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: - firstname.lastname@example.org 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.
DP ID Client ID
1 2 0 2 3 9 0 0
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
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
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: _____________
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.
(Authorized Signatory & Stamp of DP)