Zerodha Securities Pvt. Ltd.

153/154, 4th Cross, 4th Phase, JP Nagar, Dollars Colony,

Opp. Clarence School, Bangalore - 560078
Additional KYC Form for Opening a Demat Account
For Individuals
(To be filled by the Depository Participant)
Application No Date D D M M Y Y Y Y DP Internal Reference No
DP ID 12081600 Client ID
(To be filled by the applicant in BLOCK LETTERS in English)
I/We request you to open a demat account in my/ our name as per following details:-
Holder Details
Sole / First Holders Name
PAN UID
Second Holders Name
PAN UID
Third Holders Name
PAN UID
*In case of Firms, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc., although the account is opened in the
name of the natural persons, the name of the Firm, Association of Persons (AOP), Partnership Firm, Unregistered Trust, etc.,
should be mentioned above.
Type of Account (Please tick whichever is applicable)
Status Sub Status
Individual Individual Resident Individual-Director
Individual Directors Relative Individual HUF / AOP
Individual Promoter Minor
Individual Margin Trading A/c (MANTRA) Others(specify)

NRI NRI Repatriable NRI Non-Repatriable

NRI Repatriable Promoter NRI Non-Repatriable Promoter
NRI Depository Receipts Others (specify)
Foreign National Foreign National Foreign National - Depository Receipts Others (specify)

Details of Guardian (in case the account holder is minor)

Guardians Name PAN
Relationship with the applicant
I / We instruct the DP to receive each and every credit in my / our account [Automatic Credit] Yes No
(If not marked, the default option would be Yes)
I / We would like to instruct the DP to accept all the pledge instructions in my /our account without Yes No
any other further instruction from my/our end (If not marked, the default option would be No)

Account Statement Requirement As per SEBI Regulation Daily Weekly Monthly Fortnightly
I / We request you to send electronic transaction-cum-holding statement at the following Yes No
Email ID
I / We would like to share the email ID with the RTA Yes No
I / We would like to receive the Annual Report Physical Electronic Both Physical and Electronic
(Tick the applicable box. If not marked the default option would be in Physical)

12 Sign wherever you see

I/We would wish to avail the following facility:
Basic Service Demat Account facility (BSDA)
Yes No
Rajiv Gandhi Equity Savings Scheme (RGESS) Yes No
I/We wish to receive dividend/interest directly in to my bank account as given below through ECS. Yes No
(If not marked, the default option would be Yes) [ECS is mandatory for locations notified by SEBI from time to time ]
Bank Details [Dividend Bank Details]
Account type Saving Current Others (specify)
Bank Code (9 digit MICR code) IFS Code (11 character)
Account number
Bank Name
Branch Name
Bank Branch Address
City State
Country PIN code
(I) Photocopy of the cancelled cheque having the name of the account holder where the cheque book is issued, (or)
(ii) Photocopy of the bank statement having name and address of the BO
(iii) Photocopy of the passbook having name and address of the BO, (or) (iv) Letter from the Bank.
*In case of options (ii), (iii) and (iv) above, MICR code of the branch should be present/mentioned on the document.

Other Details
Gross Annual Income Details (please specify): Income Range per annum
Below Rs 1 Lakh 1-5 Lakh 5-10 Lakh 10-25 Lakh >25 Lacs
Or Net-worth as on ________________date___________________ (Net worth should not be older than 1year)
Occupation :_______________________________________________________________________________________
Please tick, if applicable: Politically Exposed Person (PEP) Related to Politically Exposed Person (RPEP)
Any other information:________________________________________________________________________________

SMS Alert Facility

MOBILE NO. +91 _____________________________
Refer to Terms &
Conditions given in [Mandatory, if you are giving Power of Attorney (POA)]
Annexure - 2.4 (if POA is not granted & you do not wish to avail of this facility, cancel this option).

