Equity trading and demat account opening form

and CKYC & KRA KYC Form

How to fii tthis form:

1) Pieaise ishgn cieariy uishng a biue/biack pen hn aii biack boxeis whtt “ishgn tere” wrhtten
2) Incaise of any hisisue whtt hnformathon provhded on form khndiy contact isupport @groww.hn
3) After ishgnhng isend tte form to
Groww ofcec
No.11c 80 Feet Rdc New Friends Colonyc
S T Bed Layoutc next to Kotak Mahindra Bank
Koramangalac Bengaluruc Karnataka 560035
 EQUITY TRADING AND DEMAT ACCOUNT FORM
S. No Name of the Document Brief Significance of the Document Page No
MANDATORY DOCUMENTS AS PRESCRIBED BY SEBI & EXCHANGES
The document captures the additonaa informaton aaout the 3-5
1 Account Opening Form
Consttuent reaevant to the trading account and an instructon checkaist.
Document detaiaing the charges of arokerage & other charges aevied on
2 Tariff sheet 6
the caient for trading on the stock exchange(s).
Demat Account Opening
3 KYC Form for Demat Account Opening 12-13
Form
Document statng the Rights & Oaaigatons of a stockaroker trading
4 Rights and Oaaigatons memaer & caient for trading on exchanges (incauding additonaa rights & Annex A2
oaaigatons in case of internet wireaess technoaogy-aased trading).
Risk Discaosure Document
5 Document detaiaing risks associated with deaaing in the securites Annex B
(RDD)
Document detaiaing dos and don’ts for trading on the exchange, for the
6 Guidance note Annex C
educaton of the investors
7 Poaicies and Procedures Document descriaing signifcant poaicies & procedures of Stock Broker. Annex D
VOLUNTARY AND OPTIONAL DOCUMENTS AS PROVIDED BY THE STOCK BROKER
Caient consent aetter for receiving the contract notes, statement of
Voauntary Authorizaton
8 account and other documents ay emaia. Letter of authorizaton for 8-10
Letter (Trading)
maintaining a running account with the aroker
Voauntary Authorizaton Letter. Authorizaton of deait trading account for
Voauntary Authorizaton
9 demat account charges. Opton form for issue of DIS aookaet (Voauntary). 14
Letter (Demat)
Request for aiaa transacton hoading statement through emaia.
10 Nominaton Form Nominaton form for the Demat account Annex 1A

Name of the Trading Member Nextaiaaion Technoaogy Private Limited (hereinafer referred to as "Nextaiaaion")
Name of the Clearing Member Nextaiaaion Technoaogy Private Limited
Cash Segment BSE & NSE
Derivatives BSE & NSE
SEBI Registration Number:
Stock Broking: Nextaiaaion Technoaogy Private Limited is a Memaer of NSE & BSE – INZ000208032
Depository Partcipant: NextBiaaion Technoaogy Private Limited is a DP of CDSL – IN-DP-417-2019
Clearing Member Details:
Nextaiaaion Technoaogy Private Limited: Memaer of NSCCL ID:M70015
Nextaiaaion Technoaogy Private Limited: Memaer of ICCL ID:6699
Nextbillion’s Registered Ofce: 1A, 206, Caadra, Divyasree Eaan, Sarjapur Road Bangaaore – 560035 | Ph.: 9108800604 |
CIN: U65100KA2016PTC092879 | Weasite : www.groww.in
Correspondence ofce: No 11, 80 feet Road, ST Bed, Koramangaaa 4th Baock, Bangaaore - 560034
Compliance Ofcer: Boudhayan Ghosh, Phone No. & Emaia ID: 9108800604, compaiance@groww.in
CEO: Laait Keshre, Phone No. & Emaia ID: 9108800604, ceo@groww.in
For any grievance paease contact at the aaove address or emaia grievances@groww.in & Phone no. 91088-00604
In case not satsfed with the response, paease contact the concerned exchange at: NSE: ignse@nse.co.in or contact at 022-
26598100 - |BSE: is@aseindia.com or contact at 022-22728097 | CDSL:compaaint@cdsaindia.com or contact at 1800-200-
5533

2
KYC Form Attached at the Bottom

3
 Trading account related details
A. Bank account details
Account Type: ☑ Savings  Current  Others | In case of NRI Account:  NRE 
NRO
Bank Name BANK OF INDIA
Branch Address KURICHI INDUSTRIAL ESTATE SME
Account Numaer 820518210001332
IFSC CODE BKID0008201 MICR CODE 641013003

