Application for Opening an Individual/Joint Account

I request you to register me as your client and in this regard the following information is furnished:

Name:

_______________________________________

Address Office

________________________________

Residence:

______________________________________

________________________________

______________________________________

________________________________

______________________________________

Office

Residence

Tel :_______________________________________

__________________________________

Fax:_______________________________________

Mobile

Date of Birth:________________________________

___________________________________

Sex: Male/Female

Educational Qualification: ________________________________

Occupation:______________________________

Residential Status : Resident Indian/Non-Resident Indian/Others

Name Of Your Bank:_________________________________

Branch Address:____________________________________

____________________________________

Telephone No:

Account No:______________________________________

Client ID:________________________________________

DP ID:__________________________________________

(Please submit a letter from the banker attesting account number, opening date and signature)

Annual Income for the last three years: ___________________________________________

Income Tax No. (PAN/GIR): ____________________________________________________

Market Value or Portfolio as on _________:________________________________________

Whether Registered with any Broker Member: Yes/No

Name of the Broker and Exchange: _____________________________________

Client Code No:___________________________________

Introduced by :

Name:

_________________________________

Address

_________________________________

_________________________________

_______________________Tele______________

Copy of any two of the following proof of identity should be submitted:
Passport :__________ No_______Place of Issue _____________Exp.Date ________
Driving License : ________ Ration Card : _____
Voters Identity Card : ________ Copy of IT Return : ______ Tel. Bill: _____

The information furnished above is true to the best of my knowledge and belief, and I undertake to inform you of any changes therein, immediately in writing. I am agreeable to enter into an agreement to abide by your terms and conditions.

ATTESTATION BY BANK

Signature:_________________________

I hereby declare that Mr./Ms_________________________has a current/savings Bank A/c No._____________with _________Branch of _____________________ Bank. He/She has signed across the photograph and in the trading Account with VERTEX are similar to the signature, he/she had given to us in the Bank A/c opening documents.

Date:

Bank Seal

Signature and Designation Of Bank Official

Note :
1. Each client has to use one registration form. In case of joint name/family members, submit separate form for each person.
2. Original documents may be verified at the time of filling of application.
3. The information given above would be confidential. However, if the information is required by any government agency it may be given to them.

From:

Date:

____________________________

____________________________

Trading Account No.............................

To

VERTEX  Securities Ltd
II nd Floor
Thottathil Towers
Market Road
Cochin –18

Dear Sir,
Ref:
This is to inform you that most of my order; order modifications & cancellation will be passed on to you through Telephone. Hence I request you to execute those orders and confirm to me through telephone only followed by Contract Notes. I hereby agrees to collect Contract Notes from your office within 24 hours and hence please do not dispatch the Contract Notes to my address.

Thanking You,

Yours faithfully,