Transactions Using I wish to avail the TRUST facility using the Mobile number registered for SMS Alert Facility. I have
Secured Texting Facility read and understood the Terms and Conditions prescribed by CDSL for the same.
(TRUST). Refer to Terms I/We wish to register the following clearing member IDs under my/our below mentioned BO ID
and Conditions registered for TRUST
Annexure 2.6
Yes No
Stock Exchange Name/ID Clearing Member Name Clearing Member ID (Optional)

To register for easi, please visit our website www.cdslindia.com. Easi allows a BO to view his
ISIN balances, transactions and value of the portfolio online.

13 Sign wherever you see

 Zerodha Securities Pvt. Ltd.
153/154, 4th Cross, 4th Phase, JP Nagar, Dollars Colony,
Opp. Clarence School, Bangalore - 560078

Schedule-A Tariff Structure

For individuals/HUF/corporates
Details POA Clients
Option-1
Stamp charges payable upfront Rs.50/-
Annual Maintenance Charges
a. Individuals/Non Individual (except Corporate) Rs.300/- +Service Tax
b. Non Individual - Corporate Rs.1000/- + Service Tax
Transaction Charges : (Market Trades)
a. Buy(Receive) Nil
b. Sell (Debit) Rs.8/- + Rs 5.50/- (CDSL Charges)
Transaction Charges : (Off-Market Trades)
a. Buy(Receive) Nil
b. Sell (Debit) 0.03% or Rs.25/- whichever is higher
Demat (Per certificate) Rs. 10/- (Subject to minimum of Rs.25/- per ISIN)
Rs. 15/- (Subject to minimum
Remat (Per certificate)
of Rs. 50/- per ISIN) + CDSL Charges
Courier charges per Demat/Remat/Demat Rejn. Rs. 50/-
Pledge Request Rs. 20/- + Rs. 12 per request (CDSL Charges)
Unpledge Request Rs. 20/- + Rs. 12 per request (CDSL Charges)
Pledge invocation Rs. 20/-
Periodic Statement
a. By Email Free
b. Physical Rs. 50/- (+Courier charges at actual)
Adhoc / Non Periodic Statement Requests
a. By Email Rs.10/- per request
Rs. 50 per request upto 10 pages. Every additional page
b. Physical
at Rs. 5 (+Courier charges at actual)
Delivery instruction
a. First Delivery Instruction Book Free (10 Leaves)
b. Every Addl Booklet (10 Leaves) Rs.100/-
Cheque Bounce Charges Rs. 350/-
Failed Transactions Rs. 50 per ISIN
Modification in CML Rs. 25/- per request
KRA Upload / Download Rs. 50/-
NOTE :
For all purposes the bill date shall be construed as the date demand and the bills will be considered as the bill cum notice for
payment and Zerodha Securities Pvt. Ltd. reserves the right to freeze depository account for debit transaction in case of non
payment of charges after two days from the bill date.
Interest at 18% p.a will be charged on the outstanding bill amount if not paid within the due date. The above tariff is subject to
change. Changes if any will be intimated 30 days in advance Annual Maintenance Charge (AMC) is non refundable. Service
Tax is applicable on all above charges except stamp charges.

First/Sole Holder
or Guardian
F1 (in case of Minor) S1 Second Holder T1 Third Holder

14 Sign wherever you see

Date : D D M M Y Y Y Y
To,
Zerodha Securities Pvt. Ltd.
153/154, 4th Cross, Dollars Colony, 4th Phase, JP Nagar, Opp. Clarence Public School, Bangalore - 560078.

Dear Sir,
Sub : Requesting for bill/transaction/holding statement through email.

I/We request you to send me/us bill, transaction and holding statement of my CDSL Demat account no. 12081600__________
________at following email address: ____________________________________________________________________
I/We fully agree and are aware of following Terms and Conditions mentioned below.
(a) that I/We will not receive the bill, transaction and holding statements in paper form.
(b) that I/We will take all the necessary steps to ensure confidentiality and secrecy of the login name and password of the
internet/email account.
(c) that I/We am/are aware that the bill, transaction and holding statements may be accessed by other entities in case the
confidentiality /secrecy of the login name and password is compromised.
(d) that I/We in case bill, transaction and holding statements are sent by email, I/We will immediately inform the Zerodha
Securities. about change in email address, if any.
In case, the Zerodha Securities is not able to provide bill/transaction statement to its Clients by email or on website due to any
reason (including bounced emails), Zerodha Securities Pvt. Ltd. will ensure that the transaction statement is provided to me/us
in paper form as per the time schedule stipulated in the Bye Laws & Business Rules of CDSL.

