DP ID: Client Id - Karvy

1 Application for incorporating Changes in Client Details To: Karvy Stock Broking Ltd., Depository Participant, Karvy House , 46, Avenue 4, Street , Banjara Hills, Hyderabad 500 034 (DP Ids: IN300394; IN301557; IN301926; IN302470) I/We hereby request you to incorporate changes in my/our demat / Trading A/c as per the following details: Trading A/c Only Demat A/c Only Trading A/c + Demat A/c Change of Address Bank Details DP Details in Trading A/c Contact Details Trading Code: _____ dp id : _____ Client Id: _____ Old Address Details: New Address Details: City: PIN: City: PIN: Address Proof Enclosed: Voter ID Card Driving Licence Ration Card Rental Agreement Aadhaar Card Telephone Bill/Electricity Bill (not more than 3 months old) Bank Passbook/Bank Statement (not more than 3 months old) Others (Please specify)_____ Photo ID Proof Enclosed.

2 PAN Card Passport Voter ID Card Aadhaar Card Driving Licence Others (Please specify)_____ Old Bank Details: New Bank Details: Bank Name: Bank Name: Address: Address: Account No. Account No. IFSC Code: MICR: IFSC Code: MICR: Documents Enclosed: Cancelled Cheque Bank Passbook Bank Statement (not more than 3 months old) Photo ID Proof Enclosed: PAN Card Passport Voter ID Card Driving Licence Aadhaar Card Others (Please specify)_____ Additional Depository Details (For Trading A/c only) Old Details: DP ID_____ Client ID_____ DP Name: _____ New Details: DP ID_____ Client ID_____ DP Name: _____ Documents Enclosed: DP Client Master Report Statement of Transaction Statement of Holding Photo ID Proof Enclosed: PAN Card Passport Voter ID Card Aadhaar Card Driving Licence Others (Please specify)_____ Contact Details (OLD): Contact Details (NEW): Telephone (Land Line with STD Code):_____ Mobile:_____ Email Id:_____ Telephone (Land Line with STD Code):_____ Mobile:_____ Email Id.

3 _____ Signature(s) Name of A/c Holder First Holder Second Holder Third Holder I/We hereby authorize(Name)_____who sign as_____ to deliver the application to Karvy Stock Broking Limited. (Latest Transaction Statement to be provided) _____ _____ _____ Signature of Sole / 1st holder Signature of 2nd holder Signature of 3rd holder Client / Authorised representative to sign once again in the presence of Karvy officials_____ Branch: Emp ID:_____ Emp Name: _____ Sign:_____ Branch Seal: H O: Emp ID:_____ Emp Name: _____ Sign:_____ Acknowledgement We hereby acknowledge the receipt of your request for A/c Modification for the following Account subject to verification: dp id : _____Client ID:_____, Trading A/c:_____ Client Name.

4 Office Seal, Sign, Date & Time of Receipt Instructions: 1) All documents should be self attested. 2) All documents shall be verified against original. 3) In case of a joint A/c, all holders should sign. Date: D D M M Y Y Y Y A - 5A - 5 IDENTITY DETAILS Please affixyour recent passportsize photograph andsign across itPHOTOGRAPH1. Name of the Applicant3a. Gender 3b. Marital status Single MarriedMale Female 3c. Date of Birth/DDMMYYYY/ 5a. PAN ADDRESS DETAILSOTHER DETAILS 4. Any other information:2. Occupation (Please tick any one and give brief details): HousewifeStudentOthers (Please specify) Private Sector Government ServiceBusinessProfessionalAgriculturist Retired 3.

5 Please tick, if applicable: Politically Exposed Person (PEP) Related to a Politically Exposed Person (PEP)OR1. Gross Annual Income Details (Please Specify) Income range per annum: Below 1 Lac 1-5 Lac 5-10 Lac 10-25 Lac More than 25 LacsNet-worth (Net worth should not be older than 1 year) Amountas on (date)/DDMMYYYY/Date:I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and 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 3. Contact DetailsTel. (Off.)Tel. (Res.)E-Mail Nationality Indian Other (Please specify) 1. Address for Correspondence Pin CodeCity / Town / Village4. Permanent Address (If different from above or overseas address, mandatory for Non-Resident Applicant)City / Town / Village Pin CodeCountryPlease fill this form in ENGLISH and in BLOCK LETTERS(Please tick the box on left margin of appropriate row where CHANGE/CORRECTION is required and provide the details in the corresponding row) Acknowledgement REQUEST (Please tick the appropriate) 2.

