ACCOUNT
OPENING FORM
For Individual Client Nominee Annexure A
Nomination Form for Demat Accounts and Mutual Fund (MF) Folios
Date : 08/07/2025 DP ID 12088700/701/702/703 Client ID: 1560306460
Name : Gummadi Bhagyaraj
PAN : HTFPB2240N
I / We hereby nominate the following person(s) who shall receive all the assets held in my / our account / folio in the event
of my / our demise, as trustee and on behalf of my / our legal heir(s) *
Nomination Details
Mandatory Details Additional Details
Share of
Name of Postal Mobile number Identity D.o.B. of
nominee Relationship Guardian
nominee Address & E-mail Number nominee
(%)
GUMMADI PRASAD
9701756761 XXXXXXXX3620 01/12/2000
Nominee 1 100.00 BROTHER
Prasadgummadi36@[Link]
m
Nominee 2
Nominee 3
Nominee 4
Nominee 5
Nominee 6
Nominee 7
Nominee 8
Nominee 9
Nominee 10
Signed by: Gummadi Bhagyaraj
eSigned using Aadhaar ([Link])
Date: 2025-07-08 [Link] IST
(sign here)
Corporate/Registered Office: Vaishnavi Tech Park, South Tower, 3rd floor,
Sarjapur Main Road, Bellandur, Bengaluru – 560103, Karnataka
SEBI Registration Number: BSE-CM, NSE-CM,MCX-CM: INZ000301838 ; Date
23.09.2021 CIN: U65100KA2016 PTC092879 | Depository Participant (DP) of
CDSL (DP ID - 88700/88701/88702) & NSDL (ID- IN304480)
ACCOUNT
OPENING FORM
For Individual Client Nominee Annexure A
*Joint Accounts:
Event Transmission of Account / Folio to
Demise of one or more joint holder(s) Surviving holder(s) through name deletion
The surviving holder(s) shall inherit the assets as owners.
Nominee
Demise of all joint holders simultaneously – having nominee
Demise of all joint holders simultaneously – not having nominee Legal heir(s) of the youngest holder
** if % is not specified, then the assets shall be distributed equally amongst all the nominees (see table in ‘Transmission aspects’).
*** Provide only number: PAN or Driving Licence or Aadhaar (last 4). Copy of the document is not required.
**** to be furnished only in following conditions / circumstances:
Date of Birth (DoB): please provide, only if the nominee is minor.
Guardian: It is optional for you to provide, if the nominee is minor.
1) I / We want the details of my / our nominee to be printed in the statement of holding, provided to me/ us by the AMC / DP as follows; (please tick, as appropriate)
Name of nominee(s) ✔ Nomination: Yes / No
2) I hereby authorize _________________________(nominee number ____) to operate my account on my behalf, in case of my incapacitation in terms of paragraph 3.5 of
the circular. He / She is authorized to encash my assets up to ___% of assets in the account / folio or Rs. _____________. (strike off portions that are not relevant)
3) This nomination shall supersede any prior nomination made by me / us, if any.
Name(s) of holder(s) Signature(s) of holder Witness Signature*
Sole / First Holder (Mr./Ms.) Gummadi Bhagyaraj
Second Holder (Mr./Ms.)
Third Holder (Mr./Ms.)
* Signature of two witness(es), along with name and address are required, if the account holder affixes thumb impression, instead of wet signature.
Rights, Entitlement and Obligation of the investor and nominee:
If your are opening a new demat account / MF folios, you have to provide nomination. Otherwise, you have to follow procedure as per 3.10 of this circular.
You can make nomination or change nominee any number of times without any restriction.
You are entitiled to recive acknowledgement from the AMC / DP for each instance of providing or changing nomination.
Upon demise of the investor, the nominees shall have the option to either contiune as joint holders with other nominees or for each nominee(s) to open separate single
account / folio.
In case all your nominees do not claim the assets from the AMC / DP, then the residual unclaimed asset shall continue to be with the AMC in case of MF units and with
the concerned Depository in case of Demat account.
You have the option to designate any one of your nominees to operate your account / folio, if case of your physical incapciation. This mandate can be changed any time
you choose.
The signatories for this nomination form in joint folios / account, shall be the same as that of your joint MF folio / demat account. i.e.
o ‘Either or Survivor’ Folios / Accounts - any one of the holder can sign
o ‘Jointly’ Folios / Accounts - both holders have to sign
Signed by: Gummadi Bhagyaraj
eSigned using Aadhaar ([Link])
Date: 2025-07-08 [Link] IST
(sign here)
Corporate/Registered Office: Vaishnavi Tech Park, South Tower, 3rd floor,
Sarjapur Main Road, Bellandur, Bengaluru – 560103, Karnataka
SEBI Registration Number: BSE-CM, NSE-CM,MCX-CM: INZ000301838 ; Date
23.09.2021 CIN: U65100KA2016 PTC092879 | Depository Participant (DP) of
CDSL (DP ID - 88700/88701/88702) & NSDL (ID- IN304480)
ACCOUNT
OPENING FORM
For Individual Client Nominee Annexure A
Transmission aspects
AMCs / DPs shall transmit the folio / account to the nominee(s) upon receipt of 1) copy of death certificate and 2) completion / updation of KYC of the nominee(s).
The nomimee is not required to provide affidavits, indemnitites, undertakings, attestations or notarization.
Nominee(s) shall extend all possible co-operation to transfer the assets to the legal heir(s) of the deceased investor. In this regard, no dispute shall lie against the AMC / DP.
In case of multiple nomineees the assets shall be distributed pro-rata to the surviving nominees, as illustrated below.
% share as specified by investor % assets to be apportioned to surviving nominees upon
at the time of nomination demise of investor and nominee ‘A’
% of A’s share to
Nominee %Share Nominee % intial Share Total % share
be apportioned
A 60% A 0 0 0
B 30% B 30% 45% 75%
C 10% C 10% 15% 25%
Total 100% 40% 60% 100%
Signed by: Gummadi Bhagyaraj
eSigned using Aadhaar ([Link])
Date: 2025-07-08 [Link] IST
(sign here)
DECLARATION FORM
FOR OPTING OUT OF
NOMINATION
To Date: NA
Trading Member/Participant/Mutual Fund/AMC
UCC/DP ID NA
Client ID (only for Demat account) NA
Sole/First Holder Name NA
I / We hereby confirm that I/We do not wish to appoint any nominee(s) in my/our trading/demat account/mutual fund folio(s) and understand the issues
involved in non-appointment of nominee(s) and further are aware that in case of death of all the account holder(s), my / our legal heirs would need to
submit all the requisite documents/information for claiming of assets held in my/our trading/demat account/mutual fund folio(s), which may also include
documents issued by Court or other such competent authority, based on the value of assets held in the trading/demat account/mutual fund folio(s).
Name and Signature of Holder(s)*
* Signature of witness, along with name and address are required, if the account holder affixes thumb impression, instead of signature
Signed by: Gummadi Bhagyaraj
eSigned using Aadhaar ([Link])
Date: 2025-07-08 [Link] IST