I/We hereby request you to send the statements:

Daily Fortnightly Weekly Monthly

Yours faithfully,

First/Sole Holder
or Guardian
F2 (in case of Minor) S2 Second Holder T2 Third Holder

15 Sign wherever you see

 Space For Franking
Power Of Attorney (Voluntary)
KNOW ALL MEN BY THESE PRESENTS THAT I/WE Mr./Ms./M/s.(First holder) __________________________________________
_______________________________ (Second holder) _________________________________________________________
(Third holder)________________________________________ an individual/a sole proprietary concern/a partnership firm/a body
corporate/trust, registered/incorporated, under the provisions of the Indian Partnership Act, 1932/the Companies Act 1956/2013, or
any relevant Act, having his/her/its residence/registered office/place of business at
__________________________________________
_______________________________________________ (hereinafter referred to as Beneficial Owner) wish to avail/have availed
the broking/e-broking facilities and services offered (hereinafter referred to as "Services") by Zerodha (hereinafter referred to as
Zerodha), a Partnership Firm registered under the Indian Partnership Act of 1932, having its registered office at 153/154, 4th Cross,
4th Phase, JP Nagar, Dollars Colony, Opp. Clarence School, Bangalore - 560078 and is a Member (Trading Member) of the National
Stock Exchange of India Limited (NSE) & Bombay Stock Exchange limited (BSE) respectively (hereinafter referred to as the
Exchange).
Whereas in the course of availing the services and for meeting the settlement obligation thereof on the Exchanges, I/We do hereby
nominate, constitute and appoint M/s. Zerodha (Member Broker), hereinafter referred to as Zerodha acting through their Partners
and/or duly authorised staff for the purpose, as my/our true and lawful attorneys for my depository account with Zerodha Securities
Pvt. Ltd. (Depository Participant) DP ID 12081600, Client ID ___________ to execute and perform severally the following acts, deeds,
matters and things, provided the attorney complies with all applicable conditions of all or any of their services offered by them in their
1. To have and exercise the powers and/or authority, to do and/or execute the acts, deeds, matters and things specified in Mandatory
and Voluntary Client Registration Documents between Zerodha and the Beneficial Owner as may be applicable in relation to the
transactions executed by the client.
2. To Operate depository account/(s) for the purpose of transferring any collateral to the margin account and honouring delivery
obligations for any transaction executed with Zerodha Securities Pvt. Ltd. which is registered as a Depository Participant, as a stock
broker registered with Securities and Exchange Board of India (SEBI).
3. To Sign instructions on my behalf with respect to debit/credit the depository account/(s) for the credit or benefit of my/our account
with Zerodha for the transactions carried by me/us with Zerodha.
4. To issue instructions relating, executing delivery/receipt instructions, pledge creation instructions, pledge closure instructions,
lending and borrowing instructions, to operate the depository account by issue and receipt of instructions for the above mentioned
purpose and such other authorization given by me/us severally on behalf of all of us, or all/any of us jointly, in any electronic form, in
any format and at any time either through the portal of Zerodha or through the internet will be validly constituted attorney to intimate the
same to the Depository Participant for the purpose of debiting or crediting my account opened with the Depository Participant.
5. To validate on my/our behalf any such instruction so given to the Depository Participant(s), in written/physical or other form as may
be required by the concerned Depository Participant.
6. For these purposes and to this extent, Zerodha is empowered by me/us, to affix their signatures to any document, form or any other
record, being a delivery participant, as required by the concerned depository.
7. I/We also undertake to pay such demat charges/fees and such other charges incurred by Zerodha under this Power of Attorney and
that I/We further authorise Zerodha to debit my/our account with Zerodha with the said charges as and when the same becomes due
for payment and I/we hereby undertake to pay the same immediately on demand made by Zerodha. All charges have been mentioned
in the Tariff sheet in the application form.
8. To register this power of attorney with the Depository Participant and/or with any other party concerned as is required within the
parameters of this Power of Attorney.
9. To sign all applications, apply for, subscribe to or enter into correspondence with respect to any Initial Public Offers/Offers For Sale
of securities of the companies/units of mutual funds, asset management company or any other investment products offered through
the website www.zerodha.com (owned by Zerodha Securities Pvt. Ltd.) or any other means as per the instructions made available to
them by me/us as on the website or otherwise.
10. To make payment to any party with respect to the aforesaid products mentioned in Point 9 above on my/our behalf to fulfil the
transaction requested by me/us.

