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Know Your Client (KYC)

Intermediary
Application Form (For Individuals Only) CDSL VENTURES LIMITED
Logo
….Exploring New Horizons

Please fill the form in ENGLISH and in BLOCK letters

Fields marked * are mandatory Application Number: KD146120

Fields marked + are pertaining to CKYC and mandatory only if processing CKYC
also Application Type*:  New
NewKYC
KYC  Modification
Modification KYCKYC

KYC Mode*: Please Tick (✓)

Normal
Normal EKYC OTP
OTP EKYC
EKYC Biometric
Biometric Online
Online KYC KYC Offline Offline
KYC EKYC Digilocker Digilocker

1. Identity Details (please refer guidelines overleaf)

PAN* BHRPD3379N Please enclose a duly attested copy of your PAN Card
____________________________
ANISH SURYAKANT DEOLEKAR
Name* (same as ID proof)
Maiden Name+ (if any)
Fathers/Spouse’s Name* Suryakant Deolekar

Date of Birth* 12-12-1989

Gender* Male
Male Female Female
Transgender Transgender
Marital Status* Single
Single Married Married Recent passport size
Nationality* Indian
Indian Others Other Applicant Photo

Residential Status* Resident Individual

Resident Individual Non-Resident Indian (NRI)
Non Resident Indian
Please Tick (✓) Person ofNational
Foreign Indian Origin Foreign
Person of Indian Origin+
National
Cross Signature across photograph

(Passport mandatory for NRIs and Foreign Nationals. PIO selection is only for CKYC and not for KRA KYC.
Select NRI or Foreign National based on Nationality of the individual)

Proof of Identity (POI) submitted for PAN exempted cases (Please tick)
A — Aadhaar Card XXXX XXXX __ __ __ __
(Expiry Date)
B — Passport Number
C — Voter ID Card
(Expiry Date)
D —Driving License
E —NREGA Job Card
F — NPR
Z —Others (any document notified by Central Government)

Identification Number
2. Address Details* (please refer guidelines overleaf)
A. Correspondence/ Local Address*
Line 1* Venus Mension, B- Wing, Room No 001 Opp Shivdarshan Tow

Line 2 er Sector- 20 D Navi Mumbai Digha Thane Maharashtra 400

Line3 708

City/Town/Village* Thane District Thane

+ Pin Code* 400708
State* Maharashtra Country* India
Address Type* Residential/Business
Residential/Business Residential
Residential Business
Business Registered
RegisteredOffice
Office Unspecified
Unspecified

Applicant e-SIGN

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

1
1
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B. Permanent residence address of applicant, if different from above A / Overseas Address* (Mandatory for NRI Applicant)
Line 1* Venus Mension, B- Wing, Room No 001 Opp Shivdarshan Tow
Line 2 er Sector- 20 D Navi Mumbai Digha Thane Maharashtra 400
Line3
708
City/
Thane + Thane 400708
Town/Village* District Pin Code*
Maharashtra India
State* Country*
Address Type* Residential/Business
Residential/Business Residential
Residential Business
Business RegisteredOffice
Registered Office Unspecified
Unspecified
Proof of Address* (attested copy of any 1 POA for correspondence and permanent address each to be submitted)
A — Aadhaar Card XXXX XXXX __ __ __ __
4114
B — Passport Number (Expiry Date)

C — Voter ID Card
(Expiry Date)
D —Driving License
E —NREGA Job Card
F — NPR Letter
Z—Others (any document notified by Central Government)

Identification Number

3. Contact Details (in CAPITAL)

Email ID* [email protected]
________________________________________________________________________________________
Mobile No. * _____ ____________________________
9321801175

Tel (Off) _____ ____________________________ Tel (Res) _____ ____________________________

4. Applicant Declaration
I/We hereby declare that the KYC details furnished by me are true and correct to Applicant e-SIGN Applicant Wet Signature
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/We hereby consent to receiving information from CVL KRA through SMS/Email on
the above registered 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/Digilocker XML file, along
with passcode and as applicable, with KRA and other Intermediaries with whom I
have a business relationship for KYC purposes only.

07-06-2024
DATE: _________________________ (DD-MM-YYYY) Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Mumbai
PLACE: _______________________________________ Date:Fri Jun 07 08:50:40 IST 2024

5. For Office Use Only

In-Person Verification (IPV) carried out by* Intermediary Details*

IPV Date Self certified

Self certifieddocument copiesreceived
document copies received (OVD)
(OVD)

Emp. Name True Copies

True Copiesof
ofdocuments received
documents received (Attested)
(Attested)

AMC / Intermediary Name :

Emp. Code

Emp. Designation

Employee Signature and Stamp Institution Name and Stamp

2
2
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Proof of Identity - PAN

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 3
16px

Proof of Address

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 4
16px

Signature

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 5
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Stock Broking & Demat

Account Opening Form

6
Account
16px Opening Kit

Index of Documents :

Sr. No Name of Document Brief Significance of the document Page No.

MANDATORY DOCUMENTS AS PRESCRIBED BY SEBI & EXCHANGES

A. KYC Form - Document captures the basic information

about the constituent and an instruction / checklist
1 Account Opening Form 12-21
B. Document captures the additional information about
the constituent relevant to trading account and an
instruction / checklist

Document stating the Rights & Obligations of stock broker

/ trading member and client for trading on Exchanges
2 Rights and Obligations As per Annexure A
including additional rights & obligation in case of internet /
wireless technology-based trading.

Rights and Obligation of

Document stating the Rights & Obligations of Depository
3 Beneficial Owners and As per Annexure A
Participant and client for demat account.
Depository Participant

Risk Disclosure Document detailing risk associated with dealing in

4 Document (RDD) securities market As per Annexure A

Document detailing do’s and don’ts for trading on

5 Guidance Note Exchange, for the education of the investors and Investor As per Annexure A
charter for Trading and DP

Document describing significant policies and procedures

6 Policies & Procedures As per Annexure A
of the stock broker

Document detailing the rate / amount of brokerage and

7 Tariff Sheet other charges levied on the client for trading on the Stock 22-23
Exchange(s)

8 Nomination Form to nominate / opt out of nomination 24-26

Most Important Terms Highlighting the most important terms and conditions as
9 36
& Conditions prescribed by the Exchanges

VOLUNTARY AND OPTIONAL DOCUMENTS AS PROVIDED BY THE STOCK BROKER

Contains voluntary undertakings by the client with respect

9 Undertaking to PhonePe Wealth Broking Pvt. Ltd. (PPWB) internal 27-28
operations during relationship with PPWB

Letter of Authorisation for maintaining Running Account

Running Account
10 with PPWB and client consent letter for receiving SMS 29-30
Authorisation
from PPWB

11 Mobile Declaration Terms and Conditions for receiving SMS Alerts from CDSL 17

Execution of ‘Demat Debit and Pledge Instruction’ (DDPI)

Demat Debit and
for transfer of securities towards deliveries / settlement
12 Pledge instruction 35
obligations, pledging / re-pledging of securities and for
(DDPI)
other purposes as prescribed by regulator.

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Membership Details

Name of the Stock Broker / Clearing Member PhonePe Wealth Broking Private Limited

PhonePe Wealth Broking Private Limited,

Member of NSE & BSE
SEBI Stock Broker Registration Number: INZ000302639
Dated October 8, 2021

Depository Participant services through PhonePe Wealth Broking

Registration Number
Private Limited

DP Registration Number: IN-DP-696-2022 dated June 24, 2022

Research Analyst Registration Number - INH000013387

MF ARN:187821

Office - 2, Floor 3, Wing A, Block A, Salarpuria Softzone, Bellandur

Registered Office Address Village, Varthur Hobli, Outer Ring Road, Bangalore South,
Bangalore , Karnataka - 560103

080-68727687
Phone No

Fax NA

Website https://share.market

Office - 2, Floor 3, Wing A, Block A, Salarpuria Softzone, Bellandur

Correspondence Office Address Village, Varthur Hobli, Outer Ring Road, Bangalore South,
Bangalore , Karnataka - 560103

Shrenik Shah
Compliance Officer: Phone No:080-68727689
Email id: [email protected]

Senior Managing Official / Director Details

Name Phone No Email ID

Ujjwal Jain 080-68722200

Nilesh Datta Naik 080-68722200 [email protected]

Sai Prakash Manchikanti 080-68722200

8
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For any grievance, please contact PPWB at the above address or email [email protected] and Phone Num-
ber: 080-68727687

In case not satisfied with the response, please contact the concerned Exchange at

NSE: [email protected] or contact at 022-26598100

BSE: [email protected] or contact at 022-22728097
CDSL:[email protected] or contact at 1800-200-5533

Filing complaints on SEBI Complaint Redress System (SCORES) –

Easy & quick (Scores Link) : https://scores.gov.in/scores/Welcome.html

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Instruction /Checklist for filing KYC form

A. General Instructions

• Self-attestation of documents is mandatory.

