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Nomination for Trading and Demat Account

Annexure-1A
NOMINATION REGISTRATION ID: UCC/BO ID: DATE :
I (customer name) the sole holder/Guardian (in case of minor) hereby declare that:
I nominate the following person who is entitled to receive security balances lying in my account, Particulars whereof are given below,
in the event of my death
NOMINEE DETAILS 1st NOMINEE 2nd NOMINEE 3rd NOMINEE
Name of the nominee(s)(Mr./Ms)
Percentage of allocation
(If not equally shared, please specify
percentage)
Relationship with the Applicant (if any)
Address of the Nominee

Mobile number of the Nominee


Email ID of the Nominee
Proof of identity submitted
Fill below details only if the nominee is a minor
DATE OF BIRTH
Name of the Guardian of Nominee
Address of the Guardian of Nominee

Relationship of the Guardian with the


Nominee
Mobile number of the Guardian
Email ID of the Guardian
Proof of identity submitted
Residual Securities
(Tick any one nominee. If tick not marked default
will be first nominee)

Details of Witness
Witness 1st Witness 2nd Witness

Name:

Address:

Signature:

Name

Sole Holder
Signature

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