First/Sole Holder
or Guardian
F3 (in case of Minor) S3 Second Holder T3 Third Holder

1 Sign wherever you see

11. To enter into correspondence with any party with respect to any transaction in any investment products.
12. To forward all such applications placed through the website to the online-IPO module of the concerned Exchange or owner/issuer
of Investment Product.
13. To receive intimation from the Exchange and any other party regarding the allocation/allotment/rejection/regret of the securities or
such other Investment Product applications / subscriptions / withdrawal or any other communications.
14. To authorize Zerodha to invest on behalf of me/us and to hold the mutual fund/asset management company(ies) based on the
request given by me/us. I confirm not to hold such mutual fund/asset management company/Zerodha liable for any transaction
processed based on my/our request to correspond with and give notice to the corresponding asset management company/body
corporate(s) issuer/registrar and transfer agent of securities including giving instructions with regard to nomination/change in
investment plans/any other changes that may be necessitated pursuant to the authorization given by me/us to Zerodha in this regard.
15. To deposit/transfer on allotment, the securities, debentures, units of the mutual funds and/or all other investments products applied
through Zerodha, on allotment, to my/our Beneficial Owner Demat Account opened for the purpose with the Zerodha-DP.
16. To do all other acts and things as may be necessary to affect the subscriptions/purchase/redemption or any other transaction in
any investment Product for which services are availed from Zerodha.
17. To debit my Trading account towards trade related fees or charges payable to Zerodha or a third party service provider or to any of
the affiliates/subsidiaries of Zerodha by virtue of I/We using/subscribing to any of the facilities/service provided either by Zerodha or
through a third party service provider or by any other security or financial instrument on behalf of me/us through Zerodha or any third
party. To bind ourselves with respect to any instruction given by first holder or any other holder to Zerodha.
18.In case of any erroneous transfer done by attorney, the attorney may return the same to my account as soon it comes to their
notice.
19.To send the consolidated summary of client wise, scrip wise buy and sell position with average rates by email.
20.To authorize Zerodha to transfer the securities to any of the demat accounts of Zerodha as mentioned in Annexure B.
21. We the joint holders of demat account agree, ratify and confirm to bind ourselves to any instructions given by the client herein
above mentioned who shall be the exclusive beneficiary of the transactions carried out pursuant to this power of attorney in favour of
the Director/(s) and/or the Authorised Signatories, who have in token thereof, subscribed their signature thereto.
That the Power of Attorney herein referred to is revocable at any time without notice subject to such revocation shall not be applicable
for any outstanding settlement obligation arising out of the trades carried out prior to receiving request for revocation of POA.
That, I/We hereby declare that all the actions taken by my/our above mentioned attorney (herein Zerodha) in this regards shall be
deemed to be an action done by me/us and if necessary shall be ratified by me /us on the instruction of the said attorney and that such
actions will be binding on me/us.
I/We agree that Zerodha is entitled to credit the proceeds of any instruction. This document shall be subject to the jurisdiction of the
courts in Bangalore.
In witness whereof I/We have executed this revocable Power of Attorney on the day, date and year herein below mentioned.

In witness whereof I/We have executed this revocable power of Attorney on the day, date and year herein below mentioned.

