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Shyamol Equity Management Limited
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Shyamol Equity Management Limited
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Joint Applicant
Information of Joint Applicant
Nominee 1
Your Nominee Details
Nominee Guardian
Nominee Guardian Details
Power of Attorney
(POA) Form
Account type
*
Cash
Margin
Client Name
*
Name of contact person
*
In Case of Individual
*
Male
Female
Occupation
*
Father’s Name/ Husband Name
*
Mothers Name
*
Date of birth
*
Address
*
City
*
Post Code
*
State/Division
*
Country
*
Telephone
Mobile Phone
Fax
Email
If Company
Bank Name
Branch Name
Account No
Routing No
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Zone
Division
TIN/Tax ID
Nationality
National ID No:
Passport No
Passport Issue Place
Passport Issue Date
Expiry Date
Electronic Dividend Credit
Yes
No
Residency
Resident
Non resident
Name
*
Father’s Name/ Husband Name
*
Mothers Name
Date of birth
Sex
Male
Female
Nationality
Address
Third Signatory
Telephone
Name in Full
*
Short Name of Nominee
*
Relationship with Account holder
*
Percentage (%)
Address
City
Post Code
State/Division
Country
Nationality
Telephone
Mobile Phone
Fax
Email
Passport No/NID No
Passport Issue Place
Passport Issue Date
Expiry Date
Residency
Resident
Non resident
Date of birth
Name in Full
*
Short Name of Nominee
*
Relationship with Nominee
*
Date of birth of minor
Maturity Date of minor
Address
City
Post Code
State/Division
Country
Nationality
Telephone
Mobile Phone
Fax
Email
Passport No/NID No
Passport Issue Place
Passport Issue Date
Expiry Date
Residency
Resident
Non resident
Date of birth
Name of CDBL Participant
*
Name of POA Holder
Short Name of POA
Address
City
Post Code
State/Division
Country
Residency
Resident
Non resident
Nationality
Date of birth
Telephone
Mobile Phone
Fax
Email
Passport No/NID No
Passport Issue Place
Passport Issue Date
Expiry Date
Effective from
Effective To