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    UniCap Investment Limited

    BO Account Openning Form

    Please fill all names correctly. All communication shall be sent only to the First Named Account Holder's correspondence address.

    Please tick whichever is applicable

    BO Category:RegularOmnibusClearing
    BO Type:IndividualCompanyJoint Holder

    I/We request you to open a depository account in my/our name as per the following details:

    1. First Applicant

    Name in Full of Account Holder

    Short Name of Account Holder (Insert full name starting with Title i.e. Mr./Mrs./Ms./Dr., abbreviate only id over 30 characters)

    Title i.e. Mr./Mrs./Ms./Dr.

    (In case of a Company/Firs/Statutory Body) Name of Contact Person:

    In case of Individual:

    Occupation (30 characters):

    Father's/Husband's Name:

    Mother's Name:

    2. Contact Details

    Address:

    City:

    Post Code:

    State/Division:

    Country:

    Telephone:

    Mobile:

    Fax:

    E-mail:

    3. Passport Details

    Passport No:

    Issue Place:

    Issue Date:

    Expiry Date:

    4. Bank Details

    Routing Number

    Bank Account Number

    Bank Name

    Branch Name

    District Name

    Bank Identifier Code (BIC)

    SWIFT Code

    International Bank A/C No.(IBAN)

    Electronic Dividend Credit:

    Tax Exemption (if any):

    YesNo

    TIN/Tax ID:

    5. Others Information

    Residency

    Nationality

    Date of Birth

    Statement Cycle Code

    Internal Ref. No (To be filled in by CDBL Participant)

    In Case of Company:

    Registration No.

    Date of Registration

    6. Joint Applicant (Second Account Holder)

    Name in Full of Account Holder

    Short Name of Account Holder (Insert full name starting with Title i.e. Mr./Mrs./Ms./Dr., abbreviate only id over 30 characters)

    Title i.e. Mr./Mrs./Ms./Dr.

    7. Photographs

    Recent passport size Photograph of 1st Applicant or Authorized Signatory in case of Limited Co. Only

    Recent passport size Photograph of 2nd Applicant or Authorized Signatory in case of Limited Co. Only

    Please paste recent passport size Photograph of Authorized Signatory in case of Limited Co. Only

    Nominee or Heirs Details

    I/We nominate the following person(s) who is/are entitled to receive securities outstanding in my/our account in the event of the death of the sole holder / all the joint holders.

    Name in Full

    Short Name of Nominee (Insert full name starting with Title i.e. Mr./Mrs./Ms./Dr., abbreviate only id over 30 characters)

    Title i.e. Mr./Mrs./Ms./Dr.

    Relationship with A/C Holder

    Percentage

    Address:

    City:

    Post Code:

    State/Division:

    Country:

    Telephone:

    Mobile:

    Fax:

    E-mail:

    Passport No:

    Issue Place:

    Issue Date:

    Expiry Date:

    Residency

    Nationality

    Date of Birth

    Guardian's Details (if Nominee is Minor)

    Name in Full

    Short Name of Guardian(Insert full name starting with Title i.e. Mr./Mrs./Ms./Dr., abbreviate only id over 30 characters)

    Title i.e. Mr./Mrs./Ms./Dr.

    Relationship with Nominee

    Date of Birth of Minor:

    Maturity Date of Minor:

    Address:

    City:

    Post Code:

    State/Division:

    Country:

    Telephone:

    Mobile:

    Fax:

    E-mail:

    Passport No:

    Issue Place:

    Issue Date:

    Expiry Date:

    Residency

    Nationality

    Date of Birth

    Photographs of Nominees / Heirs

    Recent passport size Photograph of Nominee / Heir

    Recent passport size Photograph of Guardian