• Copies of all documents that are submitted need to be compulsorily self-attested by the applicant and accompanied by
originals for verification. In case the original of any document is not produced for verification, then the copies should be
properly attested by entities authorized for attesting the documents, as per below list mentioned list.
• If any proof of identity or address is in a foreign language, then translation into English is required.
• Name & address of the applicant mentioned on the KYC form, should match with the documentary proof submitted.
• If correspondence & permanent addresses are different, then proofs for both must be submitted.
• Sole proprietor must make the application in his individual name & capacity.
• For non-residents and foreign nationals, (allowed to trade subject to RBI and FEMA guidelines), copy of passport/PIO Card/ OCI
Card and overseas address proof is mandatory.
• For foreign entities, CIN is optional; and in absence of DIN no. for the directors, their passport copy should be given.
• In case of Merchant Navy NRI’s, Mariner’s declaration or certified copy of CDC (Continuous Discharge Certificate) is to be
submitted.
• For opening an account with Depository participant or Mutual Fund, for a minor, photocopy of the School Leaving Certificate/
Mark sheet issued by Higher Secondary Board/ Passport of Minor/Birth Certificate must be provided.
• Politically exposed persons (PEP) are defined as individuals who are or have been entrusted with prominent public functions
in a foreign country e.g., Head of State or of Government, senior politician, senior government/judiciary/military officer, senior
executive of state-owned corporation, important political party official, etc

B. Proof of Identity (POI)

• PAN card with photograph is mandatory for all applicants except those who are specifically exempt from obtaining PAN (listed
in Section D).
• Original Verified Documents (OVD) are acceptable: Unique Identification Number (UID) (Aadhaar) / Passport / Voter ID card /
Driving License / Letter issued by NPR / NREGA job card
• If driving license number or passport is provided as proof of identity, then expiry date is to be mandatorily furnished.
• Mention identification / reference number if Z Others (any document notified by the central government) is ticked.
• Others Identity card with applicant’s photograph issued by any of the following: Central/ State Government Departments,
Statutory/Regulatory Authorities, Public Sector Undertakings, Scheduled Commercial Banks, Public Financial Institutions,
Colleges affiliated to Universities, Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council, etc., to their members; and Credit
cards/Debit cards issued by Banks.

C. Proof of Address (POI)

• PoA to be submitted only if the submitted PoI does not have an address or address as per PoI is invalid or not in force.
• Others includes Utility bill which is not more than 3 months old of any service provider (electricity, landline telephone, piped
gas, water bill); Bank account or Post Office savings bank account statement; Documents issued by Government departments
of foreign jurisdictions and letter issued by Foreign Embassy or Mission in India
• Identity card/document with address issued by any of the following: Central/ State Government Departments, Statutory/
Regulatory Authorities, Public Sector Undertakings, Scheduled Commercial Banks, Public Financial Institutions, Colleges
affiliated to Universities, Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council, etc., to their members.
• Self-declaration of High courts/Supreme court judges, giving the new address in respect of their own accounts.
• For FII/Sub account, Power of attorney given by FII/Sub account to the custodians (which are duly notarized and/or apostilled
or consularized) that gives registered address should be taken.
• Proof of address in name of spouse may be accepted.
• Registered lease or Sale agreement/ Flat maintenance bill / Insurance copy / Ration card / Latest Property tax
• Original Verified Documents (OVD) are acceptable: Unique Identification Number (UID) (Aadhaar) / Passport / Voter ID card /
Driving License / Letter issued by NPR / NREGA job card.

D. Exemptions/Clarifications to PAN (*Sufficient documentary evidence in support of such claims to be collected)

• Investments (including SIPs), in Mutual Fund schemes up to INR 50,000/- per investor per year per Mutual Fund.
• Transactions undertaken on behalf of Central/State Government, by officials appointed by Courts, e.g., Official liquidator, Court
receiver, etc.
• Investors residing in the state of Sikkim.

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• UN entities/multilateral agencies exempt from paying taxes/filing tax returns in India.

• In case of institutional clients, namely FIIs, MFs, VCFs, FVCIs, scheduled commercial bank, Multilateral and Bilateral
development financial institutions, State Industrial development corporations, insurance companies registered with IRDA and
public financial institutions as defined under section 4A of the Company Act 1956, custodians shall verify the PAN card details
with the original PANs and provide duly certified copies of such verified PAN details to the intermediary.

E. List of people authorized to attest the documents:

• Authorized officials of Asset Management Companies (AMCs).

• Authorized officials of Registrar & Transfer Agent (RTA) acting on behalf of the AMC.
• KYC compliant mutual fund distributors affiliated to Association of Mutual Funds (AMFI) and have undergone the process of
‘Know Your Distributor (KYD)’
• Notary Public, Gazette Officer, Manager of a Scheduled Commercial/Co-operative Bank or Multinational Foreign Banks (Name,
Designation & Seal should be affixed on the copy).
• In case of NRIs, authorized officials of overseas branches of Scheduled Commercial Banks registered in India, Notary Public,
Court Magistrate, Judge, Indian Embassy/ Consulate General in the country where the client resides are permitted to attest the
documents.

F. Online Mode Processing of KYC:

1. EKYC BIOMETRIC

• Applicant may directly upload their documents (OVD) as scanned images on intermediary’s portal.
• The documents should be e-signed.
• Applicant details are verified using UIDAI Biometric details.
• Original Seen Verification (OSV) of documents as well as IPV / VIPV is exempted.
• Intermediary attestation on documents is exempted.

2. EKYC OTP

• Applicant may directly upload their documents (OVD) as scanned images on intermediary’s portal.
• The documents should be e-signed.
• Applicant details are verified using OTP.
• Original Seen Verification (OSV) of documents as well as IPV / VIPV is exempted.
• Intermediary attestation on documents is exempted.

3. ONLINE KYC

• Applicant may directly upload their documents (OVD) as scanned images on intermediary’s portal.
• The documents should be e-signed.
• Virtual In Person Verification (VIPV) is mandatory as per SEBI guidelines.
• Intermediary attestation on documents (OSV) is exempted.

4. OFFLINE EKYC

• Applicant may directly upload their document (PAN copy) as scanned images on intermediary’s portal.
• The documents should be e-signed.
• Digital KYC performed through Offline Aadhaar e-KYC. OVD sourced from Offline Aadhaar e-KYC. Original Seen Verification
(OSV) of documents as well as IPV/VIPV is exempted.

5. DIGILOCKER

• Digital KYC performed through the documents (OVD) sourced from Digilocker. Original Seen Verification (OSV) of documents
as well as IPV/VIPV is exempted.
• Intermediary attestation on documents is exempted.

