Date:

To,
M/s Geojit BNP Paribas Financial Services Ltd.,
Civil Line Road, Padivattom
Kochi 682 024.
Dear Sirs,
I / We, ., resident of / having office at
. hereby state as under.
2. That I am a client of Geojit BNP Paribas Financial Services Limited with a Trading
Account with you in my individual name/ Corporate name under the Trade Code No.
., having executed the Member Client Agreement and the Individual Client
Registration Form.
3. That I agree that have been introduced by . who is
registered as a remiser with Geojit BNP Paribas Financial Services Limited.
.
Thanking You,
Sincerely Yours,
By (Client Signature)
ClientName:
Address:

By (Remiser Signature)
Remiser Name:
Remiser Code:
Address: