Application form for registration of Email-id and Mobile Number

Personal Details

Name of applicant: Primary Applicant (1)______________________________

Secondary Applicants (2)___________________ (3)____________________

Unique Client Code: ____________________________________

Depository Account No: ____________________________________

Email-id: ____________________________________

Mobile No.: ____________________________________

SMS Alerts-NSDL

I/We understand that under the SMS Alert facility offered by NSDL, will enable me to receive Alert messages through the Short Messaging Service (“SMS”) over my mobile phone, with respect to transaction information relating to my DP account.

I/We understand that for the above purpose, you are required to take from me/us an appropriate mobile number to receive the SMS Alerts. Accordingly please make note of the mobile number furnished by me above and enable the SMS flag for my Depository account.

I/We have read and understood the terms and condition given relating to the SMS Alerts facility offered by NSDL. I/We shall be bound by the said terms and conditions as in force, and may be amended by NSDL from time to time and the use of the SMS Alert facility will be deemed to be acceptance of those terms and conditions

Insta Alert

I/We understand that under the Insta Alert facility offered by Consortium Securities Pvt. Ltd. will enable me/us to receive customized alert messages through Short Messaging Service (“SMS”) over my/our mobile phone, as chosen by me/us, and informed to the Consortium Securities Pvt. Ltd., as above with respect to events/transactions/information relating to my Account. I/We declare that the email-id and mobile number furnished by me/us above belong to me/us and are in my/our safe custody. I/We shall keep Consortium Securities Private Limited informed of any change in my/our email-id and mobile number.

Authorization for Communication in electronic form :

I/We understand that the contract note maybe issued in electronic form in the format as prescribed by the stock exchanges/SEBI in accordance with the Information Technology Act 2000. In pursuance of the same, I/We hereby opt for receipt of contact notes in electronic form as well as all other communication including but not limited to account statement, holding statement , transaction statement, trade, order confirmations and any other notices electronically.

I/we understand that for the above purpose you are required to take from the client “An appropriate email account” for you to send electronic contract notes and other information. Accordingly please take the above email account for sending contract notes and other communication to me/us. The log report of your dispatching software shall be conclusive proof of dispatch of contract notes and any other electronic communication to me/us, such dispatch shall be deemed to mean receipt by me/us and shall not be disputed by me/us on account of any non receipt/delay receipt for any reason whatsoever.

I also agree that non-receipt of bounced mail notification by you shall amount to delivery at my/our email-id.

__________________________________________________________________________________________

Signatures (1)____________________ (2)__________________ (3)___________________

Date ___________________