11
 Know Your Client (KYC)
16px
Intermediary
Application
Know Your Form (KYC)
Client (For Individuals Only) CDSL VENTURES LIMITED
Logo
Know Your Client (KYC)
….Exploring New Horizons Intermediary
Application Form (For Individuals only)
Application Form (For Individuals Only) Application Number:
CDSL KD146120
VENTURES LIMITED
Know
Know
Please Your
fill theYour
form inClient
Client
ENGLISH (KYC)
and(KYC)
in BLOCK letters Logo
….Exploring New Horizons Intermediary
Intermediary
• Fields marked
Please* are
Application
Application fill mandatory
the form in ENGLISH & in BLOCK letters
Form
Form (For
(For Individuals
Individuals Only)Only) Application CDSL
Number:
CDSL VENTURES
VENTURESLIMITED
LIMITED
•Please Fields marked
fill the form
+
* are
in ENGLISH andmandatory
in BLOCK letters Logo
Logo
• Fields marked are pertaining to CKYC and mandatory only if processing CKYC
Fields marked * are pertaining to CKYC & mandatory
also marked * are mandatory
Fields
Application Type*:
Type :  New
ApplicationNumber:
Application NewKYC
….Exploring
….ExploringNew
NewHorizons
KYC
Horizons
 Modification KYC
Modification KYC
only if processing CKYC also
Please
Please
fillfill
thethe
form
formin in
ENGLISH
ENGLISHand
andininBLOCK
BLOCKletters
letters
KYC Mode*:
Fields marked + are pertaining
also
PleasetoTick
CKYC(✓)
Application
Application Type*:
and mandatory only if processing CKYC
Number:  New KYC
Number:  Modification KYC
Fields marked
Fields marked * are mandatory
* are mandatory
Normal EKYC
Normal OTP EKYC Biometric Online KYC Offline EKYC Offline KYCDigilockerDigilocker
KYC MODE + +
onlyEKYC OTP EKYC Biometric Online KYC
KYC
Fields
Fields
also
also
Mode*:
marked
markedareare
pertaining
pertaining
PleasetotoCKYC
CKYC
Tick and
(✓)andmandatory
mandatoryonly ififprocessing
processing CKYC
CKYC
Application Type*: Type*:  NewNewKYC KYC Modification
ModificationKYC KYC
1. Identity
Normal DetailsEKYC (pleaseOTP refer guidelines EKYCoverleaf)
Biometric Online KYC Offline EKYC Digilocker
1.KYC
Identity
KYCMode*: DetailsPlease
Mode*: (please
Please Tickvrefer
Tick (✓) guidelines overleaf)
(✓)
PAN*
1. Identity
Normal
Normal DetailsEKYC EKYCOTP
(please OTPrefer guidelines EKYC
EKYCoverleaf)
Biometric Online
Online
Please enclose a duly attested copyKYC
KYC
of your PAN Card Offline
OfflineEKYC
EKYC Digilocker
Digilocker
____________________________
PAN* BHRPD3379N (Please enclose a duly attested copy of your PAN Card)
1.1.Identity
PAN*
Name*IdentityDetails
Details
ID proof)(please
(pleaserefer
referguidelines
____________________________
(same as guidelines overleaf)
overleaf)
Please enclose a duly attested copy of your PAN Card

Name*
PAN* (same
PAN* as ID+ proof) ANISH
PleaseSURYAKANT attestedDEOLEKAR
Maiden
Name* Name (if any)
____________________________
(same____________________________
as ID proof)
Please enclose a duly
duly attested copy
copyof
ofyour
yourPAN
PANCard
Card

Maiden Name* (if

Fathers/Spouse’s + any) Name*
Maiden
Name*
Name*(same Name (if
(sameasasIDID any)
proof)
proof)
Date of Birth*+ + Name*
Father’s/Spouse’s
Fathers/Spouse’s Name* Suryakant Deolekar
Maiden
MaidenName Name (if(ifany) any)
Gender*
Date Male Female Transgender
Date ofofBirth*
Birth* Name*
Fathers/Spouse’s
Fathers/Spouse’s Name* 12-12-1989
Marital Status*
Gender* Single
Male Married
Female Transgender Recent passport size
Date
DateofofBirth*
Birth*
Gender
Nationality* Male Female
Indian TransgenderOther Applicant Photo
Marital
1.Gender*
Identity
Gender* Status* Single
Details (please refer guidelines
Maleoverleaf)
Male Married
Female Transgender
Transgender Recent passport size
Residential
Nationality* Status* Resident
Indian Individual Other Non Resident Indian Applicant Photo
Marital
Marital
Marital Status*
Status*
Status* SingleSingle
Single Married Married Recentpassport
Recent passport sizesize
Please Tick (✓)
Residential Status* Foreign National
Resident Person of Indian Origin+ Applicant
Applicant Photo
Photo
Nationality*
Nationality* Indian Individual
Indian Other Non Resident Indian Cross Signature across photograph

Nationality*
Please Tick (✓) Indian Others
(Passport mandatory for NRIs and Foreign Nationals. PIO selection is only for CKYC and
+ not for KRA KYC.
Residential
ResidentialStatus*
Status* Foreign
Resident
Resident
Select National
Individual
Individual
NRI or Foreign Person
Non
Non
National based on Nationality of of Indian
Resident
Resident
the individual) Origin
Indian
Indian Cross Signature across photograph

Please Tick
Please (✓)
Tick (✓) (Passport mandatory for NRIs and Foreign Nationals. PIO selection is only for CKYC and+ +not for KRA KYC.
Proof of Identity (POI) submitted
Resident for
Foreign
Select
PAN
Individual
Foreign exempted
National
National
NRI or Foreign
cases
Non-Resident Indian
Person
National based on Nationality ofPerson
(Please tick) of(NRI)
of IndianOrigin
Indian
the individual) Origin
Cross
Cross Signature
Signature across
across photograph
photograph
Residential Status XXXX XXXXforfor__ __and__Foreign
__ Nationals.
ProofA of—Identity
Aadhaar(POI) Cardsubmitted(Passport
(Passport
Person
Select
mandatory
offor
SelectNRI
mandatory
Indian
NRIor
PAN Origin
orForeign
NRIs
exemptedNRIs
ForeignNational
cases Nationals.
Foreign PIOselection
PIO
(PleaseNational
National based on Nationality
tick)
Nationality ofofthe
selectionisisonly
theindividual)
individual)
onlyfor
forCKYC
CKYCandandnot
notfor
(Expiry Date)
forKRA
KRA KYC.
KYC.

AB— — Aadhaar
Passport Card Number XXXX XXXX __ __ __ __
Proof
Proof
(Passport ofofIdentity
Identity
mandatory (POI)
(POI)
for NRIs andsubmitted
submitted
Foreign for
forPIO
Nationals. PAN
PAN exempted
exempted
selection casesand(Please
is only for CKYC (Please
not fortick)
tick)
KRA KYC. Select NRI or
Foreign National based on Nationality of the individual) (Expiry Date)
BC— — Passport
Voter ID Card Number XXXX
XXXX XXXX
XXXX __
__ __ __ __
AA——AadhaarAadhaarCard Card (Expiry Date)

Proof ofD —Driving

Identity License
(POI) submitted for PAN exempted cases
(Expiry
(ExpiryDate)
Date)
BCB— — Voter ID Card (Please tick)
—Passport
Passport Number
Number (Expiry Date)
DE —NREGA
—Driving Job Card
License
A.CAadhaar
C— —Voter
VoterIDID
Number Card
Card xxxx xxxx
(Expiry
(ExpiryDate)
Date)
F —NREGA
— NPR Job Card
DED—Driving
—DrivingLicenseLicense
B. FZPassport
—Others Expiry Date
—
E E—NREGANPR Number
—NREGA Job
JobCard
Card
(any document notified by Central Government)