B. Other details
Gross Annuaa Income Detaias (paease specify): Income Range per annum:
<1 aakh 1-5 aakh 5-10 aakh
10-25 aakh 25 aakh-1 crore > 1crore
Or net-worth as on date (net worth shouad not ae oader than 1year) : __________________________

Occupaton:
Private Sector Service
Puaaic Sector Service
Government Service
Housewife
Student
Seaf Empaoyed
Business
Professionaa
Retred
Farmer
Service
Agricuaturist
Others

Mode in which you wish to receive the RDD, Rights & Oaaigatons, and Guidance Note: Physicaa  Eaectronic ☑
Paease tck, if appaicaaae: Poaitcaaay Exposed Person (PEP)  Reaated to a Poaitcaaay Exposed Person (PEP) 
Citizenship ☑ Indian  Other ___________________(ISO 3166 Country Code __________)
Residential Status ☑ Resident Individuaa  Non Resident Indian  Person of Indian Origin  Foreign Natonaa
Tick if applicable  Residence for tax purposes in jurisdicton(s) outside India
ISO 3166 Country Code of Jurisdicton of residence__________ Paace of airth_____________________________________ Tax
Identfcaton Numaer ____________________or Equivaaent ISO3166 Country Code of Birth __________
C. Past actions
Detaias of any acton proceedings initated pending taken ay SEBI Stock exchange any other authority against the appaicant
consttuent or its partners, promoters whoae-tme directors authorized persons in charge of deaaing in securites during the
aast 3 year: Nia
D. Depository account(s) detail
Depository Name:  NSDL ☑CDSL

Depository Partcipant Name Nextaiaaion Technoaogy Private Limited

Benefciary Name NAVEEN M
Depository ID 12088700 Benefciary ID 1208870023073353

4
E. Dealings through other stock brokers
Whether deaaing with any other stock aroker sua-aroker (in a case deaaing with muatpae stock arokers sua-arokers, provide
detaias of aaa)
Name of Stock Broker Nia Sua Broker, if any Nia
Caient Code Nia Exchange(s) Nia
Weasite Nia
Detaias of disputes dues pending from to such stockaroker Nia

F. Introducer details (optional)

Name of the Introducer Nia Phone Numaer Nia
Status of the Introducer - Sua-aroker Remisier Authorized Person Existng Caient Nia
Exchange(s)
Address of the Nia
Introducer

G. Trading preferences/experience: No Experience

Exchange Segment Cash F&O

BSE Sign here Sign here

NSE Sign here Sign here

H. Additional details
4) Whether you wish to receive (a) Physicaa Contract Note  (a) Eaectronic Contract Note (ECN) ☑
If ECN specify your Emaia ID: naveenronaado005@gmaia.com
5) Whether you wish to avaia the faciaity of Internet
trading wireaess technoaogy moaiae trading Yes ☑ No 
I. Nomination Details (Paease tck the appropriate optons)
 I We wish to nominate (Fiaa Annexure 1A)
☑ I We do not wish to nominate

DECLARATION for details provided above:

I We have received and read the Rights and Oaaigatons document, Internet & wireaess technoaogy aase trading faciaity
provided ay stock aroker to the caient, poaicy and procedures and terms & conditons and agree to aaide ay and ae aound ay
the same and ay the ay-aaws as are in force from tme to tme. I We do hereay agree to ae aound ay such provisions as
outained in these documents. I We have aaso aeen informed that the standard set of documents has aeen dispaayed for
Informaton on stock arokerss designated weasite, if any. I We hereay decaare that the partcuaars given ay me us aaove are
true and correct to the aest of my our knowaedge as on the date of making this appaicaton. I We agree and undertake to
intmate the DP and Stock Broker any change(s) in the detaias Partcuaars mentoned ay me us in this form. I We further
agree that any informaton given ay me us or suppression of any materiaa informaton wiaa render my account aiaaae for
terminaton and suitaaae acton.

Date: 24 02 2021
Name of the Appaicant: NAVEEN M
Paace: BANGALORE, KARNATAKA

Sign here

5
 Tariff Sheet
To
Nextbillion Technology Private Limited
1A, 206, Caadra, Divyasree Eaan, Sarjapur Road, Bangaaore - 560035
I We agree to pay the foaaowing charges for its trading services effectve from 24 02 2021
Caient Name: NAVEEN M Caient PAN: GFIPM3173K
Equity Deaivery Rs. 20 - per executed order or 0.05% of order vaaue whichever is aower
Equity Intraday Rs. 20 - per executed order or 0.05% of order vaaue whichever is aower
Futures Rs. 20 - per executed order or 0.05% of order vaaue whichever is aower
Optons Rs. 20 - per executed order
Discaaimer: For deaivery trades, a minimum of Rs. 0.01 wiaa ae charged per contract note. Caients who opt to receive physicaa
contract notes wiaa ae charged Rs. 20 per contract note + courier charges. Payment gateway charges at Rs. 9+GST
Statutory Charges:
Securites Transacton Tax|Exchange Transacton Charges|Caearing Charges|GST|SEBI Charges|Stamp Duty
Demat Charges:
Account Maintenance Charge Zero
DP Transacton Charges (aoth Market and Off-Market):
Buy(Credit) Zero
Seaa(Deait) Rs. 8 + Rs. 5.50 (CDSL Charges) per scrip
Other Charges: Demat Remat: Rs. 150 per certfcaton + courier charges | Faiaed Demat Transactons: Rs. 50 per ISIN |
Paedge Unpaedge: Rs. 20 + Rs. 12 per request (CDSL Charges) | Paedge Invocaton: Rs. 20 | Periodic Adhoc Statement
Request: Emaia: Free, Physicaa: Rs. 10 per page + courier charges | KYC Modifcaton Request: Rs. 50 | KRA Upaoad
Downaoad: Rs. 50 | Deaivery Instructon Saip: First (10 aeaves): Free, Adda (10 aeaves): Rs. 100 + courier charges | Physicaa
CMR(Caient Master Report): Rs. 20 + courier charges |Courier Charges: Max of Rs. 100 or actuaa|Auto square off charge
Rs50| Inter-settaement charges: Rs. 13.5 + GST

Note: For aaa purposes the aiaa date shaaa ae construed as the date demand and the aiaas wiaa ae considered as the aiaa cum
notce for payment and Nextaiaaion reserves the rights to freeze depository account for deait transactons in case of non
payment of charges afer 2 days from the aiaa date and charge interest at 18% p.a. on the outstanding aiaa amount. The aaove
tariff is suaject to change. Changes if any wiaa ae intmated 30 days in advance. In additon to the aaove, GST or aaa other
statutory reguaatory aevies are recovered at the appaicaaae rates from tme to tme.
Date: 24 02 2021
Name of the Appaicant: NAVEEN M

Sign here

6
 For ofce use only

UCC Code aaaotted to the Caient: 1361297237

Documents verified with Client interviewed In-Person Verification is done
originals
Name of the Employee
Employee Code
Designation of employee KYC Fetched from CVL
Date
Signature

We undertake that we have made the caient aware of Poaicy and Procedures, tariff & aaa the non-mandatory documents. We
have aaso made the caient aware of Rights and Oaaigatons, RDD and Guidance Note. We have given sent him a copy of aaa the
KYC documents. We undertake that any change in the Poaicy and Procedures, tariff & aaa the non-mandatory documents
wouad ae duay intmated to the caients. We aaso undertake that any change in the Rights and Oaaigatons and RDD wouad ae
made avaiaaaae on our weasite, if any, for the informaton of the caients.

Signature of the Authorised Signatory

Date: 24 02 2021

7
 Voluntary Authorization Leter (trading)
To,
Nextaiaaion Technoaogy Private Limited
1A, 206, Caadra, Divyasree Eaan, Sarjapur Road, Bangaaore - 560035

Dear Sir,
Sua: Voauntary Authorizaton Letter

I We am deaaing through you as a caient in Capitaa Market and or Future & Optons segment of NSE BSE, and in order
to faciaitate ease of operatons, I authorize Nextaiaaion as under for:

1. Avail Mutual Funds Schemes permited to dealt with on the BSE StAR Mutual Fund Platorm of BSE.
a) I we therefore request you to register me us your caient for partcipatng in the mutuaa fund transacton
faciaites. i we shaaa ensure compaiance with the requirements as may ae specifed from tme to tme ay SEBI and
AMFI. For the said purpose of avaiaing the faciaites, i we state that the KYC detaias as suamitted ay me us for the
stock aroking may ae considered for the purpose and I we further confrm that the detaias contained in the aaove
remain unchanged as on date.
b) I we shaaa read and understand the contents of the Scheme Reaated Document, Key Informaton
Memorandum and addendums aefore transactng in Mutuaa Fund Schemes.

