* WIRE Ref No.
For Head Office Use
Inward No:
Received Date:
Requisition form for Addition / Deletion / Modification of Account Details in Equity/Commodity
EQUITY COMMODITY BOTH Date:___/___/___________
To,
Motilal Oswal Securities Ltd. / Motilal Oswal Commodities Broker Pvt. Ltd.
2nd Floor, Palm Springs Center, Malad Link Road, Malad (W), Mumbai - 400 064. *Mandatory Fields
I/We request you to make the following Addition/Deletion/Modification to my/our account in your records. Account details are as under: -
* Depository Account Number: 1 2 0 1 0 9
* Trading Account Number: *PAN of 1st Holder:
* Please tick Request & Category
Request For Category Existing Details New Details
1
Modification Address Details
Email ID
Mobile / Landline Number
Bank Details
Signature
Note: In case of Addition, please enter 'Nil' in "Existing Details'
2 Request For Category Existing Details New Details
Addition Bank Details
Modification Other DP Details
____________ pls specify
____________ pls specify
____________ pls specify
I/We wish to update the above changes in KRA / Demat / Back office account.
Family Declaration:
Please Fill up below declaration in case Email/ Mobile is already updated in sole / first holder account and wish to update same details for
Family member/s as per SEBI guidelines.
I and my family members hereby request that mobile number being ____________________and email ID being ____________________________________,
belonging to sole / first account holder shall be considered in your records for the purpose of receiving communication from you or Stock Exchanges or Depository
with regard to details of trading / DP transactions executed through you.
Thus, any communication relating to our trading and demat account should be sent to the above mentioned mobile number and e-mail ID. This facility shall be
extended to us as an exception, for our convenience of receiving transaction details at a single mobile number and e-mail ID. I understand that for the purpose of
availing the above facility “family” means self, spouse, dependent children and dependent parents.
Sr. No. Client Name Client Code Relationship with sole/ first holder Signature
Use separate sheet for more family members (if any)
Declaration : I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief. In case any of the
above information is found to be false or untrue or misleading or misrepresenting, I am/we are aware theat I/we may be held liable for it.
* Client Name Sole / First Holder Second Holder Third Holder
* Client Signature
" " " " "Version: 1.4
"
Acknowledgement
Received Addition/Deletion/Modification request for: Address Details Email ID Mobile/Landline Number Bank Details Signature Other DP Details
Depository Account Number: 1 2 0 1 0 9
Receipt Date and Stamp
Trading Account Number:
Version: 1.4