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Account details addition/modication/deletion request form
Zerodha
Zerodha Securities Private Limited
Zerodha Commodities Private Limited
Application number
Dated
Please ll all details in BLOCK LETTERS in English
12081600
DP ID
Client ID
Account holder details
First/sole holder
Second holder
Third holder
Name
Mother’s name
Aadhaar
PAN
I/We request to carry out the change of address/signature in the demat account.
I/We request to carry out the change of address/signature in the KRA and demat account.
I/We request you to make the following additions/modications/deletions to my/our account in your records.
Details: Please specify ‘Change of
address’, ‘Change of bank details’,
‘Change of telephone number’, etc.
Type of change: Please specify
if addition/modication/deletion
Existing details
New details
Attach an annexure (with signature(s)) if the space above is found insufcient.
F
First/Sole Holder
or Guardian
(in case of Minor)
S
Second Holder
T
Third Holder
FOR OFFICE USE ONLY
In Person Verication (IPV) Details:
Name of the Person who has done the IPV: ___________________________________________________
Designation: ____________________________________ Employee ID: __________________________
Name of the Organization: ZERODHA
Date of the IPV:
D
D
M
M
Y
Y
Y
Y
Signature of the Person who has done the IPV
Seal/Stamp of the Intermediary
Acknowledgement
We have received the account modication/addition/deletion request for the account with details below on D D M M Y Y Y Y
Application no.
DP ID
Client ID
First/sole holder
Third holder
Second holder
Account holder’s name
Modication request for
Seal & signature of
authorised signatory
AccountDetailsModificationDeletionForm.pdf (PDF, 1.41 MB)
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