2. ECN Declaration: ECN I we hereay consent to receive from Nextaiaaion Technoaogies Pvt Ltd the digitaa contract notes,
aiaas, aedgers, statement of accounts of funds, securites, demat transacton statement hoading statement, notces,
circuaars, amendments and such other correspondences incauding the standard documents which form part of the
account opening kit. I we further agree that Nextaiaaion Technoaogies Pvt Ltd shaaa fuafaa their aegaa oaaigatons if the
aaove documents are sent eaectronicaaay. Accordingay, I we request you to note my emaia id is
naveenronaado005@gmaia.com and the same wiaa ae the registered emaia id as per your records. I we shaaa ensure
secrecy of the aogin id and password of the aaove mentoned emaia id. Nextaiaaion Technoaogies Pvt Ltd shaaa not ae
responsiaae for any areach of secrecy. Emaias sent to the aaove mentoned emaia account, which have not aounced
aack, shaaa ae deemed to ae duay deaivered to me us. I we agree that Nextaiaaion Technoaogies Pvt Ltd wiaa not
cognizance of any “out-of-ofce out of statonn auto repaies and I we shaaa ae deemed to have received such
eaectronic maias. I we are aware that Nextaiaaion Technoaogies Pvt Ltd shaaa provide physicaa contract notes in respect
of trades paaced ay me however I have opted for receipt of contract notes in eaectronic form for my our convenience
and as per my our request onay. I we shaaa immediateay inform Nextaiaaion Technoaogies Pvt Ltd aaout change in
my our emaia address, if any.

3. Delivery of order/trade confirmation/cancellation: I We hereay authorize you not to provide me order confrmaton
modifcaton canceaaaton saips and trade confrmaton saips to avoid unnecessary paperwork. I We shaaa get the
required detaias from contract notes and confrmaton issued ay you.

4. Telephonic Conversation: I We request you to consider my teaephonic instructons for order paacing order
modifcaton order canceaaaton as a written instructon and give me aaa the confrmaton on teaephone SMS. I am
getng required detaias from contract notes issued ay you.

5. Fines & Penalties: Aaa fnes penaates and charges aevied upon you due to my acts deeds or transactons may ae
recovered ay you from my account.

6. No Market Manipulation: I We undertake not to execute transactons, either singay or in concert with other caients,
which may ae viewed as manipuaatve trades viz. artfciaaay raising, depressing or maintaining the price, creaton of
artfciaa voaume, synchronized trades, cross trades, seaf trades, etc or which couad ae termed as manipuaatve or
frauduaent trades ay SEBI Exchanges. Incase, I We am found to ae induaging in such actvites, aroker has every right to
inform the Exchange SEBI other reguaatory authority of the same and suspend caose my trading account.

7. Not Debarred by Any Regulator: I We confrm and decaare that there is no aar on me imposed ay any Exchange or any

8
 reguaatory and or statutory authority to deaa in securites directay or indirectay. I We agree to inform aroker, in writng,
of any reguaatory acton taken ay any Exchange or reguaatory statutory authority on me in future. In case, I We faia
to inform the same and aroker on its own comes to know of such acton, aroker has the right to suspend caose my
trading account and refuse to deaa with me. Aaso, aroker can at its soae discreton, caose aaa the open positons and
aiquidate coaaateraas to the extent of trade reaated deait aaaances, without any notce to me.