ZF——OthersIdentification Number
C.FVoter—NPRNPR (any document notified by Central Government)
ID Card
2. Address Details* (please refer guidelines overleaf)
Identification Number
Z Z—Others
—Others (any
(anydocument
documentnotified
notifiedbybyCentral
CentralGovernment)
Government)
A.
2.D.Correspondence/
Address Details*Local
Driving License Address*
(please refer guidelines overleaf) Expiry Date
Identification
Identification Number
Number
Line
2.
A. 1*
2.Address
Address Details*
Details*Local
Correspondence/ Address*
(please
(pleaserefer
referguidelines
guidelines overleaf)
E. NREGA Job Card
Line 1*
Line 2
A.A.Correspondence/
Correspondence/Local
Local Address*
Address*
Line3
F.
Line NPR
21*
Line
Line1*
City/Town/Village*
Line3 District
+ Pin Code*
Line
Line 22
Z. Others (any document notified by Central Govt) ID Number
State* Country* + Pin Code*
City/Town/Village*
Line3
Line3 District
2.Address
Address Type*
Details* (please refer guidelines overleaf)
Residential/Business ResidentialCountry* Business Registered Office Unspecified
State*
City/Town/Village*
City/Town/Village* District
District
++ Pin
PinCode*
Code*
A. Correspondence/ Local Address*
Address
State* Type*
State* Residential/Business ResidentialCountry*
Country*Business Registered Office Unspecified
Applicant e-SIGN
Line 1* Venus Mension, B- Wing, Room No 001 Opp Shivdarshan Tow
Address
AddressType*
Type* Residential/Business
Residential/Business Residential Business
Business Registered
RegisteredOffice
Office Unspecified
Unspecified
Line 2 er Sector- 20 D Navi Mumbai Digha Thane Maharashtra 400 Applicant e-SIGN

Line 3 708 Applicant

Applicante-SIGN
e-SIGN

City/Town/Village* Thane District* Thane PIN Code* 400708

State* Maharashtra Country* India Applicant e-SIGN 1

Residential/Business Residential Business 1

Address Type* Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Registered Office Unspecified Date:Fri Jun 07 08:50:40 IST 2024 11

12
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B. Permanent residence address of applicant, if different from above A / Overseas Address* (Mandatory for NRI Applicant)

Line 1* Venus Mension, B- Wing, Room No 001 Opp Shivdarshan Tow

Line 2 er Sector- 20 D Navi Mumbai Digha Thane Maharashtra 400
Line 3 708
City/Town/Village* Thane District* Thane PIN Code* 400708
State* Maharashtra Country* India

Address Type* Residential/Business Residential Business Registered Office Unspecified

Proof of Address* (attested copy of any 1 POA for correspondence and permanent address each to be submitted)

A. Aadhaar Number xxxx xxxx 4114

B. Passport Number Expiry Date

C. Voter ID Card

D. Driving License Expiry Date

E. NREGA Job Card

F. NPR

Z. Others (any document notified by Central Govt) ID Number

3. Contact Details (in CAPITAL)

Email ID* [email protected] Mobile No* +91 9321801175

Tel (off) Tel (res)

4. Applicant Details

I/We hereby declare that the KYC details furnished by me are true and correct to Applicant e-SIGN Applicant Wet Signature
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/We hereby consent to receiving information from CVL KRA through SMS/Email on
the above registered 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/Digilocker XML file, along
with passcode and as applicable, with KRA and other Intermediaries with whom I have
a business relationship for KYC purposes only.

DATE: 07-06-2024 (DD_MM-YYYY)

PLACE: Mumbai Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

5. For Office Use Only

In-Person Verification (IPV) carried out by* Intermediary Details

IPV Date
Self certified document copies received (OVD)
Emp. Name
True Copies of documents received (Attested)
Emp. Code
AMC/ Intermediary
Name
Emp. Designation

Employee Signature and Stamp Institution Name and Stamp

13
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6. OTHER DETAILS

Private Sector Public Sector Government Sector Business

A Occupation Type Professional Self-Employed Retired Housewife

Agriculturalist Others Student

Gross Annual
B Below 1 Lacs 1-5 Lacs 5-10 Lacs 10-25 Lacs More than 25 Lacs
Income Details

I am an Indian Resident. I am neither a specified US person,

US citizen/ green card holder nor a Tax resident of any other country YES NO

ISO 3166 Country Code of

Jurisdiction residence

Tax identification number or

Equivalent
C
Place of Birth

ISO 3166 country code of Birth

Addition / Deletion of Related Person - Details of Related Person

Addition of Related Person Deletion of Related Person

KYC number of Related Person

N/A
(if available)

Related person type Guardian of Minor Assignee Authorised Representative

Name N/A

Addition of Related Person - Details of Related Person

Identity Proof submitted N/A

D
Identification Number N/A

Expiry Date N/A

Other (any document notified by

N/A
central Government)

Identification Number N/A

Simplified Measure Account

N/A
Document Type Code

Identification Number N/A

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 14
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7. TRADING ACCOUNT DETAILS

Bank account Details

Customer Name ANISH SURYAKANT DEOLEKAR

Account Type SAVINGS

Bank Name Federal Bank

Bank Branch EPIFI FEDERAL NEO BANKING

A
Branch address

Account Number 55550129528798

MICR Number

IFSC Code FDRL0005555

Mode in which you wish to receive RDD,

B Rights and obligation, Guidance Note and Physical Electronic
other standard documents

Politically Exposed Person None

C Politically Exposed Person
Related to Politically Exposed Person

PAST REGULATORY ACTIONS

Details of any action/proceedings No such past actions

initiated/pending/ taken by SEBI/ Stock
exchange/any other authority against Yes, details as
D the applicant/ constituent or its partners,
promoters/whole time directors/
authorized persons in charge of dealing in
securities during the last 3 years:

8. DEPOSITORY ACCOUNT DETAILS

Depository Name CDSL

Depository Participant Name PhonePe Wealth Broking Pvt Ltd

Beneficiary Name ANISH SURYAKANT DEOLEKAR

Depository ID 12096000

Beneficiary ID

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 15
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9. DEALING THROUGH OTHER STOCKBROKER

Whether dealing with any other stockbroker / sub broker (in case dealing with multiple stock broker/ sub broker provide details
of all)

Name of the Stockbroker / Sub broker (if

any)

SEBI registration number

Registered address

Contact details

Client Code

Exchange

Website

Details of dispute / dues pending from /to

stock broker

10. INTRODUCER DETAILS (optional)

Name of the Introducer N/A

Status of the Introducer - Sub broker/

N/A
Remisier / AP / Existing client

Address of the Introducer N/A

Phone Number N/A

Signature N/A

11. TRADING PREFERENCES

Please sign in the relevant boxes where you wish to trade. Please strike off the segment not chosen by you.

MCX,
Exchanges NSE, BSE & MSEI NCDEX, BSE
& NSE

All Mutual Commodity

Cash F&O Currency Debt
Segments Funds Derivatives

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

If you do not wish to trade in any of the segments / Mutual Fund, please mention here
.
Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 16
16px

Financial Proof (Required for activation of derivatives segment)

1. Copy of ITR Acknowledgement (Income Tax Return)

2. Form 16

3. Copy of Annual Accounts

4. DP (Depository Participant) statement

5. Salary Slip

6. Net Worth Certificate

7. 6 months Bank statement

8. Any other relevant documents substantiating ownership of Assets.

12. ADDITIONAL DETAILS

Contract Note Declaration

Contract Note (ECN) to be delivered through : Physical Contract Note Electronic Contract Note (ECN)

If ECN, your email address [email protected]

Self Spouse
The E-mail ID mentioned above belongs to
Dependent Children Dependent Parent

Mobile Trading

Whether you wish to avail the facility of

internet trading / wireless technology / YES NO
mobile trading :

Self Spouse
The mobile number mentioned above
belongs to :
Dependent Children Dependent Parent

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 17
16px

For office use only

UCC Code allotted to the Client KD146120

________________________________________

Documents verified with In-Person Verification

Client interviewed by
originals done by

Name of the Employee

Employee Code

Designation of employee

Date

Signature

I / We undertake that we have made the client aware of ‘Policy and Procedures’, tariff sheet and all the
non-mandatory documents. I/We have also made the client aware of ‘Rights and Obligations’ document (s),
RDD and Guidance Note. I/We have given/sent him a copy of all the KYC documents. I/We undertake that
any change in the ‘Policy and Procedures’, tariff sheet and all the non-mandatory documents would be duly
intimated to the clients. I/We also undertake that any change in the ‘Rights and Obligations’ and RDD would
be made available on my/our website, if any, for the information of the clients.

