1.

Personal Details
Name* PRATIK PRADEEP SAJEKAR
Maiden Name (If any*)
Father/Spouse Name* PRADEEP SAJEKAR
Mother Name*
Date of Birth* 04/06/2004
Gender* Male
Marital Status* Unmarried
Citizenship* Indian
Residential Status* Resident Individual
Occupation Type* STUDENT
2. Proof of Identity
PAN* QHEPS2122G
AADHAAR*
3. Proof of Address
Address Type* RESIDENTIAL/BUSINESS
Proof of Address* AADHAAR
Correspondence Address
Address Line 1* S/O PRADIP,ANANT DESHMUKH CHAWL, AZAD NAGAR NO.1
Address Line 2 HANUMAN CHOWK,NEAR CASTLE MILL
Address Line 3 THANE,THANE
City/Town/Village* THANE
State* MAHARASHTRA
Country* INDIA
Pincode* 400601
Permanent Address
Address Line 1* S/O PRADIP,ANANT DESHMUKH CHAWL, AZAD NAGAR NO.1
Address Line 2 HANUMAN CHOWK,NEAR CASTLE MILL
Address Line 3 THANE,THANE
City/Town/Village* THANE
State* MAHARASHTRA
Country* INDIA
Pincode* 400601
4. Contact Details
Tel.(Off.) Tel.(Res.)
Mobile No.* 9076191090 Fax
Email ID* pratiksajekar04@gmail.com
5. EMUL
I hereby declare that the aforesaid mobile number belongs to SELF
I hereby declare that the aforesaid E-mail ID belongs to SELF

1
6. Applicant Declaration
I/We hereby declare that the KYC details furnished by me are true and
correct to the best of my/our knowledge and belief and I/we under-take to
inform you of any changes therein, immediately. In case any of the above
information is found to be false or untrue or misleading or
misrepresenting, I am/we are aware that I/We may be held liable for it. I
am aware of other modes of KYC which are available and I have chosen
Aadhaar based method voluntarily. My Aadhaar record can be used by
KRA agencies only for the specific purpose validating/ maintaining/
sharing my KYC record and as an audit evidence. I will have an option to
request for deleting of my Aadhaar record. I hereby give my consent for
receiving information including Central KYC Registry through SMS/Email
on the above registered mobile number/email address. I am/we are also
aware that for Aadhaar OVD based KYC, my KYC request shall be
validated against Aadhaar details. I/We hereby consent to sharing my/our
masked Aadhaar card with readable QR code or my Aadhaar XML/Dig
locker XML file, along with pass code and as applicable, with SEBI, KRA,
CKYC and other Institutions/ agencies/ Intermediaries with whom I have
a business relationship for KYC purposes only.
Date Place
7. Attestation/For Office use only
Document Received
Intermediary/Institution Details In-person verification (IPV), Documents verified with original & Client interviewed by
Name Globe Capital Market Employee/SB/AP ASHWANI KUMAR SEBI Number of AP (If Globe Capital Market
Limited(GCML) name Applicable) Limited(GCML)
Employee ID G00547 Designation Executive
CKYC Institution IN0116 Signature esigned
Code

2
3
 DigiLocker verified e-Aadhaar
This document is generated from verified Aadhaar XML obtained from DigiLocker with due user consent and authentication

Document type e-Aadhaar generated from DigiLocker verified Aadhaar XML

XML verified

Generation date 2024-02-22T17:26:58.913+05:30 Download date 2024-02-22T17:26:58.913+05:30

Masked Aadhaar number

xxxxxxxx7244
Name Pratik Pradeep Sajekar

Date of Birth 04-06-2004

Gender Male

c/o , s/o S/O Pradip

Address S/O Pradip,Anant Deshmukh Chawl, Azad

Nagar No.1, Hanuman Chowk,Near Castle
Mill,Thane,Thane,Thane,Maharashtra,400601

Landmark Near Castle Mill Locality Anant Deshmukh Chawl, Azad Nagar No.1, Hanu

City / District Thane

Pin Code 400601 State Maharashtra

www.digio.in | For Limited Circulation | CONFIDENTIAL 4

Digitally signed e-Aadhaar XML

<?xml version="1.0" encoding="UTF-8" standalone="yes"?>

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