CUSTOMER CARE NO : 01143180323, 326, 346TOLL FREE NO : 1800 103 1055
             
   BEZEL REGISTRATION FORM
Registration Type
Type* :
Select Exchanges * :   NSE-CASH   NSE F&O   CURRENCY
Introducer Details :        
Associate Member :
Details of Company/Firm
Name of Company/Firm* :  
Status * :
Registration Number (if any) * :
IT PAN number * :
Income Tax Number (PAN/GIR) :
Resident Status * :
Account Type* :
Annual Income* :
Net Worth : ∗ Net worth should not be older than 1 year.
Sales Tax Reg Details
Local Sales Tax State Registration No :
Validity date :
Central Sales tax Registration No :
Validity Date :
Correspondence Address
Address :
City / PO / Town* :
District* :
Pin* :
State* :
Country* :
Mobile Number* :
Telephone Number :
Fax Number :
Proof of Address :
Permanent Address
: If same as coresspondance address ?  
Address :
City / PO / Town* :
District* :
Pin* :
State* :
Country:* :
Mobile Number* :
Telephone Number :
Fax Number :
Proof of Address :
Bank Account Details
Bank Name :
Branch Address :
Bank Account No :
A/c Type :
MICR Code No :
IFSC Code No :
Bank Account Details(B)
Bank Name :
Branch Address :
Bank Account No :
A/c Type :
MICR Code No :
IFSC Code No :
Depository Account Details
Depository Participant Name :
Depository Name :
Beneficiary Name :
DP ID :
Beneficiary ID(BO ID) :
Details of (KARTA/TRUST/PROMOTERS/PARTNERS/DIRECTORS)
Name* :
DOB :
PAN* :
Mobile* :
DIN/UDI :
E-mail id :
Address for Correspondence
City / PO / Town :
District :
Pin :
State :
Country :
Bank Account Details
Bank Name Branch Address & Pin Code Bank Account No A/c Type 9 Digit MICR Code No.
Disclaration For Name Mismatch
My name mentioned in PAN card is :
In additional ID proof : Voter id       Passport       Driving License      
In Bank A/c No :   in  
Term & Condition