Signature

Date :
Seal & Stamp of Broker

18
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PhonePe Wealth Broking Pvt Ltd (Additional KYC form for opening a Demat Account)

I hereby give my consent for mapping my UCC/ Trading account with Demat account opened with PhonePe
Wealth Broking Pvt Ltd. Participant)
For Individual Resident Account (To be filled by the Depository Participant)

For Individual Resident Account (To be filled by the Depository Participant)

Application Number KD146120

Date 07-06-2024

DP Internal Ref No KD146120

DP ID 12096000

Client ID

I/We request you to open a demat account in my/ our name as per following details :

(To be filled by the applicant in BLOCK LETTERS in English)

Holder’s Details

Sole / First Holder Name ANISH SURYAKANT DEOLEKAR

PAN BHRPD3379N UID

Exchange NSE BSE UCC

ID

Second Holder Name

PAN UID

Third Holder Name

PAN UID

Status Individual

Sub Status Individual Resident

DP Internal Ref No KD146120

I/We instruct the DP to receive each and every credit

in my/our account (If not marked, the default option YES NO
would be Yes)

I/We would like to instruct the DP to accept all the

pledge instructions in my/our account without any oth- YES NO
er further instruction from my/our end (if not marked,
the default option would be No)

Transfer of securities held in the beneficial owner DDPI E - DIS

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 19
16px

Daily Weekly Monthly

Account Statement Requirement:
Fortnightly As per SEBI Regulation

I/We request you to send electronic transac-

tion-cum-holding statement at the following
YES NO
Email ID: [email protected]

I/We would like to receive the Annual report in (Tick the Physical Mode Electronic Mode Both
applicable box. If not marked the default option would be Physical)

I would like to avail the Basic Service Account Facility

(BSDA) YES NO

I/We wish to receive dividend/interest directly in to

my bank account as given below through ECS (if not YES NO
marked, the default option would be ‘Yes’) [ECS is mandatory for
locations notified by SEBI from time to time]

DIS Booklet:

I/We require you to issue Delivery Instruction Slip (DIS) booklet to me / us immediately on opening of
my / our CDSL account though registered for eDIS / DDPI for executing delivery instructions for settling
stock exchange trades.

I/We do not require the Delivery Instruction Slip (DIS) booklet for the time being, since I/We have issued
a DDPI/registered for eDIS in favour of PPWB for executing the delivery instructions for settling stock
exchange trades [settlement related transactions] effected through such Clearing Member/or for
executing delivery instructions through eDIS. However, the Delivery Instruction Slip (DIS) booklet should
be issued to me/us immediately on my / our request at any later date.

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

Date : 07-06-2024

20
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Bank account Details for crediting Dividends

Account Type SAVINGS

Bank Name Federal Bank

Bank Branch EPIFI FEDERAL NEO BANKING

Branch address

Account Number 55550129528798

MICR Number

IFSC Code FDRL0005555

Customer Name ANISH SURYAKANT DEOLEKAR

SMS Alert Facility (Refer to YES NO

Terms & Conditions)

Mobile No +91 9321801175

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

MODE OF OPERATION FOR EXECUTION OF TRANSACTIONS (Transfer, Pledge & Freeze)

Jointly Anyone of the Holder

Consent for Communication to be received by first account holder/ all Account holder: (Tick the applicable box. If no marked the default option
would be first holder.

All Holder

First Holder Second Holder Email ID: [email protected]

Third Holder

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 21
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Tariff Sheet
Charges Amount

Equity Intraday ₹20 per executed order or 0.05% whichever is lower*

Equity Delivery ₹20 per executed order or 0.05% whichever is lower*

F&O - Futures ₹20 per executed order*

F&O - Options ₹20 per executed order*

WealthBasket Platform Fees Zero Platform fees for all WealthBasket

Additional ₹30 per executed order placed through RMS / Auto

RMS or Auto Square off charges
Square off intraday or otherwise by PPWB

Charge Head Equity Delivery Equity Intraday F&O - Futures F&O - Options

0.125% of the intrinsic

value on options
Security Transaction 0.025% on sell 0.0125% on the sell that are bought and
0.1% on turnover
Tax turnover side exercised. 0.0625%
on sell side (on
premium

Exchange Transaction 0.0495% (on

0.00322% of turnover 0.00322% of turnover 0.00188%
charges (NSE) premium)

Exchange Transaction
0.00375% of turnover 0.00375% of turnover 0 0.005%(on premium)
charges (BSE)

SEBI Turnover Fees 0.0001% of turnover 0.0001% of turnover 0.0001% of turnover 0.0001% of turnover

0.015% on buy 0.003% on buy

Stamp Duty 0.002% on buy side 0.003% on buy side
turnover turnover

IPFT 0.0001% of turnover 0.0001% of turnover 0.0001% of turnover 0.0005% of turnover

Notes:
• *Please note that the above applicable brokerage may reduce during any promotional offer.
• Brokerage will not exceed the rates specified by SEBI and the Exchanges
• Clients who opt to receive Physical contract notes will be charged ₹50 per contract note. In case of ECN bounce, Rs. 100 per contract note
would be charged by debiting your ledger towards courier and handling charges.
• Charges for other value added services will be applicable at the time of availing such service
• Fund transfer charge of ₹15 per transaction except for UPI transactions
• Interest will be levied at 18% per annum on the outstanding amount beyond settlement date till the date of payment and will be charged on
daily basis
• GST is applicable on all above charges except stamp charges
• PPWB acts as a distributor of mutual funds and WealthBaskets curated by SEBI registered investment advisors and research analysts.Disputes
with respect to the distribution activity would not have access to Exchange investor redressal or Arbitration mechanism.

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

Date : 07-06-2024

22
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Sheet for Demat Account :

Stamp charges payable for DDPI upfront Nil

Annual Maintenance Charges (charged Monthly)

(NIL for 1st Year)

a Individuals Rs.15 per month charged Quarterly in advance from 2nd year onwards

Transaction Charges: (Market Trades)

Buy( Receive) Nil

Sell (Debit) Rs. 13.50 per instruction per ISIN

Transaction Charges: (Off-Market Trades)
Buy(Receive) / Sell (Debit) Nil / 0.04% or Rs.50 whichever is higher

Demat / Remat (Per certificate) Rs. 150 per certificate

Courier charges per Demat/Remat/.CMR Rs. 100

Pledge Request Rs. 20 per request

Unpledge Request Rs. 20 per request

Pledge invocation Rs. 20 per request

Margin Pledge Rs. 20 per request

Margin Unpledge Rs. 20 per request

Margin Repledge Rs. 20 per request

Periodic Statement
By Email / Physical Free / Rs. 100 per request

Adhoc / Non-Periodic Statement Requests

a By Email Rs.50 per request

Rs. 100 per request up to 10 pages.

b Physical
Every additional page at Rs. 5

Delivery instruction

a First Delivery Instruction Book Free (10 Leaves)

b Every Additional Booklet (10 Leaves) Rs.100

Payment Bounce Charges Rs. 350

Failed Transactions Rs. 50 per ISIN

Modification in CML (such as Email, Mobile,

Address, Bank Details and other profile details Rs. 100 per request
modification)

Note: For all purposes, the bill date shall be construed as the date demanded and the bills will be consid-
ered as the bill cum notice for payment. PhonePe Wealth Broking Private Ltd. reserves the right to freeze
depository accounts for debit transactions in case of non payment of charges after two days from the
bill date. The above tariff is subject to change. Changes if any will be intimated 30 days in advance.
Digitally Signed by: Annual Maintenance Charge (AMC) is non refundable. GST is applicable on all above charges except-
Name:ANISH SURYAKANT DEOLEKAR stamp charges. Any instruction to PPWB to transfer securities from customer’s account shall be reject-
Date:Fri Jun 07 08:50:40 IST 2024 ed by PPWB, if there is any debit balance or any unpaid amounts due as per this tariff sheet to PPWB.

Signature

23
16px

13. NOMINATION DETAILS FOR TRADING AND DEMAT ACCOUNT.

I/ We do wish to Nominate (fill below details)

I/ We do NOT wish to nominate (refer to Declaration form)

I/We wish to make a nomination [As per details given below]

I/We wish to make a nomination and do hereby nominate the following person(s) who shall receive all
the assets held in my / our account in the event of my / our death.

