To,

Compliance Department
Kantilal Chhaganlal Securities Pvt.Ltd
3rd Floor, Kohli Villa,
Near Shopper Stop,
S. V. Road, Andheri (West),
Mumbai - 400058

Updated KYC details for Client Code____________as on ________________

Name
Client Code :
Address*

Phone No.**

Mobile No. (Mandatory)**

E-Mail ID (Mandatory)

Income Range*** Below Rs.1lac Rs.5 lacs to Rs.10 lacs

Rs.1 lac to Rs.5 lac Rs.10 lacs to Rs.25 lacs
Above Rs.25 lacs

Value of Investment
Networth (Company) Rs.__________________ as on ____/_____/___________
Rs._______________ lacs as certificated as end ______200__

Trading Activities Investment Arbitrage Trading

Segments Traded(Mandatory) BSE Cash _______________________ NSE Cash________________________

Sign against segments you trade (Sign above) (Sign above)

NSE F&O _______________________MCX-SX(Currency) ___________________

(Sign above) (Sign above)

MCX _______________________ NCDEX _______________________

(Sign above) (Sign above)

Investment Experience ____________ Years in stocks ____________ Year in Derivatives

____________ Years in other financial products.

* Submit latest Telephone bill\Electricity bill\ Bank statement \Rent agreement as Address proof.
**Submit latest mobile bill copy in case of post paid and recharge receipt in case of prepaid.
*** Submit latest IT returns or form-16 or Networth certificate
All modification requests should be accompanied with a clear PAN copy if demat account is not with
us.

I hereby confirm that the above details are correct and that I am trading in the segments\exchanges
specified above

________________________________________________
(Signature of client)