Sole/First Holder

Motilal Oswal Financial Services Limited

Know Your Client (KYC) Application Form (For Individuals Only)
Application No.
Please fill the form in ENGLISH and in BLOCK letters
Fields marked * are mandatory KYC No. (Mandatory for KYC update request)
Fields marked + are pertaining to CKYC and mandatory only if
processing CKYC also
Application Type*: New KYC Modification KYC Minor
Please Tick (✓) ite my account and update my KYC details Re-activate my account with no change in KYC

UCC DP Account 1 DP Account 3

Date____/____/_______ DP Account 2 DP Account 4

KYC Mode*: Please Tick (✓) Normal EKYC OTP EKYC Biometric Online KYC Offline EKYC Digilocker
Modification type*: Please Tick (✓) PAN Name Date of Birth Correspondence/Local Address
Permanent residence address Mobile E-mail Others_____________________________
1. Identity Details (please refer guidelines overleaf)
PAN*
Name* (same as ID proof)
Maiden Name+ (if any)
Fathers/Spouse’s Name*
Mother Name (Optional)
Date of Birth*
Gender* Male Female Transgender
Marital Status* Single Married
Nationality* Indian Other
Residential Status* Resident Individual Non Resident Indian
Foreign National Person of Indian Origin+ .
Please Tick (✓) (Passport mandatory for NRIs and Foreign Nationals. PIO selection is only for CKYC and not for KRA
KYC. Select NRI or Foreign National based on Nationality of the individual)
Proof of Identity (POI) submitted for PAN exempted cases (Please tick)
A - Aadhaar Card
B - Passport Number (Expiry Date)
C - Voter ID Card
D - Driving License (Expiry Date)
F - NPR E - NREGA Job Card
G - EKYC Authentication H - Offline verification of Aadhar
(any document notified by Central Government)
Z - Others
Identification Number
Gross Annual Income Details: Below 1 Lac 1-5 Lac 5-10 Lac 10-25 Lac 25 Lac - 1 Crore
> 1 Crore Net-worth (*Net worth should not be older then 1 year) as on (date) D D M M Y Y Y Y
2. Address Details* (please refer guidelines overleaf)
A. Correspondence/ Local Address*
Line 1*
Line 2
Line3
City/Town/Village* District* Pin Code*
State / U.T Code* Country* ISO-3166 Code
Address Type* Residential/Business Residential Business Registered Office Unspecified
NOTE: For list, of two digit State/UT & list of ISO3166, kindly visit www.motilaloswal.com / Download Option
1 Modification From Version 8.3
 Motilal Oswal Financial Services Limited
B. Permanent residence address of applicant, if different from above A / Overseas Address* (Mandatory for NRI Applicant)
Line 1*
Line 2
Line3
City/Town/Village* District* Pin Code*
State / U.T Code* Country* ISO-3166 Code
Address Type* Residential/Business Residential Business Registered Office Unspecified
Proof of Address* (attested copy of any 1 POA for correspondence and permanent address each to be submitted)
Certified copy of OVD or equivalent e document of OVD obtained through digital KYC process needs to be submitted. (Any one of the
following OVD)
A - Aadhaar Card
B - Passport Number (Expiry Date)
C - Voter ID Card
D - Driving License (Expiry Date)
Z - Others (any document notified by Central Government)
Identification Number
3. Contact Details (in CAPITAL) - (All communications will be sent to Mobile No. / Email Id)
Email ID * Mobile No. *
Client Code Client Name Relationship Signature
Self
Spouse
Please Fill up declaration in case
Email/Mobile is already updated in Mother
sole/first holder account and wish to Father
update same details for Family Son
members as per SEBI guideline
Daughter

4. Applicant Declaration
I/We hereby declare that the KYC details furnished by me are true and Name Signature
correct to the best of my/our knowledge and belief and I/we under-take
to inform you of any changes therein, immediately. In case any of the First Holder
above information is found to be false or untrue or misleading or
misrepresenting, I am/We are aware that I/We may be held liable for it. .
I/We hereby consent to receiving information from CVL / KRA / CERSAI
through SMS/Email on the above registered number/Email address.
Second Holder
I am/We are also aware that for Aadhaar OVD based KYC, my KYC
request shall be validated against Aadhaar details. I/We hereby .
consent to sharing my/our masked Aadhaar card with readable QR
code or my Aadhaar XML/Digilocker XML file, along with passcode and Third Holder
as applicable, with KRA and other Intermediaries with whom I have a
business relationship for KYC purposes only.
.
DATE: (DD-MM-YYYY) PLACE:
5. For Office Use Only
In-Person Verification (IPV) carried out by* Intermediary Details*
Name of the Organization
Self certified document copies received (OVD)
NSE / BSE / MCX / NCDEX - AP Registration Number
SIGN True Copies of documents received (Attested)
MP&
Person name doing IPV / docs / PAN verification
R STA AMC / Intermediary Name / Code : 1100010900
Designation / MOFSL Employee code UBBE CERSAI Code : IN0269
IX R
AFF
Date of IPV / Document Verification SE
PLEA
Date of PAN Verification with IT Site Motilal Oswal Financial Services Ltd
Signature of the Person

Modification From Version 8.3