Name ANISH SURYAKANT DEOLEKAR

UCC KD146120

DEMAT

Nomination Details

Nomination can be made up to

Details of 1st Nominee Details of 2nd Nominee Details of 3rd Nominee
three nominees in the account

Name of the
1 Sneha Deolekar
nominee(s) (Mr./Ms.)

Equally 100% % %
Share of [If not
equally,
2 each please
Nominee specify Any odd lot after division shall be transferred to the first nominee mentioned in the form.
percentage]

Relationship with the

3 SPOUSE
Applicant (If Any)

Venus Mension, B-
Wing, Room No 001
Opp Shivdarshan Tower
Address of Sector- 20 D Navi
Nominee(s) Mumbai Digha Thane
Maharashtra 400708
4

Navi Mumbai
City / Place:
Maharashtra
State & Country:
India

PIN CODE 400708

Mobile / Telephone
5 No. of nominee(s)
(optional)

Email ID of nominee(s)
6
(optional)

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 24
16px

Nomination can be made up to

Details of 1st Nominee Details of 2nd Nominee Details of 3rd Nominee
three nominees in the account.

Nominee Identification
details (optional)
[Please tick any one of following
and provide details of same]

Photograph & Signature

PAN
7
Aadhaar

Savings Bank Account No.

Proof of Identity

DEMAT Account ID

Sr. Nos. 8-14 should be filled only if nominee(s) is a minor:

Date of Birth {in case

8
of minor nominee(s)}

Name of Guardian
9 (Mr./Ms.) {in case of
minor nominee(s)}

Address of
Guardian(s)

10

City / Place:

State & Country:

PIN CODE

Mobile / Telephone
11 no. of Guardian
(optional)

Email ID of Guardian
12
(optional)

Relationship of
13 Guardian with
nominee

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 25
16px

Nomination can be made up to

Details of 1st Nominee Details of 2nd Nominee Details of 3rd Nominee
three nominees in the account.

Guardian Identification
details (optional)
[Please tick any one of following and
provide details of same]

Photograph & Signature

PAN
14
Aadhaar

Savings Bank Account No.

Proof of Identity

DEMAT Account ID

Name(s) of holder(s) Signature(s) of holder*

Sole / First Holder (Mr./Ms.) ANISH SURYAKANT DEOLEKAR Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Second Holder (Mr./Ms.)

Third Holder (Mr./Ms.)

Note :

This nomination shall supersede any prior nomination made by the account holder(s), if any.
The Trading Member / Depository Participant shall provide acknowledgement of the nomination form to the account holder(s)

Declaration for opting out of Nomination : I / We hereby confirm that I / We do not wish to appoint any
nominee(s) in my / our trading / demat account and understand the issues involved in non-appointment
of nominee(s) and further are aware that in case of death of all the account holder(s), my / our legal heirs
would need to submit all the requisite documents / information for claiming of assets held in my / our
trading / demat account, which may also include documents issued by Court or other such competent
authority, based on the value of assets held in the trading / demat account.

Name and Signature of holder(s)*

1. _______________________________ 2. _______________________________ 3. _______________________________

26
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Sub: Voluntary Undertaking/Authorisation
With respect to member-constituent relationship and mandatory and voluntary (optional) documents executed
between us, I/we do hereby authorize PPWB to do the following:
i) Order placement Instruction:

I understand that you require written instructions from me for placing/modifying/cancelling orders.
However, since it is not practical for me to give written instructions for placing/modifying/cancelling order.
Even If I have facility to trade online through Internet and wireless technology, I may have to place orders
by physically visiting/calling/emailing the call centre/branch specified for the said purpose by PPWB in
case of breakdown of internet connectivity or other similar reasons. I hereby request you to kindly accept
my verbal orders /instructions, in person or over phone or Email and execute the same. I understand the
risk associated with placement of verbal orders and accept the same. I shall not disown orders under
the plea that the same were not placed by me provided I am sent ECN/Physical contract notes or trade
confirmations through SMS and other approved modes. I/we also agree that non-receipt of bounced
mail notification by you shall amount to delivery of contract note at my/our email ID. I indemnify PPWB
and its employees against all trade related losses, damages, actions which you may suffer or face, as a
consequence carrying out my instructions for orders placed verbally
ii) No Market Manipulation:

I undertake not to execute transactions, either singly or in concert with other clients, which may be viewed
as manipulative trades viz. artificially raising, depressing or maintaining the price, creation of artificial
volume, synchronized trades, cross trades, self-trades, etc. or which could be termed as manipulative or
fraudulent trades by SEBI/Exchanges. In case I am found to be indulging in such activities, PPWB has every
right to inform the Exchange/SEBI/other regulatory authority of the same and suspend/close my trading
account.

iii) Errors and Omissions:

I understand and agree that inadvertent errors may occur, while executing orders placed by me. In such
circumstances PPWB shall make all reasonable efforts to rectify the same and ensure that I am not put to
any monetary loss. I understand and agree that I shall not hold PPWB responsible beyond this and claim
additional damages/loss. I understand and agree that my request to modify or cancel the order shall not be
deemed to have been executed unless and until the same is confirmed by PPWB.
iv) Not Debarred by Any Regulator
I confirm and declare that there is no bar on me imposed by any Exchange or any regulatory and/or
statutory authority to deal in securities directly or indirectly. I agree to inform PPWB, in writing, of any
regulatory action taken by any Exchange or regulatory/ statutory authority on me in future. In case I fail to
inform the same and PPWB on its own comes to know of such action, PPWB has the right to suspend/close
my trading account and refuse to deal with me. Also, PPWB can at its sole discretion, close all the open
positions and liquidate collaterals to the extent of trade related debit balances, without any notice to me.

v) PMLA Declaration:

I declare that I have read and understood the contents and the provisions of the PMLA Act, 2002 as
displayed on website of PPWB. I further declare that I shall adhere to all the provisions of PMLA Act, 2002.
vi) Indemnification:

I hereby indemnify and hold PPWB, its Directors and employees harmless from and against all trade related
claims, demands, actions, proceedings, losses, damages, liabilities, charges and/or expenses that are
occasioned or may be occasioned to the PPWB directly or indirectly, relating to bad delivery of shares/
securities and/ or third party delivery, whether authorized or unauthorized and fake/forged/stolen shares/
securities/transfer documents introduced or that may be introduced by or through me during the course
of my dealings/ operations on the Exchange(s) and/ or proof of address, identity and other supporting/
documents provided by me at the time of registration and/ or subsequently.

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

27
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vii) Deliveries:

The client shall ensure that the shares are properly transferred to the designated demat account of PPWB,
for effecting delivery to the Exchange against the sale position of the client. Such transfers shall be entered
by the client within the time specified by SEBI/Exchanges/PPWB. In case the client fails to transfer the
shares on time to PPWB, PPWB shall not be responsible for any loss/damages arising out of such delayed
transfers.

I/We have received and read the below mentioned documents of PPWB and agree to abide by and be
bound by the same and the By Laws as are in force from time to time.

Part B - Additional Documents

Sr. No Brief Description of the document Link

Rights and obligations of Stockbrokers, sub- Part B

1 brokers and Clients as prescribed by sebi and stock
Exchanges.

Internet & wireless technology-based trading facility

2 Part B
provided by Stockbroker to the client

Rights and obligations of beneficial owner and

3 depository darticipant as prescribed by SEBI and Part B
depositories
Risk disclosure document for capital market and
4 derivatives segments Part B

5 Guidance note - Do’s and Dont’s for trading on the Part B

Exchange(s) for investors

6 Policies and procedures Part B

Part B
7 Investor charter

Date: 07-06-2024

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024
Signature

28
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Running Account Authorisation

I/We are dealing through you as a client in Capital Market and/or Future & Option segment and/or Currency
segment and/or Interest Rate future Segment & in order to facilitate ease of operations and upfront
requirement of margin for trade.

