Attach Additional Account to the Smart Card - Individuals
(One Form to be filled for each account separately)
To, Date:
DP Name : _________________________
I / We wish to register for SPEED-e service and intend to operate my/our demat accounts using an existing smart card as per the details given below:
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Client Id |
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DP Id |
I |
N |
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Sole / First Holder’s Name |
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Second Holder’s Name |
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Third Holder’s Name |
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2. User Id preference
Preference 1 : ____________________
Preference 2 : ____________________
Preference 3 : ____________________
Allotted User Id : ____________________
(to be filled by DP. If the preferred User Id is not available , the DP will allot another User Id.)
I / We authorise the following person to operate my / our account through SPEED-e (In case of joint holders you may authorise any one of the joint holders or any other person to become a Power of Attorney for operating SPEED-e). The details of the smart card user (either the sole holder or POA holder) are given below :
1. Name of smart card user : _____________________________________
2. Address : _____________________________________
_____________________________________
_____________________________________
___________________ PIN ______________
3. Email : ___________________
4. Existing Smart Card Details
Certificate Serial No. : ____________________
Smart Card Serial No. : ____________________
User Id : ____________________
Client Id : ____________________
Declaration
The rules and regulations pertaining to SPEED-e service which are in force have been read and understood by me/us and I/we agree to abide by and to be bound by the same. I/We declare that the account details given above indeed belong to me/us. I/We also authorise the following individual named below to operate my/our account using SPEED-e.
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Name |
Signature |
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Sole/First Holder Name |
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Second Holder Name |
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Third Holder Name |
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(to be signed by account holders)
The rules and regulations pertaining to SPEED-e service which are in force now have been read and understood by me and I agree to abide by and to be bound by the same. I declare that the information given by me is true and correct. I further agree that if any information given by me is false or misleading or any material fact is suppressed, it will render my SPEED-e service liable for termination and appropriate action.
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Name |
Signature |
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Sole Holder/POA Holder (Smart Card User) |
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(to be signed by smart card user)
For office use (DP) ---- Not to be filled by Applicant
The application form is verified with the details of the beneficial owner’s account and certify that the same is in order.
Original Registration Request No. : _________________________
Registration Request No. : _________________________
Name of Authorised Signatory : __________________________
Signature : __________________________
(DP’s stamp & Date)
For office use (NSDL)
Token Id : _______________
Smart Card Serial No. : _______________
Certificate Serial No. : _______________
Maker : ______________ Sign. & Date : _____________
Checker : ______________ Sign. & Date : _____________
___________________________________________________________________
Acknowledgment
Date : _____________
Received an application for subscribing to SPEED-e from _________________________ (sole/first holder name) having Client Id _________ .
(Name & Seal of the DP)