Account details addition/modication/deletion request form
Zerodha Broking Limited Application number Dated
Zerodha Commodities Private Limited
Please ll all details in BLOCK LETTERS in English
DP ID 12081600 BO ID Client (Login) ID
Account holder details
First/sole holder Second holder Third holder
Name
Mother’s name
Aadhaar
PAN
I/We request to carry out the change of address/signature in the demat account.
I/We request to carry out the change of address/signature in the KRA and demat account.
I/We request you to make the following additions/modications/deletions to my/our account in your records.
Details: Please specify ‘Change of Type of change: Please specify
address’, ‘Change of bank details’, Existing details New details
if addition/modication/deletion
‘Change of telephone number’, etc.
Attach an annexure (with signature(s)) if the space above is found insufcient.
First/Sole Holder
or Guardian
F (in case of Minor) S Second Holder T Third Holder
FOR OFFICE USE ONLY
In Person Verification (IPV)details:
Name of the Person who has done the IPV:___________________________________________________
Designation: ____________________________________ Employee ID: __________________________
Name of the Organization: ZERODHA BROKING LTD.
Date of the IPV: D D M M Y Y Y Y Signature of the Person who has done the IPV Seal/Stamp of the Intermediary
Acknowledgement
We have received the account modication/addition/deletion request for the account with details below on D D M M Y Y Y Y
DP ID Client ID Application no.
First/sole holder Second holder Third holder
Account holder’s name
Modication request for
Seal & signature of
authorised signatory