Annexure B
Particulars DP ID Client ID Particulars DP ID Client ID
CDSL BSE Principal A/C 12081600 00013706 CDSL BSE Early Pay-in A/C 11000010 00023629
CDSL NSE Pool A/C 12081600 00000061 NSDL BSE Pool A/C IN300095 11619878
CDSL Client Margin A/C 12081600 00101805 NSDL NSE Pool A/C IN300095 11496000
CDSL NSE Early Pay-in A/C 11000011 00019678 NSDL Client Margin A/C IN300095 11614253

Dated at Bangalore on this_________________________________________day of__________________________________

First/Sole Holder
or Guardian
F4 (in case of Minor) S4 Second Holder T4 Third Holder

WITNESSES
Witness Name Witness Name

Address Address

Signature Signature

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Annexure E

Option form for issue of DIS booklet Voluntary

Date : D D M M Y Y Y Y
DP ID Client ID
First Holder Name
Second Holder Name
Third Holder Name

To,
Zerodha Securities Pvt. Ltd.
153/154, 4th Cross, Dollars Colony, 4th Phase, JP Nagar, Opp. Clarence Public School, Bangalore - 560078.
Dear Sir,
I/We hereby state that: [select one of the option given below]
Option 1:
I/We require you to issue Delivery Instruction Slip (DIS) booklet to me / us immediately on opening my / our CDSL account
though I/ We have issued a Power of Attorney (POA) in favour of Zerodha Securities Pvt. Ltd. for executing delivery instructions
for settling stock exchange trades (Settlement related transactions) effected through such Clearing Member.

Option 2: OR
I/We do not require the Delivery Instruction Slip(DIS)for the time being, Since I/We have issued a POA in favour of Zerodha
Securities Pvt. Ltd. for executing the delivery instructions for settling stock exchange trades [settlement related transaction]
effected through such Clearing Member. However, the Delivery Instruction Slip (DIS) booklet should be issued to me / us
immediately on my / our request at any later date.
I/We hereby select Option 1 Option 2

First/Sole Holder
or Guardian
F5 (in case of Minor) S5 Second Holder T5 Third Holder

Client E-mail ID Optional

Client Mobile Number

Declaration
I hereby declare that the mobile no./email ID mentioned in the Account opening form/ request for change in mobile no./email
ID is my own
Request letter for registration of mobile no./email ID of person belonging to the client's family

Please note that the mobile no./email id/both mentioned in the Account opening form/ request for change in mobile no./email ID
belongs to Mr/Mrs./Ms. ______________________________________________________________________ who is my
______________________________ [relationship with the client]

First/Sole Holder
or Guardian
F6 (in case of Minor)

[Only the mobile no./email id of your spouse, dependent children and dependent parents can be registered in your demat account]

1 Sign wherever you see

 Nomination Details - Annexure 1A
Zerodha Nomination Registration No. Dated
Zerodha Securities Private Limited
Zerodha Commodities Private Limited
Note that only 1st Nominee will be considered for Zerodha and Zerodha Commodities Pvt. Ltd. accounts.

I/We the sole holder/joint holders/guardian (in case of minor) hereby declare that:
I/We do not wish to nominate any one for this demat account.
I/We nominate the following person who is entitled to receive security balances lying in
my/our demat account, particulars whereof are given below, in the event of my/our death.
Nomination Details
Up to 3 nominations can be made Details of 1st Nominee Details of 2nd Nominee Details of 3rd Nominee
Name of the nominee(s) (Mr./Ms.)
Share of each nominee Distribute equally
[If not equally shared,
please specify %age] Any odd lot after division shall be transferred to the rst nominee mentioned in the form.
Relationship With the Applicant (if any)
Address of nominee(s)

Mobile/Telephone no. of nominee(s)

Email ID of nominee(s)
Proof of identity submitted

Fill below details only if the nominee is a minor

Date of birth
Name of the guardian
Address of guardian(s)

Mobile/Telephone no. of guardian(s)

Email ID of guardian(s)
Relationship of guardian with nominee
Proof of identity submitted

Details of the Witness

Witnesses (Only applicable in case the account holder has made nomination)
Witness Name
Address Address

Signature Signature

First/Sole Holder
or Guardian
F7 (in case of Minor) S6 Second Holder T6 Third Holder

Acknowledgement
We have received the nomination request for the account with client ID
Account holders name
Received by
Signature of authorised signatory

1 Sign wherever you see