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Modification Form

This document is a form for requesting changes in demographic and other details for accounts held with Mansukh Securities & Finance Limited. It requires the account holder to provide personal information, contact details, occupation, annual income, and bank details. The form also includes declarations regarding the ownership of provided contact information and instructions for receiving electronic communications and statements of account.

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vorachirag98
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59 views1 page

Modification Form

This document is a form for requesting changes in demographic and other details for accounts held with Mansukh Securities & Finance Limited. It requires the account holder to provide personal information, contact details, occupation, annual income, and bank details. The form also includes declarations regarding the ownership of provided contact information and instructions for receiving electronic communications and statements of account.

Uploaded by

vorachirag98
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Mansukh Securities & Finance Limited

Mansukh House, Plot No. 6, Opp. Mother Dairy, Pandav Nagar, Delhi – 110 092
DP ID [ NSDL- IN301653, CDSL- 12016400 / 12016402 / 12016403 / 12016404 ]
FORM FOR CHANGE IN DEMOGRAPHIC AND OTHER DETAILS
I / We request you to make the following changes to my/our account. (Please Tick () whichever is applicable)
Demat Account Trading Account Both Date D D M M Y Y Y Y
(To be filled by the BO, Please fill all the details in BLOCK LETTERS in English)
DP ID Client ID Trading Code
Private Service Public Service Govt. Service Business Professional Retired
Occupation
Student Housewife Agriculturiest Others___________________________
Annual Income Up to 1 Lac 1-5 Lac 5-10 Lac 10-25 Lac 25 Lac – 1 Crore Above 1 Crore

Contacts Details for receiving SMS & electronic communications for above mentioned demat and trading accounts.
First / Sole Holder Second Holder Third Holder
Mobile No.

Email ID

I hereby declare that the aforesaid mobile I hereby declare that the aforesaid mobile I hereby declare that the aforesaid mobile
number belongs to Me or My family & number belongs to Me or My family & number belongs to Me or My family &
email id belongs to Me or My Family email id belongs to Me or My Family email id belongs to Me or My Family
(spouse, dependent children and dependent parents) (spouse, dependent children and dependent parents) (spouse, dependent children and dependent parents)
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.
Bank Details Primary Bank Details Secondary Bank Details
Bank A/c Type Savings Current C.C. / O. D.
Bank A/C
Bank Name :
Branch Address :
PIN Code :
IFSC Code MICR

Address Details

City PIN Code


State Country

Signature of Account Holder(s)


First / Sole Holder Second Holder Third Holder

Name

Signature

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