NOMINATION FORM FOR ELIGIBLE TRADING & DEMAT ACCOUNT (CDSL/NSDL) - ANNEXURE A

SEBI circular No. SEBI/HO/MIRSD/RTAMB/CIR/P and SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2022/23 dated July 23, 2021 and February 24, 2022
JM FINANCIAL SERVICES LIMITED
Reg. Office: 7th Floor, Cnergy, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400 025 FORM FOR NOMINATION
Adm. Office: 1st & 2nd Floor, Suashish IT Park, Plot No. 68 E, Off. Datta Pada Road, (To be lled in by individual applying singly or jointly)
Opp. Tata Steel, Borivali (East), Mumbai 400 066.
UCC
Date Client ID
DP ID
I/We wish to make a nomination. [As per details given below]
Nomination Details
I/We wish to make a nomination and do hereby nominate the following person(s) who shall receive all the assets held in my / our 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 Equally [If not equally, % % %
each please specify
Nominee 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)

City / Place:
State & Country:
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 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)}
9 Name of Guardian (Mr./Ms.)
{in case of minor nominee(s) }
10 Address of Guardian(s)

City / Place:
State & Country:
PIN Code
11 Mobile / Telephone No. of Guardian #
#
12 Email ID of Guardian
13 Relationship of Guardian with nominee
14 Guardian Identification details #
[Please tick any one of following
and provide details of same]
Photograph & Signature PAN
Aadhaar Saving Bank
account no. Proof of Identity
Demat Account ID
Page with Signature
(First/Sole Holder or Guardian Signature)
(Second Holder Signature) (Third Holder Signature)
(In case of Minor)
Name

FH SH TH
Signature

Details of Witness for Nomination*

Name of the witness Address Signature of witness*
FW
1.

2. SW

* Signature of witness, along with name and address are required, if the account holder affixes thumb impression, instead of signature
# Optional Fields (Information required at Serial nos. 5, 6, 7, 11, 12 & 14 is not mandatory)
Declaration Form for Opting out of Nomination
ANNEXURE B to SEBI circular No. SEBI/HO/MIRSD/RTAMB/CIR/P/2021/601 dated July 23, 2021
To, Date
JM FINANCIAL SERVICES LIMITED
Reg. Office: 7th Floor, Cnergy, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400 025
Adm. Office: 1st & 2nd Floor, Suashish IT Park, Plot No. 68 E, Off. Datta Pada Road, Opp. Tata Steel, Borivali (East), Mumbai 400 066.

UCC

DP ID
Client ID (only for Demat account)

Sole/First Holder Name

Second Holder Name

Third Holder Name

I / We hereby confirm that I / We do not wish to appoint any nominee(s) in my / our trading / demat account and understand the issues involved in non-
appointment of nominee(s) and further are aware that in case of death of all the account holder(s), my / our legal heirs would need to submit all the
requisite documents / information for claiming of assets held in my / our trading / demat account, which may also include documents issued by Court or
other such competent authority, based on the value of assets held in the trading / demat account.
First/Sole Holder Second Holder Third Holder
Name

Signature FH SH TH

Details of Witness
Name of the witness Address Signature of witness*
FW
1.

SW
2.

* Signature of witness, along with name and address are required, if the account holder affixes thumb impression, instead of signature
Notes: IV. Nomination in respect of the beneficiary owner account stands
1. All communication shall be sent at the address of the Sole/First holder rescinded upon closure of the beneficiary owner account.
only. Similarly, the nomination in respect of the securities shall stand
2. Thumb impressions and signatures other than English or Hindi or any terminated upon transfer of the securities.
of the other language not contained in the 8th Schedule of the V. Transfer of securities in favour of a Nominee shall be valid
Constitution of India must be attested by a Magistrate or a Notary discharge by the depository and the Participant against the legal
Public or a Special Executive Magistrate. heir.
3 For receiving Statement of Account in electronic form: VI. The cancellation of nomination can be made by individuals only
I. Client must ensure the confidentiality of the password of the holding beneficiary owner accounts on their own behalf singly or
email account. jointly by the same persons who made the original nomination.
Non-individuals including society, trust, body corporate,
II. Client must promptly inform the Participant if the email address
partnership firm, Hindu Undivided Family, holder of power of
has changed.
attorney cannot cancel the nomination. If the beneficiary owner
III. Client may opt to terminate this facility by giving 10 days prior account is held jointly, all joint holders will sign the cancellation
notice. Similarly, Participant may also terminate this facility by form.
giving 10 days prior notice.
VII. On cancellation of the nomination, the nomination shall stand
IV. Client is aware that he/she will not receivethetransaction rescinded and the depository shall not be under any obligation to
statements/intimations in paper form since client have opted for transfer the securities in favour of the Nominee(s).
digital mode of communication.
VIII. Nomination can be made upto three nominees in a demat account.
V. Client is aware that the transaction statement/intimations may In case of multiple nominees, the Client must please specify the
be accessed by other entities in case the confidentiality/secrecy percentage of share for each nominee that shall total upto hundred
of the login name and password is compromised. percent. In the event of the beneficiary owner not indicating any
VI In case of joint account, on death of any of the joint account percentage of alloction/ share for each of the nominees, the default
holders, the surviving account holder(s) has to inform Participant option shall be to settle the claims equally amongst all the
about the death of account holder(s) with required documents nominees.
within one year of the date of demise IX On request of Substitution of existing nominees by the beneficial
4. Instructions related to nomination, are as below: owner, the earlier nomination shall stand rescinded. Hence, details
I. The nomination can be made only by individuals holding of nominees as mentioned in the NOMINATION FORM at the time
beneficiary owner accounts on their own behalf singly or jointly. of substitution will be considered. Therefore, please mention the
Non-individuals including society, trust, body corporate, complete details of all the nominees.
partnership firm, Hindu Undivided Family, holder of power of X Copy of any proof of identity must be accompanied by original for
attorney cannot nominate. If the account is held jointly all joint verification or duly attested by any entity authorized for attesting
holders will sign the nomination form. the documents, as provided in KYC CHEKLIST.
II. A minor can be nominated. In that event, the name and address XI Saving bank account details shall only be considered if the
of the Guardian of the minor nominee shall be provided by the account is maintained with the same participant.
beneficial owner. XII DP ID and client ID shall be provided where demat details is
III. Only individual/natural person(s) can be a nominee(s). The required to be provided.
Nominee(s) shall not be artificial person created/ dressed by the 5. Strike off whichever is not applicable.
law or by a fiction such as trust, society, body corporate,
6. Two witness shall attest signature(s) / thumb impression(s) if the
partnership firm, Hindu Undivided Family, etc. A non-resident
account holder affixes thumb impression, instead of signature.
Indian can be a Nominee, subject to the exchange controls in
force, from time to time.

JM FINANCIAL SERVICES LIMITED

Reg. Office : 7th Floor, Cnergy, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400 025
Adm. Office: 1st & 2nd Floor, Suashish IT Park, Plot No. 68 E, Off. Datta Pada Road, Opp. Tata Steel, Borivali (East), Mumbai 400 066
Tel. No. : (91 22) 6761 7000, Email: [email protected]
Client Code_____________________ Demat BO ID________________________________
We hereby acknowledge the receipt of the Nomination Form from ________________________________________________who has nominated
_______________________________ his/her nominee for the Trading and Demat Account maintained with us.

JM FINANCIAL SERVICES LIMITED

Date D D M M Y Y Y Y Stamp & Signature