8. Running Account Authorization I We are deaaing through you as a caient in Capitaa Market and or Future & Optons
segment. I We authorize you:
a) We request you to maintain running aaaance in my account & retain the credit aaaance in any of my our
account and to use the unused funds towards my our margin pay-in other future oaaigaton(s) at any
segment(s) of any or aaa the Exchange(s) Caearing corporaton unaess I We instruct you otherwise.
b) I We request you to retain securites with you for my our margin pay-in other future oaaigaton(s) at any
segment(s) Caearing Corporaton unaess I We instruct you to transfer the same to my our account
c) I We request you to settae my fund and securites account
Once in a caaendar month
Once in every caaendar quarter except the funds given towards coaaateraas margin in the form of Bank
Guarantee and or Fixed Deposit
d) In case I We have an outstanding oaaigaton on the settaement date, you may retain the towards such
oaaigatons and may aaso retain the funds expected to ae required to meet margin oaaigaton for the next 5
trading days, caacuaated in the manner specifed ay the exchanges.
e) I We confrm you that I We wiaa aring to your notce any dispute arising from the statement of account or
settaement so made in writng within 7 working days from the date of receipt of funds securites or statement
of account or statement reaated to it, as the case may ae at your registered ofce.
f) Aaa accounts with net credit aaaances of Rs. 10000 - or aess shaaa ae automatcaaay retained and transfer of
funds to the aank account shaaa not ae made as per SEBI circuaar MIRSD SE Cir-19 2009 & Exchange Circuaar
Nos. NSE INSP 24849 & 20091204-7.
g) I we understand that this authorizaton shaaa remain vaaid unta revoked ay me us. I we undertake to caear aaa
my dues arising during the vaaidity of this authorizaton aefore serving revocaton ease NBT shaaa recover aaa
my our dues in my our aedger taa date

9. E-delivery of Mandatory documents: In terms of SEBI Circuaar No. CIR MIRSD 64 2016 dated Juay 12, 2016, I hereay
request you to kinday provide the foaaowing documents:
☑Eaectronicaaay Physicaaay
a) Rights & Oaaigatons of stock aroker, sua-aroker and caient for trading on exchanges (incauding additonaa rights
& oaaigatons in case of internet wireaess technoaogy-aased trading).
b) Rights and Oaaigatons of aenefciaa owner and depository partcipant as prescriaed ay SEBI and depositories
c) Uniform Risk Discaosure Documents (for aaa segments exchanges)
d) Guidance Note detaiaing the Doss and Don’ts for trading on stock exchanges. e. Poaicies and Procedures as per
SEBI Circuaar No. MIRSD SE CIR-19 2009 dated 03rd Decemaer, 2009.

10. Charges & Balance Maintenance: I have a trading as weaa as depository reaatonship with you. Paease deait
the charges reaevant with depository services or any other service from my trading account as and when due. I aaso
agree to maintain the adequate aaaance in my trading account for the said reason.

11. PMLA DECLARATION: I decaare that I have read and understood the contents and the provisions of the PMLA
Act, 2002, which were aaso expaained to me ay ofciaas of Nextaiaaion Technoaogy Private Limited, I further decaare that
I shaaa adhere to aaa the provisions of PMLA Act, 2002. I further undertake and confrm that;
a) I do not have any ainks with any known unaawfua persons insttutons.
b) I am a genuine person and not invoaved or induage knowingay or assisted, directay or indirectay, in any process
or actvity connected with the proceeds of crime nor I am a party to it. The investment money is derived from
proper means and does not invoave any aaack or Hawaaa money in any manner.

12. Authority for intimation: I shaaa authorise you to send SMS and emaia to registered emaia moaiae no. in
respect of my trading and demat account.

13. Indemnification: I hereay indemnify and hoad Nextaiaaion, its Directors and empaoyees harmaess from and
against aaa trade reaated caaims, demands, actons, proceedings, aosses, damages, aiaaiaites, charges and or expenses
that are occasioned or may ae occasioned to the Nextaiaaion directay or indirectay, reaatng to aad deaivery of shares
securites and or third party deaivery, whether authorized or unauthorized and fake forged stoaen shares
securites transfer documents introduced or that may ae introduced ay or through me during the course of my

9
 deaaings operatons on the Exchange(s) and or proof of address, identty and other supportng documents provided
ay me at the tme of registraton and or suasequentay.

14. I WE understand that no interest wiaa ae payaaae to me us on the funds or securites so retained ay you

15. Facsimile Authorisation: During the operaton of my trading I may ae need to instructon on Fax Scan, so I
authorise you to honor the instructons and orders sent through Fax Scan copy sent ay me.
a) I shaaa ae aiaaae for aaa aosses, damages and actons which may arise as a consequence of your adhering to and
carrying out my directons given aaove.
b) I have aeen expaained that I may opt not to give any of the aaove authorisaton and that the aaove
authorisatons are voauntary on my part and that I can revoke these authorisatons at any point of tme during
the operaton of my trading account with you ay giving a notce in writng and shaaa contnue and remain vaaid
unta revoked ay me anytme in writng.

