NominationDetails:

PRECHECK

FollowingprechecktobedonebeforesendingtherequestsforNomination(DPand
Trading accounts) to enable us to process the requests expeditiously and to avoid
possiblerejections.
Instructionsrelatedtonomination,areasbelow:

1. The nomination can be made only by individuals holding beneficiary owner

accountsontheirownbehalfsinglyorjointly.Nootherentityincludingsociety,
trust,bodycorporate,partnershipfirm,KartaofHinduundividedFamily,holder
ofpowerofattorneycannominate.Iftheaccountisheldjointlyalljointholders
willsignthenominationform.

2. Aminorcanbenominated.Insuchacase,thenameandaddressoftheGuardian
oftheminornomineeshallbeprovidedbythebeneficialowner.

3. TheNomineeshallnotbeatrust,society,bodycorporate,andpartnershipfirm,
KartaofHinduUndividedFamilyorapowerofAttorneyholder.Anonresident
IndiancanbeaNominee,subjecttotheexchangecontrolsinforce,fromtimeto
time.

4. Detailsofwitnessandsignaturearecompulsory.

5. Existingdetailsarecorrectlymentionedincaseofchangeinnominee.

6. Strikeoffwhicheverisnotapplicable.

(To be submitted in Duplicate)

To,

SBICAP Securities Ltd.

'A' Wing, Mafatlal Chamber, 2nd Floor,
N. M. Joshi Marg, Lower Parel (E), Mumbai - 400 013.
Tel.: 022 - 4227300/01 / email: helpdesk@sbicapsec.com

Sub: Application for Nomination Addition / Change / Deletion request form (To be Filled in CAPITAL letters only)
Dear Sir,
Please make necessary changes / addition in my/our account/s as per details given below: (PLEASE TICK APPR OPRIATE OPTION TO MAKE NECESSARY CHANGES)

CHANGE TO BE EFFECTED IN :

Trading Account

Depository Account

Trading Code:

BO ID:

1 2

Trading + Depository Account

4

Name of 1st Holder

Name of 2nd Holder

Name of 3rd Holder

NOMINATION Details

I/We the Sole holder/Joint holders/Guardian (in case of minor) hereby declare that I / We nominate the following person who is entitled to receive security balances lying
In my/our account, particulars whereof are given below, in the event of the death of the Sole holder or the death of all the Joint Holders.

Existing Details

New Details

PAN No.

PAN No.

Name _______________________________________________________________ Name _______________________________________________________________

Address _____________________________________________________________ Address _____________________________________________________________
___________________________________________________________________

___________________________________________________________________

City ______________________________ State______________________________ City ______________________________ State______________________________

Country _________________________ Pincode (Mandatory) ___________________ Country _________________________ Pincode (Mandatory) ___________________
Tel. _____________________________Mobile ______________________________ Tel. _____________________________Mobile ______________________________
Email ID _____________________________________________________________ Email ID _____________________________________________________________
Relationship with BO (if any) _____________________________________________

Relationship with BO (if any) _____________________________________________

Date of Birth (if Nominee is a minor) _______________________________________ Date of Birth (if Nominee is a minor) _______________________________________
GUARDIAN Details (If Nominee is a Minor)

As the, Nominee is a minor as on date, I/We appoint following person to act guardian and to receive the securities in this account on behalf of the Nominee in the event
of death of the Soleholder/all Joint holders.

Existing Details

New Details

Name _______________________________________________________________ Name _______________________________________________________________

Address _____________________________________________________________ Address _____________________________________________________________
____________________________________________________________________ ___________________________________________________________________
City ______________________________ State______________________________ City ______________________________ State______________________________
Country _________________________ Pincode (Mandatory) ___________________ Country _________________________ Pincode (Mandatory) ___________________
Tel. _____________________________Mobile ______________________________ Tel. _____________________________Mobile ______________________________
Email ID ________________________________________________Age __________ Email ID ________________________________________________Age __________
This nomination shall suspersede any prior nomination made by me/us and also any testamentary document executed by me / us.

Signature

2nd Holder

1st Holder

3rd Holder

Date _________________________________________________ Place ______________________________________

Details of Witness
Signature of Second Witness

Signature of First Witness

Name ____________________________________________________________

Name ____________________________________________________________

Address ___________________________________________________________

Address ___________________________________________________________

To be filled by DP
Scrutiny By Name /
Emp Code
Data Entered By
Verified By
Reference No.

Demat

Trading

For SBICAP SECURITIES LTD.

BRANCH STAMP
Authorised Signature

Nomination accepted and registered vide Registration No. ________________________ Date _______________________
For any Assistance you may kindly contact your request SSL Branch or Dial Customer Care at our Toll Free: MTNL/BSNL Users: 1800-22-3345
Private Telecom Users: 1800-209-9345write to us helpdesk@sbicapsec.com
l Compliance Officer - Mrs. Dhanashree Kenkre - Email: complaints@sbicapsec.com Contact No.022-42273301
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D:\Murli\Nomination Form.cdr