Date:

D D M M Y Y

Code

PERSONAL INFORMATION SHEET

Region:
City: Phot ograph

To,
Sign across
KARVY STOCK BROKING LTD. Phot ograph
Regd Off: 46, Avenue 4, Street No.1, Banjara Hills, Hyderabad - 500 034, Andhra Pradesh, India

Dear Sir/ Madam,

I, the undersigned, desirous of being engaged as ‘Variable Sales Associate’ for introduction of client at NSE/BSE cash
and F&O segment , have duly filled in & submit for your perusal the Personal Information Sheet as below:-
Name*

Father / Husband name*

Correspond ence Addr ess* Mailing Permanent

House no House no

Bldg Name Bldg Name

Road Roa d

Are a Area

City City

State State

Country India Cou ntry India

Pin code Pin code

Tel no (O)* Te l no (O)

(R / M) (R / M)

Bank Details:
Bank Name:* A/c No.:*
IFSC code: Branch address:

E-mail id:*

Date of Birth:* (Should not be less than 18 years)

Pan Card no* (Commission would not be released if Pan Card is not
provided)
References:*
Name:
Address

Tel no (R/M) (O)

Signature

For officia l Use o nly:

Reporti ng Name: _ _ Emp Code: _

Email id: _ _ Date received: _

To:

Mr. /Ms.
Address

Sub: Your appointment as a Variable Sales Associate

Sir,

We are pleased to appoint you as a Variable Sales Associate. You will introduce us clients for dealing in
securities at BSE/NSE from time to time.

You will be paid Commission for the clients introduced by you based on the table mentioned below and the
deal chosen by you. Commission will be paid on monthly basis by 10th of every month based on activation of
clients in a calendar month subject to deduction for waiver of Account Opening Charges, reduction due to
lower brokerage rate to be charged to the client and cheque bouncing charges.

Please tick any one Deal out of 2 as per the table below. (To be filled by VSA)

Commission payout as per Deal 1:

Measure Payouts
NCA Account Opened and cheque cleared within 30 days from Cheque issue Date Rs. 250/-
C2T (Assisted) At least once within 60 days of Account activation. Rs. 300/-
C2T(Online) At least once within 60 days of Account activation. Rs. 350/-
Fixed Fee Accounts opened and cheque cleared with no refund claims. 5% of Fixed
Commission Fee Plan Amt

Commission payout as per Deal 2:

Measure Payouts
NCA Account Opened and cheque cleared within 30 days from Rs. 250/-
Cheque issue Date.
C2T (Assisted) At least once within 60 days of Account activation. 15% of Brokerage Generated
in a year from NCA date.
C2T(Online) At least once within 60 days of Account activation. 20% of Brokerage Generated
in a year from NCA date.

Short forms Used:

NCA: New Customer Acquisition (NCA is considered when an account is first activated)
C2T: Convert to trade
NCA Date: The day Izone account is activated.
C2T (Assisted): The client places an order through dealer/ Customer Dealing desk (CDD) or by visiting Karvy branch.
C2T (Online): The client places an order online after login into his account.

Exception Handling:
 Incase the account opening charges are waived off then equivalent amount would be deducted from
the commission of that individual.
 In case the brokerage is reduced due to approval and without VFM subscription plans; no commission
would be paid for that account to the VSA under Deal 1.
 Karvy Staff/ Allied Bank’s staff accounts will not be considered for commission calculation.
 Penalty on bounced Cheques would be deducted from monthly VSA payout as per the table below.
 No of Cheque Bounce Cases in a month Penalty
1St Cheque Nil
2nd Cheque Rs. 100/-
3rd Cheque Rs. 100/- Per case
> 3 Cheques Rs. 200/- Per case

The agreement will be automatically terminated on return of 4th cheque from the clients introduced by you
during a particular month.

Please sign in duplicate in token of your confirmation that the terms & conditions are acceptable to you.

Thank you,

For Karvy Stock Broking Ltd.

Authorised Signatory.

I/we accept the above-mentioned terms & conditions.

(Signature of VSA)