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1 Dear Sir/ Madam, Nomination Registration No. dated. I/We the sole holder / Joint holders / Guardian (in case of minor) hereby declare that: I/We do not wish to nominate any one for this demat account. I/We nominate the following person who is entitled to receive security balances lying in my/our account, particulars whereof are given below, in the event of the death of the Sole holder or the death of all the Joint Holders. App. No. Code Date DP ID Client ID City State Country PIN Name Of BO Tel. No. Fax. No. Photograph UID By Nominee Relationship with BO (If any) MARKET-HUB STOCK BROKING PVT.LTD. Depository Participant : Central Depository Services (I) Ltd. SEBI Reg.No.: IN-DP-CDSL Regd.Off. : B/230,231 - International Trade Centre, Majura Gate, SURAT Tel : (0261) Fax : (0261) demat@markethubonline.com Web: NOMINATION FORM Date of birth (If nominee is a minor) As the nominee is a minor as on date, I/We appoint following person to act as Guardian: Full Name of Gaurdian City State Country PIN Affix Nominee's Photograph & Sign Across the Tel. No. Fax. No. Photograph Relationship of Guardian with Nominee UID By Guardian To receive the securities in this account on behalf of the nominee in the event of the death of the Sole holder/all Joint holders. This nomination shall supersede any prior nomination made by me/us and also any testamentary document executed by me/us. Note: Two witnesses shall attest signature(s) / Thumb impression(s). Details of the Witness First Witness Second Witness of Witness of witness Signature of Witness Nominee's signature Affix Guardian Photograph & Sign Across the Guardian signature Signature For Office use : Entry Date : Verified by Sign
2 MARKET-HUB STOCK BROKING PVT.LTD. Depository Participant : Central Depository Services (I) Ltd. SEBI Reg.No.: IN-DP-CDSL Regd.Off. : B/230,231 - International Trade Centre, Majura Gate, SURAT Tel : (0261) Fax : (0261) demat@markethubonline.com Web: Dear Sir/ Madam, NOMINATION FORM Nomination Form Registration No. dated. I/We the sole holder / Joint holders / Guardian (in case of minor) hereby declare that: I/We do not wish to nominate any one for this demat account. I/We nominate the following person who is entitled to receive security balances lying in my/our account, particulars whereof are given below, in the event of the death of the Sole holder or the death of all the Joint Holders. App. No. Code Date DP ID Bo Acc. Detail Client ID City State Country PIN Tel. No. Fax. No. Relationship with BO (If any) Date of birth (If nominee is a minor) As the nominee is a minor as on date, I/We appoint following person to act as Guardian: City State Country PIN Tel. No. Fax. No. Relationship of Guardian with Nominee This nomination shall supersede any prior nomination made by me/us and also any testamentary document executed by me/us. Signature Note: Two witnesses shall attest signature(s) / Thumb impression(s). Details of the Witness First Witness Second Witness of Witness of witness Signature of Witness For Office use :
3 Dear Sir/ Madam, MARKET-HUB STOCK BROKING PVT.LTD. Depository Participant : Central Depository Services (I) Ltd. SEBI Reg.No.: IN-DP-CDSL Regd.Off. : B/230,231 - International Trade Centre, Majura Gate, SURAT Tel : (0261) Fax : (0261) demat@markethubonline.com Web: NOMINATION FORM I/We the sole holder / Joint holders / Guardian (in case of minor) hereby declare that: I/We do not wish to nominate any one for this demat account. Nomination Registration No. dated. I/We nominate the following person who is entitled to receive security balances lying in my/our account, particulars whereof are given below, in the event of the death of the Sole holder or the death of all the Joint Holders. App. No. Code Date DP ID Client ID City State Country Affix Nomine PIN Photograph & Tel. No. Fax. No. Sign Across t Photograph By Nominee Relationship with BO (If any) Date of birth (If nominee is a minor) Nominee's As the nominee is a minor as on date, I/We appoint following person to act as Guardian: Full Name of Gaurdian Affix Guardia City State Country Photograph & PIN Sign Across t Tel. No. Fax. No. Photograph By Guardian Relationship of Guardian with Nominee Guardian This nomination shall supersede any prior nomination made by me/us and also any testamentary document executed by me/us. First/Sole Holder Second Holder Third Hol Signature Note: Two witnesses shall attest signature(s) / Thumb impression(s). Details of the Witness First Witness Second Witness of Witness of witness Signature of Witness
4 For Office use : Entry Date : Verified by Sign
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