ZEBU SHARE AND WEALTH MANAGEMENTS PRIVATE LIMITED

CIN : U67120TZ2013PTC019704
ADDITION / MODIFICATION REQUEST FORM
P S K Booshnam Mahal, No 127, First Floor, 100 Feet Bypass Road, Velachery, Chennai-600042
044-48557991 www.zebuetrade.com assist@zebuetrade.com
Application No. Date D D M M Y Y Y Y
Please fill all the details in BLOCK LETTERS in English
DP ID: 1 2 0 8 0 4 0 0 BO ID : Trading Id / Client ID :

Account Holder’s Details

Name of First / Sole Holder

Name of Second Holder

Name of Third Holder

I / We request to carry out the change of address / signature in the Demat accounts
I / We request to carry out the change of address / signature in the KRA / CYKC / Demat accounts
I/We request you to make the following additions / modifications / deletions to my/our account in your records.
Details ( Please Specify )
Addition Modification Deletion

Bank Details Contact Details

Address ( Primary / Secondary ) Signature Change
( Telephone, Mobile, Mail id , etc )

Existing Details/Signature New Details/Signature

Signature duly attested by the Banker*

*Signature must be verified by Bank in case of signature modification/change
Attach an Annexure (with signature(s)) if the space above is found insufficient.
Kindly enclose self attested ID proof along with other documents

First / Sole Holder Second Sole Holder Third Sole Holder

Name

Signature with DP

====================(Official purpose only)====================

Received Account Details Addition / Modification / Deletions request as per details given below :

DP ID : 1 2 0 8 0 4 0 0 Date D D M M Y Y Y Y
BO ID : Trading Id / Client ID :

Modification requested for:

[Specify reason]

Authorized Signatory & Seal