Shakil Rizvi Stock Limited

Corporate Member of Dhaka Stock Exchange Limited

158-160, Modhumita Building, 4th Floor, Motihjeel, Dhaka 1000 Phone: 7120899 (Hunting), Fax: 9564650, e-mail: rizvistock@shakilrizvistock.com, Web: www.shakilrizvistock.com

Sl. No.: SRSL ITD-

Date:.../.../.../

Registration form for Internet Trading

Name of Account Name of Account Operator (If, other than Individual) Fathers/Husband Name Mothers Name Trading ID (User ID) Sex
Male Femal e

BO ID
Date of Birth Contact Address City Mobile Number
(Use same Mobile Number which is in your BO accounts)

Country

Email
(Use same email address which is in your BO accounts)

Password (Minimum 6 digit) Retype Password (Minimum 6 digit)

Please Provide your Mobile Number and E-mail address to any office of Shakil Rizvi Stock Limited before registration for Internet Trading

_________________ Applicant Signature Office use: Password Entry by Check by