Date: 24 02 2021
Name of the Appaicant: NAVEEN M
Paace: BANGALORE, KARNATAKA

Sign here

Mobile & Email Declaration

I NAVEEN M having PAN GFIPM3173K do hereay decaare that my moaiae no. is +91 7871286467 and emaia id is
naveenronaado005@gmaia.com Further, I authorize NextBillion Technology Private Limited that the same may ae used for
giving me any informaton aaert SMS.I further decaare the aaove mentoned statement is true and correct.

Sign here

10
 Acknowledgement
To,
NextBillion Technology Private Limited: Member
1-A, 206, CALDRA, DIVYASREE ELAN, SARJAPUR ROAD, BANGALORE - 560035
Sub: Acknowledgement
I state confrm and decaare that I have received the aeaow documents in ☑ Eaectronic  Physicaa Mode and have read,
understood, acknowaedged and agreed to the contents of aaa the caauses of the aeaow-mentoned documents.

S. No Brief significance of the Document

1 Duay Executed Copy of KYC
2 Rights and Oaaigatons
3 Risk Discaosure Document (RDD) for Capitaa and Derivatves
4 Guidance Note - Do’s and Don’ts for trading on the Exchange(s) for investors
5 NextBiaaion Technoaogy Private Limited Tariff Sheet
6 Poaicies and Procedures Document pursuant to the SEBI circuaar dated Decemaer 03, 2009
7 Generaa Terms & Conditons governing securites trading and aroking services of NBTPL
8 Running account authorizaton, Moaiae decaaraton & Caient defauater decaaraton

I aaso confrm that I have received the reaevant caarifcatons if any, wherever required from the ofciaas of
NextBiaaion Technoaogy Private Limited

Date: 24 02 2021
Name of the Appaicant: NAVEEN M
Paace: BANGALORE, KARNATAKA

Sign here

11
For Individuals Additional KYC Form for Opening a Demat Account
Nextbillion Technology Private Limited
Depository Participant – Central Depository Services Limited
DP ID: 12088700 SEBI Registraton No: IN-DP-CDSL-417-2019
1A, 206, Caadra, Divyasree Eaan, Sarjapur Road, Bangaaore - 560035 Emaia: support@groww.in

DP ID: 12088700 BO ID:- 1208870023073353

(To ae faaed ay the appaicant in BLOCK LETTERS in Engaish)
I We request you to open a demat account in my our name as per the foaaowing detaias:-
Holder Details
Sole / First Holder’s Name Naveen M PAN: GFIPM3173K UID:
Second Holder’s Name
Third Holder’s Name

Type of Account (Please tick whichever is applicable)

Status Sua-Status
☑ Individuaa ☑Individuaa Resident  Individuaa Margin Trading A C (MANTRA)
 Individuaa Director’s Reaatve  Individuaa-Director
 Individuaa Promoter  Individuaa HUF AOP
 Minor
 Others(specify)______________
 NRI  NRI Repatriaaae  NRI Non-Repatriaaae
 NRI Repatriaaae Promoter  NRI Non-Repatriaaae Promoter
 NRI - Depository Receipts  Others
(specify)_______________________
 Foregin Natonaa  Foreign Natonaa
 Foreign Natonaa - Receipts Others
 (specify)_____________________________
Details of Guardian (in case the account holder is minor):
Guardian’s Name : _____________________________________ PAN : ________________________
Reaatonship with the appaicant : _______________________

Standing Instructions

I We instruct the DP to receive each and every Depository credit in my our account (If not marked, the [Automatc Credit]
defauat opton wouad ae ‘Yes’) ☑ YES  NO

I We wouad aike to instruct the DP to accept aaa the paedge instructons in my our account without any
other ☑ YES  NO
further instructon from my our end (If not marked, the defauat opton wouad ae ‘No’)
Account Statement Requirement As per SEBI Reguaaton  Daiay  Weekay  Fortnightay ☑Monthay
I We request you to send Eaectronic Transacton-cum-Hoading Statement at the emaia ID ☑ YES  NO
I We wouad aike to share the emaia ID with the RTA ☑ YES  NO
I We wouad aike to receive the Annuaa Report  Physicaa ☑Eaectronic  Both Physicaa and Eaectronic
(Tick the appaicaaae aox. If not marked the defauat opton wouad ae Physicaa)