I/We authorize you as under:

1. I /We request you to maintain running balance in my account & retain the credit balance in any of my/
our account and to use the unused funds towards my/our margin/pay-in/other future obligation(s) of
any segment(s) of any or all the Exchange(s)/Clearing corporation unless I/We instruct you otherwise.

2. I/We request you to settle my fund : Monthly Quarterly

3. In case I/We have an outstanding obligation on the settlement date, you may retain the requisite
funds towards such obligations and may also retain the funds expected to be required to meet margin
obligations as per the regulations, calculated in the manner specified by the exchanges from time to
time.
4. We confirm you that I will bring to your notice any dispute arising from the statement of account or
settlement so made in writing preferably within 7 working days from the date of receipt of funds or
statement of account or statement related to it, as the case may be at your registered office.
5. I/We confirm you that I can revoke the above-mentioned authority at any time.
6. This running account authorization would continue until it is revoked by me.

Date : 07-06-2024

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

29
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I/We have received and read the duly executed copy of KYC, Rights and Obligations documents, Risk Disclosure
document (RDD) for Capital and Derivatives, Guidance Note - Do’s and Don’ts for trading on the Exchange(s)
for investors, Terms & conditions, PPWB Tariff Sheet, Policies and Procedures Document, General Terms &
Conditions governing securities trading and broking services of PPWB and agree to abide by and be bound
by the same and the Bye Laws as are in force from time to time.

I/We declare that the particulars given by me/us above are true to the best of my/our knowledge as on the
date of making this application. I/We agree and undertake to intimate the PPWB of any change(s) in the
details/particulars mentioned by me/us in this form. I/We further agree that any false/misleading information
given by me/us or suppression of any material information will render my account liable for termination and
suitable action.

I agree that if I am US Person or Tax resident of a reported foreign jurisdiction other than US requiring reporting
under FATCA / CRS or any other laws, my account details required under Inter Government Agreement (IGA)
/ Multilateral Competent Authority Agreement (MCAA) signed by Indian Government, would be reported by
PPWB to the tax authority.

ECN Declaration: I am aware that the Member has to provide physical contract note in respect of all the trades
placed by me unless I myself want the same in the electronic form. I am aware that the Member has to provide
electronic contract note for my convenience on my request only. Though the Member is required to deliver
physical contract note, I find that it is inconvenient for me to receive physical contract notes. Therefore, I am
voluntarily requesting for delivery of electronic contract note pertaining to all the trades carried out/ ordered
by me. I have access to a computer and am a regular internet user, having sufficient knowledge of handling
the email operations. My email id as provided while account opening form has been created by me and not
by someone else. I am aware that non-receipt of bounced mail notification by the member shall amount to
delivery of the contract note at the above e-mail ID.

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

30
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VOLUNTARY

To,

PhonePe Wealth Broking Private Ltd.

Demat Account No : ___________________________

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

At the following Email Address : [email protected]

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 PPWB Broking. about change in email address, if any.

In case, the PhonePe Wealth Broking Private is not able to provide bill/transaction statement to its clients by
email or on website due to any reason (including bounced emails), PhonePe Wealth Broking Private 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 As Per SEBI Regulation

Yours Faithfully,

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

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VOLUNTARY
Terms And Conditions-cum-Registration / Modification Form for receiving SMS Alerts from CDSL.
[SMS Alerts will be sent by CDSL to BOs for all debits]
Definitions:
In these Terms and Conditions, the terms shall have following meaning unless indicated otherwise:
Depository means Central Depository Services (India) Limited a company incorporated in India under the
Companies Act 1956 and having its registered office at Marathon Futurex, A-Wing, 25th floor, NM Joshi
Marg, Lower Parel, Mumbai 400013 and all its branch offices and includes its successors and assigns.
1. DP means Depository Participant of CDSL. The term covers all types of DPs who are allowed to open
demat accounts for investors.
2. BO means an entity that has opened a demat account with the depository. The term covers all types of
demat accounts, which can be opened with a depository as specified by the depository from time to
time.
3. SMS means Short Messaging Service
4. Alerts means a customized SMS sent to the BO over the said mobile phone number.
5. Service Provider means a cellular service provider(s) with whom the depository has entered / will be
entering into an arrangement for providing the SMS alerts to the BO.
6. Service means the service of providing SMS alerts to the BO on best effort basis as per these terms and
conditions.

Availability:

In these Terms and Conditions, the terms shall have following meaning unless indicated otherwise:
Depository means Central Depository Services (India) Limited a company incorporated in India under the
Companies Act 1956 and having its registered office at Marathon Futurex, A-Wing, 25th floor, NM Joshi
Marg, Lower Parel, Mumbai 400013 and all its branch offices and includes its successors and assigns.

1. The service will be provided to the BO at his / her request and at the discretion of the depository.
The service will be available to those accountholders who have provided their mobile numbers to the
depository through their DP. The services may be discontinued for a specific period / indefinite period,
with or without issuing any prior notice for the purpose of security reasons or system maintenance or
for such other reasons as may be warranted. The depository may also discontinue the service at any
time without giving prior notice for any reason whatsoever.
2. The service is currently available to the BOs who are residing in India.
3. The alerts will be provided to the BOs only if they remain within the range of the service provider service
area or within the range forming part of the roaming network of the service provider.
4. In case of joint accounts and non-individual accounts the service will be available, only to one mobile
number i.e. to the mobile number as submitted at the time of registration / modification.
5. The BO is responsible for promptly intimating to the depository in the prescribed manner any change
in mobile number, or loss of handset, on which the BO wants to receive the alerts from the depository.
In case of change in mobile number not intimated to the depository, the SMS alerts will continue to be
sent to the last registered mobile phone number. The BO agrees to indemnify the depository for any loss
or damage suffered by it on account of SMS alerts sent on such mobile number.
Receiving Alerts:
In these Terms and Conditions, the terms shall have following meaning unless indicated otherwise:
Depository means Central Depository Services (India) Limited a company incorporated in India under the
Companies Act 1956 and having its registered office at Marathon Futurex, A-Wing, 25th floor, NM Joshi
Marg, Lower Parel, Mumbai 400013 and all its branch offices and includes its successors and assigns.

1. The depository shall send the alerts to the mobile phone number provided by the BO while registering
for the service or to any such number replaced and informed by the BO from time to time. Upon such
registration / change, the depository shall make every effort to update the change in mobile number
within a reasonable period of time. The depository shall not be responsible for any event of delay or loss
of message in this regard.
2. The BO acknowledges that the alerts will be received only if the mobile phone is in ‘ON’ and in a mode
to receive the SMS. If the mobile phone is in ‘Off’’ mode i.e. unable to receive the alerts then the BO may
not get / get after delay any alerts sent during such period.
3. The BO also acknowledges that the readability, accuracy and timeliness of providing the service depend
Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 32
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on many factors including the infrastructure, connectivity of the service provider. The depository shall
not be responsible for any non-delivery, delayed delivery or distortion of the alert in any way whatsoever.
4. The BO further acknowledges that the service provided to him is an additional facility provided for his
convenience and is susceptible to error, omission and/ or inaccuracy. In case the BO observes any error
in the information provided in the alert, the BO shall inform the depository and/ or the DP immediately
in writing and the depository will make best possible efforts to rectify the error as early as possible. The
BO shall not hold the depository liable for any loss, damages, etc. that may be incurred/ suffered by the
BO on account of opting to avail SMS alerts facility.
5. The BO authorizes the depository to send any message such as promotional, greeting or any other
message that the depository may consider appropriate, to the BO. The BO agrees to an ongoing
confirmation for use of name, email address and mobile number for marketing offers between CDSL
and any other entity.
6. The BO agrees to inform the depository and DP in writing of any unauthorized debit to his BO account/
unauthorized transfer of securities from his BO account, immediately, which may come to his
knowledge on receiving SMS alerts. The BO may send an email to CDSL at [email protected].
The BO is advised not to inform the service provider about any such unauthorized debit to/ transfer of
securities from his BO account by sending a SMS back to the service provider as there is no reverse
communication between the service provider and the depository.
7. The information sent as an alert on the mobile phone number shall be deemed to have been received by
the BO and the depository shall not be under any obligation to confirm the authenticity of the person(s)
receiving the alert.
8. The depository will make best efforts to provide the service. The BO cannot hold the depository liable
for non-availability of the service in any manner whatsoever.
9. If the BO finds that the information such as mobile number etc., has been changed without proper
authorization, the BO should immediately inform the DP in writing.

