COCHIN STOCK BROKERS Ltd - DOC

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					COCHIN STOCK BROKERS Ltd.                                                                 Affix duly
(Wholly Owned Subsidiary of Cochin Stock Exchange Ltd.)                                   attested
Depository Participant – CDSL. DP ID – 1202390036/1565-A17, 4th Floor, MES Building,      passport size
Kaloor, Cochin – 82017.Ph: 2400631,2401898,3098621 (code-0484) Fax-2400330                Photo(only
www.cochinstockexchange.com, E- mail: - dp@cochinstockexchange.com                        for easiest)
                      Select which ever is applicable easi        easiest
     Electronic Access to Securities Information & Execution of Secure Transactions (easiest)
          Registration form – Beneficial Owner (BO)/Clearing Member (CM)
Name of the Beneficial Owner(s) /       1.
Clearing Member (CM)                    2.
                                        3.
                  DP ID                                                    Client ID
1    2     0         2      3      9       0     0
Login Id
Dp Name                            COCHIN STOCK BROKERS LIMITED
Dp Address                         36/1565 A17, 4th FLOOR MES BUILDING JUDGES
                                   AVENUE, KALOOR COCHIN 682017. KERALA, INDIA
Email Address of the BO/CM
Tel No.
Mobile No.
Below Options are for Easiest Users only
Transfer Option                 Trusted A/c                   Account Of Choice
Details Of Trusted A/c (Submit the Under taking from Trusted A/c Holders as per format
attached, Applicable only if Trusted A/c Option is Selected)
Sl No                       DP ID                                    Client ID
1.
2.
3.
4.

I/We would like to register above-mentioned Account For the easi/easiest Service. I/We here by
agree to the terms and conditions. I/We have read earlier for availing the said service.
Date: ___________                                                           Place: _____________
Signature(s)


          First Holder                         Second Holder                           Third Holder

This is to certify that
    1. ______________________2_________________________3. ______________________

are maintaining BO A/c no 12023900____________ with us . We have verified the Signature of
the said account holders and they match with the specimen Signatures as per records.

Date:______________                                                               Place_______________

Signature: _______________________________
          (Authorized Signatory & Stamp of DP)

				
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posted:9/13/2012
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