Additional details of Sole/ First Holder for updating Unique Client Code (UCC) record with Stock Exchanges.

(Mandatory
for Individual category of demat account linked with trading account) *
Nationality : Indian Other______________
Gross Income Range per annum : < 1 lac 1 lac to 5 lac 5 lac to 10 lac
(Tel.)
Fax no.
Tel no.
10 lac to 15 lac
25 lac to 50 lac 15 lac to 20 lac 50 lac to 1 Crore 20 lac to 25 lac > 1Crore
_________________________(networth should not be older than 1 year)
Gross Income Range as on date :
Networth as on date
Please tick, if applicable :
D D M M Y Y Y Y
D D M M Y Y Y Y
Politically Exposed Person Related to a Politically Exposed Person
*For non-Individuals, required annexure to be filled and attached with the application Form
I/We hold Demat account/s with you. I/We request you to update my/our new address as given below. I/We hereby authorize one
of the account holder(s)...................................................................................................................to submit the request.
3i, Infotech Limited, Akruti Trade Centre, 3rd Floor, P.10, Road No.7,
MIDC Marol, Bhim Nagar, Andheri (East), Mumbai-400 093.
Is your correspondence address same as your permanent address.
Flat Maintenance bill/ Insurance Copy /Aadhaar Letter issued by Unique Identification Authority of India. iii)
For NRI customers, In person verification required 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.