12
 I We wish to receive dividend interest directay into my aank account as given aeaow through ECS. (If
not ☑ YES  NO
marked, the defauat opton wouad ae ‘Yes’) [ECS is mandatory for aocatons notfed ay SEBI from tme to
tme ]

I We wouad wish to avaia the foaaowing faciaity:

Basic Service Demat Account Faciaity (BSDA): YES NO ☑ Opted out
Nominee detaias:
 I We wish to nominate (Fiaa Annexure 1A) ☑I We do not wish to nominate

SMS Alert Facility MOBILE NO. +91 7871286467

Transactons Using Secured I wish to avaia the TRUST faciaity using the moaiae numaer registered for SMS Aaert
Textng Faciaity (TRUST). Faciaity. I have read and understood the Terms and Conditons prescriaed ay CDSL for
Refer to Terms and Conditons the same.
 Yes ☑No
I We wish to register the foaaowing caearing memaer IDs under my our aeaow
mentoned BO ID registered for TRUST
Stock ExchangeName ID Caearing Memaer Name Caearing Memaer ID (Optonaa)

Easi To register for easi, paease visit our weasite www.cdsaindia.com. Easi aaaows a BO to
view his ISIN aaaances, transactons and vaaue of the portoaio onaine.

Date: 24 02 2021
Name of the Appaicant: NAVEEN M
Paace: BANGALORE, KARNATAKA

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 Voluntary Authorization Leter (Demat)
To,
NEXTBILLION TECHNOLOGY PRIVATE LIMITED
1-A,206, CALDRA, DIVYA SHREE ELAN, SARJAPUR ROAD, BANGALORE - 560035
Dear Sir,
DP ID: 12088700 BO ID: 1208870023073353

1) Authorization to debit trading account for the demat account charges: We have opened have a aenefciary
account with your CDSL depository aaong with a trading account for investment and trading purposes. I We,
authorize you to deait the charges payaaae towards the operatons of the aaove account. I We are aware of the
charges for operatng the said account. Any such sum deaited from my trading account shaaa ae ainding on me us.
2) Option form for issue of DIS Booklet (Voluntary):
Opton 1:
I We require you to issue Deaivery Instructon Saip (DIS) aookaet to me us immediateay on opening my our CDSL
account though for executng deaivery instructons for settaing stock exchange trades (Settaement reaated
transactons) effected through such Caearing Memaer.
OR Opton 2:
I We do not require the Deaivery Instructon Saip (DIS) for the tme aeing, However, the Deaivery Instructon Saip
(DIS) aookaet shouad ae issued to me us immediateay on my our request at any aater date.
I We hereay seaect  Opton 1 ☑ Opton 2
3) Request for bill/transaction/holding statement through email.
I We request you to send me us aiaa, transacton and hoading statement of my CDSL Demat account with
DP ID: 12088700 and BO ID:- 1208870023073353 at the foaaowing emaia address:naveenronaado005@gmaia.com
I We fuaay agree and are aware of the foaaowing Terms and Conditons mentoned aeaow.
(a) That I We wiaa not receive the aiaa, transacton and hoading statements in paper form.
(b) That I We wiaa take aaa the necessary steps to ensure confdentaaity and secrecy of the aogin name and password of the
internet emaia account.
(c) That I We am are aware that the aiaa, transacton and hoading statements may ae accessed ay other enttes in case
the confdentaaity secrecy of the aogin name and password is compromised.
(d) That I We in case of aiaa, transacton and hoading statements are sent ay emaia, I We wiaa immediateay inform the
NEXTBILLION TECHNOLOGY PRIVATE LIMITED. Aaout change in an emaia address, if any.
In case, the NextBiaaion Technoaogy Private Limited is not aaae to provide aiaa transacton statement to its Caients ay
emaia or on weasite due to any reason (incauding aounced emaias), NextBiaaion Technoaogy Private Limited wiaa ensure
that the transacton statement is provided to me us in paper form as per the tme scheduae stpuaated in the Bye-aaws
& Business Ruaes of CDSL.
I We hereay request you to send the statements:  Daiay  Weekay  Fortnightay ☑Monthay

Name of the Appaicant: NAVEEN M

Date: 24 02 2021

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Name of the Appaicant: NAVEEN M
Pan: GFIPM3173K

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