SBISecurities Modification Form

Investment aur Trust, Dono

(° Marked Flclds arc Mandatory)

To,
SBICAP Securitles Limited INDOC NO:
Marathon Futurex, B-wing, 12th Floor, Received Date:_/
Lower Parel East, Mumbaj - 400013.
Date: | 06 2024.
iJAYANTA MATOKDAuest:SBICAP Securities Limited to modify the below mentioned details in my/our account.
tyaia Majumdlot.
" DP Number 20472 0o269779 " Trading Account
KRJo52
" PAN of 14 Holder AERPM98|5 *Gender MMale *Date of Birth
28/08/1960
* Client Type INDIVIDUAL/ NON-INDIVIDUAL
" Marital Status O
Single / Married Female

Father's ISpase Name] LATE MONI_ MOHAN MAJUMDAR Nationality ndian/ Qers
New Details
Request For Modification Existing Details

Correspondence Address

Permanent Address

Email ID-Should be in
capital letter NOT PRoVIDED JAYANTA. MATUMDAR147@ GMAIL.CoM
Mobile +91 9474462471. +91 754897347O.
Occupation

OUpto 1 Lac Rs.1 Lac to Rs.5 Lac Rs.5 Lac to OUpto 1Lac Rs.1 Lac to Rs.5 Lac Rs.5 Lac to
Rs. 10 Lac Rs.10 Lac to Rs.25 Rs.25 Lac to Above Rs. 10 Lac Rs.10 Lac to Rs.25 L Rs.25 Lac to Above
Income Range
(Specify) (Specify)

Default Bank Details

A/c No.
Bank Name
IFSC
MICR

Bank Details 1
A/c No.
Bank Name
IFSC
MICR

Bank Details 2
A/c No.
Bank Name
IFSC
MICR

Bank Details 3
A/c No.
Bank Name
IFSC
MICR
 Default DP ID

DP ID 1

DP ID 2

DP ID 3

We wish to undate the above changes in KRA/ Demat/Trading 2ccount.

members (if anyl

Family Declaration: (Use separate sheet for more family
S per SEBlguidelines, please fill up the below declaration, in case Email/ iobie is already updated in sole i.e. first hoider account and you wish to update detais
Family members. +917548973470 JAYANTA. MAJUMDAR 147@GMA 1L.COM
sole /first account
and Email ID being belonging to
land mysnall
orer family members hereby
be considered in yourrequest
recordsthat
for mobile numberof being
the purpose receiving communication from you or Stock Exchanges or Depository with regard to details oT traoins
transactions executed through you.
number and e-mail !D. This facility shall be extended to us as
Inus, any communication relating to our trading and demat account should be sent to the above mentioned mobile
an exception, for our convenience of receiving transaction details at a single mobile number and e-mail ID.
Iunderstand that for the purpose of availing the above fYcility "family" means selft, spouse, dependent children and dependent parents.
Relationship with sole/ first holder Signature
Client Name Client Code

Jayant Mojumda KRIJO52 Spouse l MSoEather ISon/ Daughter oyanta Majuemda

Madkui Majemdan Spouse ISbeusorI Son | Daughter
Spouse IMother IFather | Son !Daughter
|Medhud Moumdar
Spouse I Mother i Father ISon I Daughter

Declaration: (/We hereby declare that the details furnished SBICAP Securities Limited
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
IPV Verification
false or untrue or misleading or misrepresenting, Iam/we are Person Name doing IPV Please Affix Rubber Stemp and ign
aware that l/we may be held liable for it.
Designation/ SSL Emp code
In case of email / mobile updation, I hereby give consent to
receive all communication from SBICAP Securities on the Date of IPV/ Document Verification

above email/mobile number. Signature of the Person

Name of the Account Holder |JAYANTA MAJUMDAR MADHURI MAJUMDAR

Signature of the Holder 1st Holder 2nd Holder 3rd Holder

(Incase of Non Individual Account
affix stamp with signature) tyanta Kyjundar Madhioi Majmd
This is a physically signed document. Details of the authentications are as below

Request For Modification from ID Authentication Type Authentication Status Authentication Date / time

Registered & Corporate Dffice: SBICAP Securities limited

Marathon Futurex, Unit No. 1201, B-Wing. 12th Floor. NMJoshi Marg, Mafatlal MillCompound, Lower Parel East, Mumbai 400013.
Corporate ldentity Number (CIN): U65999MH2005PLC155485 | www.sbisecurities.in
NSE, BSE, MCX-SX &MCX | SEBI Registration No.: Stock Broker: INZO00200032 | DP Registration No.: IN-DP-314-2017
Research Analyst :INHO00000602 Portfolio Manager: INPOO0004912 | IRDA : CAO103 | AMFI ARN No. 0011