INDIABULLS VENTURES LIMITED
Corporate Identity Number (CIN): L74999DL1995PLC069631
Registered Office: M-62 & 63, First Floor, Connaught Place, New Delhi-110001
Correspondence Address: Indiabulls House, 448-451, Udyog Vihar, Phase V, Gurgaon-122016, Haryana

Declaration for availing of Basic Services Demat Account (BSDA) facility
Date
Dear Sir / Madam,
I / We wish to avail the BSDA facility for the new account for which we have submitted my / our account opening form
I / We wish to avail the BSDA facility for my / our below mentioned demat account number
DP
ID

CLIENT
ID

Name

PAN

Sole/First Holder
Second Holder
Third Holder
I/We have read and understood the regulatory (SEBI) guidelines for opening a Basic Services Demat Account and undertake to comply
with the aforesaid guidelines from time to time. I/we also undertake to comply with the guidelines issued by any such authority for BSDA
facility from time to time. I/We also agree that in case our demat account opened under BSDA facility does not meet the eligibility for
BSDA facility as per guideline issued by SEBI or any such authority at any point of time, my / our BSDA account will be converted to
regular demat account without further reference to me/us and will be levied charges as applicable to regular accounts as informed by
the DP.
I, the first / Sole holder also hereby declare that I do not have / propose to have any other demat account across depositories as a first /
sole holder

Signature(s) of Account Holder(s)

Sole/First Holder

Second Holder

Third Holder