the attorney and revocation shall be effective only after the existing obligations have been discharged in full in all respects.

IN WITNESS WHEREOF, I/We the above mentioned do hereby-set my/our hands hereon at on this day of the month of in the year in the presence of the following witness:

First Holder

Second Holder

Third holder

ACCEPTED For Farsight Securities Ltd.

Authorised Signatory

WITNESS (1):

NAME

SIGNATURE

ADDRESS

WITNESS (2):

NAME

SIGNATURE

ADDRESS