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E-KYC Declaration Form

All fields are to be filled mandatory

Advisor Declaration
Applicant’s Declaration
I have carried out KYC Document
Verification/ Attestation and In Person
NAME: _____________________________
Verification of the above customer
PAN: ______________________________

Advisor Name: ____________________


I hereby provide my consent to do KYC and ARN-229091
ARN Code: _______________________
authorise sharing of this information with
E433825
SEBI Registered intermediaries / KRAs. All EUIN: ___________________________
information provided are true and correct.
Organization: ______________________
Designation: _______________________
Applicant’s Signature:

Sign here:
IPV Date: ______________________

Advisor Signature:
Sign here

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