Sushil Financial Services Pvt.Ltd.

12, Homji Street, Mumbai – 400 001, India Tel.: +91-22-40778000 Fax: +91-22-40778006 E-mail: dp@sushilfinance.com compliance@sushilfinance.com

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Please fill all the details in BLOCK LETTER in English

DP ID Client ID

Account Holder’s Details Client Code :

Name of First A/c Holder

Name of the Second A/c Holder

Name of the Third A/c Holder

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 { A } I/ We request you to make the following additions / modifications / deletions to my / our account in your records

Details (Pls. specify change in Address, Email id, Mobile)

Pls. Specify (Addition/Deletion/

Modification)

Existing Details New Details

{ B } Demat Details / Bank Details A/c Type Client ID / Bank A/C No DP ID / MICR & IFSC Code

Default Optional

Saving/Current CDSL/ NSDL

DP / Bank Name DP / Bank Address

Attach an Annexure (With Signature) if the space above is found insufficient. First / Sole Holder Second Holder Third Holder

Name

Signature

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Note: For Modification of part {A} you need to attach KRA modification page along with 2 sets of proofs with IPV stamp

For Modification of part {B} no need to attach KRA modification page if KRA is already submitted

Accounts Details Addition / Modifications / Deletions

Request Form for Demat & Trading A/c.

Depository Participant – ID 028900 DP SEBI Reg. No. IN- DP-CDSL- 194-2002 02

Appl. No. Date

Bank Account No. MICR IFSC