Full Name :

Mother's Name :

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Address Type: -- Residential Business Residential & Business

Education : -- Under High School High School Graduation Master’s Degree Professional


Occupation : -- Business Self-Employed Salaried Housewife Retired Unemployed


Annual Income : -- Below 1Lac 1 Lac – 5 Lacs 5 Lacs – 10 Lacs 10 Lacs – 20 Lacs Above 20 Lacs


Place of Birth :

Segments :

Equity
Futures & Options
Commodity
Currency


Nominee Required :

Yes
No

Nominee DoB :

Nominee Pan No :

Nominee Relation :

Nominee Full Name :

Nominee's Mother's Full Name :

Nominee's Father's Full Name :

Nominee Income : -- Below 1Lac 1 Lac – 5 Lacs 5 Lacs – 10 Lacs 10 Lacs – 20 Lacs Above 20 Lacs

Nominee E-Mail :

Nominee Address :

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Signature Image :


Cancel Cheque/ Bank Statement (Latest 6 months) :

Income Proof (Optional) : -- Salary Slip ITR Acknowledgement DP Holdings Statement Net worth Certificate Bank Statement (Latest 6 Months) Others


Income Proof Upload :

Supporting Documents :

Reference Name (Anyone whom you know in this company) :

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