6 Father s/Spouse Name5b. Unique Identification Number (UID) / Aadhaar, if any: 6. Specify Proof of Identity submittedPAN cardOther (Please specify) A 4b. Status Resident Individual Non Resident Foreign NationalBStateCountryFax2. Specify the Proof of Address submitted for Correspondence Address:StatePublic SectorC/DDMMYYYY/DECLARATIONDS ignature of the ApplicantKNOW YOUR Client (KYC) Application Form - For Individual5. Specify the Proof of Address submitted for Permanent Address:Mobile NoFOR OFFICE USE ONLYDate of IPV:/DDMMYYYY/Name of the person who has done the IPV:Designation:Employee ID:Name of the Organization: Signature of the person who has done the IPVS ignature of the Authorised SignatorySeal/Stamp of the IntermediaryDate(Originals Verified) True copies of Documents received(Self Attested) Self Certified Document copies receivedIn Person Verification (IPV) Details:KNOW YOUR Client (KYC) - APPLICATION FORM - FOR INDIVIDUALKARVY STOCK BROKING LIMITED, 46, Avenue 4, Street No.

7 1, Banjara Hills,Hyderabad 500 034; Ph : 040 2331 2454, Fax: 040-23311968 NEW CHANGE REQUEST (Please tick (3) the appropriate)Please fill this form in ENGLISH and in BLOCK LETTERSAPPLICATION of entity Documentary requirements Corporate oCopy of the balance sheets for the last 2 financial years (to be submitted every year). o Copy of latest share holding pattern including list of all those holding control, either directly or indirectly, in the company in terms of SEBI takeover Regulations, duly certified by the company secretary/Whole time director/MD (to be submitted every year). oPhotograph, POI, POA, PAN and DIN numbers of whole time directors/two directors in charge of day to day operations. oPhotograph, POI, POA, PAN of individual promoters holding control - either directly or indirectly. oCopies of the Memorandum and Articles of Association and certificate of incorporation. oCopy of the Board Resolution for investment in securities market. oAuthorised signatories list with specimen signatures.

8 Partnership firmoCopy of the balance sheets for the last 2 financial years (to be submitted every year). oCertificate of registration (for registered partnership firms only). oCopy of partnership deed. oAuthorised signatories list with specimen signatures. oPhotograph, POI, POA, PAN of Partners. TrustoCopy of the balance sheets for the last 2 financial years (to be submitted every year). oCertificate of registration (for registered trust only). oCopy of Trust deed. oList of trustees certified by managing trustees/CA. oPhotograph, POI, POA, PAN of Trustees. HUFoPAN of HUF. oDeed of declaration of HUF/ List of coparceners. oBank pass-book/bank statement in the name of HUF. oPhotograph, POI, POA, PAN of of Existence/Constitution document. associationoResolution of the managing body & Power of Attorney granted to transact business on its behalf. or a body of oAuthorised signatories list with specimen signatures. individuals Banks/oCopy of the constitution/registration or annual report/balance sheet for the last 2 financial years.

9 Institutional oAuthorised signatories list with specimen signatures. Investors Foreign Institutional oCopy of SEBI registration certificate. Investors (FII) oAuthorised signatories list with specimen Government oSelf-certification on letterhead. Bodies oAuthorised signatories list with specimen signatures. Registered Society oCopy of Registration Certificate under Societies Registration Act. oList of Managing Committee members. oCommittee resolution for persons authorised to act as authorised signatories with specimen signatures. oTrue copy of Society Rules and Bye Laws certified by the Chairman/Secretary. INSTRUCTIONS/CHECK LIST FOR FILLING KYC FORMA. IMPORTANT POINTS: attested copy of PAN card is mandatory for all clients , including Promoters/Partners/Karta/Trustees and whole time directors and persons authorised to deal in securities on behalf of company/firm/others. of all the documents submitted by the applicant should be self-attested and accompanied by originals for verification.

10 In case the original of any document is not produced for verification, then the copies should be properly attested by entities authorised for attesting the documents, as per the below mentioned list. any proof of identity or address is in a foreign language, then translation into English is required. & address of the applicant mentioned on the KYC form, should match with the documentary proof submitted. correspondence & permanent address are different, then proofs for both have to be submitted. proprietor must make the application in his individual name & capacity. non-residents and foreign nationals, (allowed to trade subject to RBI and FEMA guidelines), copy of passport/PIO Card/OCI Card and overseas address proof is mandatory. foreign entities, CIN is optional; and in the absence of DIN no. for the directors, their passport copy should be given. case of Merchant Navy NRI's, Mariner's declaration or certified copy of CDC (Continuous Discharge Certificate) is to be submitted.