Fees:
Depository reserves the right to charge such fees from time to time as it deems fit for providing this service
to the BO.
Disclaimer:

The depository shall make reasonable efforts to ensure that the BO's personal information is kept
confidential. The depository does not warranty the confidentiality or security of the SMS alerts transmitted
through a service provider. Further, the depository makes no warranty or representation of any kind in
relation to the system and the network or their function or their performance or for any loss or damage
whenever and howsoever suffered or incurred by the BO or by any person resulting from or in connection
with availing of SMS alerts facility. The Depository gives no warranty with respect to the quality of the
service provided by the service provider. The Depository will not be liable for any unauthorized use or
access to the information and/ or SMS alert sent on the mobile phone number of the BO or for fraudulent,
duplicate or erroneous use/ misuse of such information by any third person.
Liability and Indemnity:
The Depository shall not be liable for any breach of confidentiality by the service provider or by any third
person due to unauthorized access to the information meant for the BO. In consideration of the depository
providing the service, the BO agrees to indemnify and keep safe, harmless and indemnified the depository
and its officials from any damages, claims, demands, proceedings, loss, cost, charges and expenses
whatsoever which a depository may at any time incur, sustain, suffer or be put to as a consequence of or
arising out of interference with or misuse, improper or fraudulent use of the service by the BO.
Amendments:

The depository may amend the terms and conditions at any time with or without giving any prior notice
to the BOs. Any such amendments shall be binding on the BOs who are already registered as user of this
service.
Governing Law and Jurisdiction:
Providing the Service as outlined above shall be governed by the laws of India and will be subject to the
exclusive jurisdiction of the courts in Mumbai.
Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024 33
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I/We wish to avail the SMS Alerts facility provided by the depository on my/our mobile number provided
in the registration form subject to the terms and conditions mentioned below. I/ We consent to CDSL
providing to the service provider such information pertaining to account/transactions in my/our account as
is necessary for the purposes of generating SMS Alerts by service provider, to be sent to the said mobile
number.

I/We have read and understood the terms and conditions mentioned above and agree to abide by them
and any amendments thereto made by the depository from time to time. I/ we further undertake to pay fee/
charges as may be levied by the depository from time to time.

I / We further understand that the SMS alerts would be sent for a maximum four ISINs at a time. If more
than four debits take place, the BOs would be required to take up the matter with their DP.

I/We am/ are aware that mere acceptance of the registration form does not imply in any way that the
request has been accepted by the depository for providing the service.

I/We provide the following information for the purpose of REGISTRATION / MODIFICATION (Please cancel
out what is not applicable)

BOID (Please write your 8 digit DPID) 12096000

Client ID (Please write your 8 digit Client ID)

Sole / First Holder Name ANISH SURYAKANT DEOLEKAR

Second Holder Name

Third Holder Name

Mobile Number on which messages are to

be sent (Please write only the mobile number 9321801175
without prefixing country code or zero)

The mobile number is registered in the name of ANISH SURYAKANT DEOLEKAR

Email ID (Please write only ONE valid email ID on [email protected]

which communication; if any, is to be sent)

Date : 07-06-2024

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

34
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Voluntary: Demat Debit and Pledge Instruction

As per SEBI Circular on Execution of Demat Debit and Pledge Instruction (DDPI) for transfer of securities towards
deliveries / settlement obligations, pledging / re-pledging of securities and shall be use for limited purpose as
mentioned below.

Purposev Signature

Transfer of securities held in the beneficial owner accounts of

the client towards Stock Exchange related deliveries / settle-
ment obligations arising out of trades executed by clients on Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
the Stock Exchange through the same stock broker Date:Fri Jun 07 08:50:40 IST 2024

Pledging / re-pledging of securities in favour of trading

member (TM) / clearing member (CM) for the purpose of
meeting margin requirements of the clients in connection with Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
the trades executed by the clients on the Stock Exchange Date:Fri Jun 07 08:50:40 IST 2024

Mutual Fund transactions being executed on Stock Exchange

order entry platforms Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Tendering shares in open offers through Stock Exchange

platforms Digitally Signed by:
Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Note: The DDPI herein referred to is revocable at any time subject to such revocation not being applicable if there is any outstanding settlement
obligation arising out of trades carried out in this account prior to receiving a request for revocation of DDPI.

To,

PhonePe Wealth Broking

Subject: Declaration for Confirmation of Signature

Dear Sir/Madam,

This letter is to confirm that all signatures placed on the account opening forms, and all such other docu-
ments towards PhonePe Wealth Broking Private Limited or any of its group entities, are done solely by me
with complete knowledge of all such terms and clauses contained therein.

I/We, the undersigned, would like to request PhonePe Wealth Broking Private Limited or any of its group
entities to accept the signed account opening forms and documents, even in case there may be slight varia-
tions on a few pages/areas of the document.

I/We, the undersigned, further would like to represent and warrant that in case of any misrepresentation
with respect to the signatures placed on the account opening forms or all such documents towards Pho-
nePe Wealth Broking Private Limited or any of its group entities by me/us, I/We will indemnify PhonePe
Wealth Broking Private Limited and its directors/employees/agents for all such actions.

Date 07-06-2024

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR Stamp duty of Rs.100 paid via Stamp Paper Certificate No. IN-KA01228314615144W
Date:Fri Jun 07 08:50:40 IST 2024 dated 11/05/2024
Signature

35
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Most Important Terms & Conditions (MITC)

1. Your trading account has a “Unique Client Code” (UCC), different from your demat account number. Do
not allow anyone (including your own stock broker, their representatives and dealers) to trade in your
trading account on their own without taking specific instruction from you for your trades. Do not share
your internet/ mobile trading login credentials with anyone else.

2. You are required to place collaterals as margins with the stock broker before you trade. The collateral
can either be in the form of funds transfer into specified stock broker bank accounts or margin pledge
of securities from your demat account. The bank accounts are listed on the stock broker website.
Please do not transfer funds into any other account. The stock broker is not permitted to accept any
cash from you.

3. The stock broker’s Risk Management Policy provides details about how the trading limits will be given
to you, and the tariff sheet provides the charges that the stock broker will levy on you.

4. All securities purchased by you will be transferred to your demat account within one working day of
the payout. In case of securities purchased but not fully paid by you, the transfer of the same may be
subject to limited period pledge i.e. seven trading days after the pay-out (CUSPA pledge) created in
favor of the stock broker. You can view your demat account balances directly at the website of the
Depositories after creating a login.

5. The stock broker is obligated to deposit all funds received from you with any of the Clearing
Corporations duly allocated in your name. The stock broker is further mandated to return excess funds
as per applicable norms to you at the time of quarterly/ monthly settlement. You can view the amounts
allocated to you directly at the website of the Clearing Corporation(s).

6. You will get a contract note from the stock broker within 24 hours of the trade.

7. You may give a one-time Demat Debit and Pledge Instruction (DDPI) authority to your stock broker for
limited access to your demat account, including transferring securities, which are sold in your account
for pay-in.

8. The stock broker is expected to know your financial status and monitor your accounts accordingly. Do
share all financial information (e.g. income, networth, etc.) with the stock broker as and when requested
for. Kindly also keep your email Id and mobile phone details with the stock broker always updated.

9. In case of disputes with the stock broker, you can raise a grievance on the dedicated investor grievance
ID of the stock broker. You can also approach the stock exchanges and/or SEBI directly.

10. Any assured/guaranteed/fixed returns schemes or any other schemes of similar nature are prohibited
by law. You will not have any protection/recourse from SEBI/stock exchanges for participation in such
schemes.

Digitally Signed by:

Name:ANISH SURYAKANT DEOLEKAR
Date:Fri Jun 07 08:50:40 IST 2024

Signature

36