This document is a request form to add or modify bank details and annual income details for a client's broking and demat accounts. It includes fields to provide existing and new bank account information, income range, and an authorization for the brokerage to update annual income details from other sources. The client declares that the information provided is true and correct and acknowledges submitting the modification request.

1. PLEASE FILL ALL THE DETAILS IN BLOCK LETTERS IN ENGLISH (Please mark (ü) on the appropriate column.
ADDITION OF BANK DETAILS AND UPDATION OF ANNUAL INCOME REQUEST FORM
NOTES: Any one Proof Required from the following list (Self attested by client and all joint holders, if any):
Bank details: Copy of cheque with name printed, copy of bank passbook, copy of bank statement of accounts duly attested by bank authorities not older
than 3 months with cancelled cheque.
Second Holder Third Holder
Signature
Client Name
First/Sole Holder/Authorized Signatory
Acknowledgment Receipt
We hereby acknowledge the receipt of the your instruction for modication of the following Account subject to verication:
Seal and Signature
Bank Details Gross Annual Income Details
Modication request for
(Specify reason)
1. Bank Details (tick Default)
ü for
Existing Details New Details
I/We hereby declare that the details furnished above are true and correct to the best of my/our knowledge and belief. In case any of the above mentioned
information is found to be false or untrue or misleading or misrepresenting, I/we am/are aware that I/we may be held liable for the same. Further, I/we hereby
give my/our consent to MACM that in future if they receive my/our updated annual income details / net-worth details, if any, then they are authorized to update
the same in my/our broking and/or demat account with them, in my/our records with the stock exchanges, depositories and/or any other regulated entities,
and/or to any regulatory authorities without seeking any conrmation from me/us in this regard.
A/c No.:
A/c Type:
MICR :
IFSC Code:
Bank Name & Branch address
A/c No.:
A/c Type:
MICR :
IFSC Code:
Bank Name & Branch address
2. Gross Annual Income Details as on the Date of this Declaration: Income Range per annum (Please Specify)
Net worth should not be older than 1 year. In case of Non-Individual, Gross Annual Income Details and Net Worth both are required.
Net worth as on (Date) `
Account Holder’s Details PAN:
CDSL DP ID: 1 2 0 9 2 9 0 0 BO ID: Client Code:
Date: D D M M Y Y Y Y
CDSL DP ID: 1 2 0 9 2 9 0 0 BO ID: Client Code:
Date: D D M M Y Y Y Y
Dear Sir/Madam,
I/We request you to make the following additions/modications to my/our Broking and Demat accounts as per option selected by me/us as below.
Addition
Or
Modication
In Person Verication/Original Veried/Signature in My Presence CDSL DP ID:
Branch : Employee Name : Employee Code:
Employee Sign. : Date: Place :
1 2 0 9 2 9 0 0
D D M M Y Y Y Y
MIRAE ASSET CAPITAL MARKETS (INDIA) PRIVATE LIMITED
Below `1 Lac 1 - 5 Lacs 5 - 10 10 - 25 more than - `25 Lacs
` ` `
Lacs Lacs
NameofTradingMember&DP: MIRAEASSETCAPITALMARKETS(INDIA)PRIVATELIMITED
SEBI Registration No and Date: Stock Broker (NSE & BSE) :- INZ000163138 (22/01/2018), Depository Participant (CDSL) : - IN-DP-
589-2021 (24/05/2021), Merchant Banker :- MB/INM000012485 (14/03/2018), Research Analyst :- INH000007526 (14/01/2020)
Trading and Clearing Member Code: 90144 and M52040, BSE Clearing No: 6681, CDSL DP ID : 12092900, AMFI Registered (ARN)
MutualFundDistributor:188742,PANNoandGSTRegistrationNo.: AALCM3742Kand27AALCM3742K1Z3
RegisteredOfficeAddress: UnitNo506,5thFloor,WindsorBldg.,Kalina,Off.CSTRoad,Santacruz(East), Mumbai-400098
Tel.:022-62661300
Main/Correspondence Office Adress : Unit No 502, 5th Floor, Leela Business Park, Andheri Kurla Road, Near Airport Road Metro
Station,Andheri(East),Mumbai–400059 Tel: 18002100818, EmailID:help@mstock.com
Note: 1 In case of Addition of New bank Details, the same will be updated in only Trading Account 2) In case of default bank change , the same
will be updated in Both Trading and Demat accounts.