Date:

To ,

Compliance Department

Jhaveri Securities Limited

301/302, Payal Tower II, Sayajigunj, Vadodara-390020Gujarat

Sub: CTCL Terminal Request Form

Dear Sir/Madam,

I/We desire to activate/modify/deactivate new/existing CTCL Terminal as per the details mentioned below:

In case of AP/Sub Broker SEBI Registration No. of the Sub broker/AP
Name of the Sub Broker/AP/Branch
Office Address where the terminal to be installed(Complete Address with Pincode)
Contact Person Name of Sub Broker/AP/ Branch
Telephone No. with STD Code
Email ID
Mode Of Connectivity
CTCL Terminal / New/Existing/Deactivation
Segment / NSE CM
NSE FO
BSE
Purpose Of Terminal / View / Trading
Branch Code/Commission Code
Details of the Approved User in whose name the terminal is to be activated
Name of the Approved User / Mr./Mrs./Ms.
First Name
Middle Name
Last Name
Date of Birth
PAN
Mobile No.
Email ID
Residence Address (Complete Address with Pin code)
Registration details of NISM and their Validity / FO-
Currency-
Relationship of the Approved User in Relation to the Branch/Authorised Person / Employee/Employee of Authorised Person /Authorised Person

I/We hereby agree and bind myself/ourselves to be responsible for all acts, quotations made and transactions done, trades made, or effected by Mr. / Ms. ______as our Approved User on the Trading System on the Cash Market / Futures & Options / Currency Segment of the Sock Exchange. I confirm that I am aware for CTCL User charges are debited to My/Our Commission Account in Advance on Monthly basis.

I/We shall ensure that he/she will not execute any order on his/her own account or on account of anyone without such order having my/our prior approval in writing.

In case of Mr. /Ms. ______ceasing to be associated with us as ______, we shall

communicate to you and seek the disablement of the User Id so allotted against this application.

We are also aware that the NCFM certificate has a validity of ___ years and accordingly the

User Ids so allotted would be withdrawn by the Member on the expiry of such period unless the said certification is revalidated.

I / We certify that we have not applied for any other User Id in the name of Mr. / Ms. ______on the same segment for which this ID’s now being applied for.

The User Id so allotted would be utilized by Mr. / Ms. ______only to access the Odin/ Dion trading system.

Signature of the Approved User

Date:Location:

FOR OFFICE USE ONLY

Terminal ID
12/13 Digit id / NSEFO
NSECM
BSE
Date of Activation / Modification /Deactivation
IP Address (for IT Purpose)

Note: Please attached the certified copy of PAN/Certificate of the Approved User

Date:

To ,

Compliance Department

Jhaveri Credits and Capital Limited

301/302, Payal Tower II, Sayajigunj, Vadodara-390020 Gujarat

Sub: CTCL Terminal Request Form

Dear Sir/Madam,

I/We desire to activate/modify/deactivate new/existing CTCL Terminal as per the details mentioned below:

Details of the Approved User in whose name the terminal is to be activated
Name of the Approved User / Mr./Mrs./Ms.
First Name
Middle Name
Last Name
Date of Birth
PAN
Mobile No.
Email ID
Residence Address (Complete Address with Pin code)
Registration details of NISM and their Validity / MCX-
NCDEX-
Relationship of the Approved User in Relation to the Branch/Authorised Person / Employee/Employee of Authorised Person /Authorised Person
In case of AP/Sub Broker SEBI Registration No. of the Sub broker/AP
Name of the Sub Broker/AP/Branch
Office Address where the terminal to be installed(Complete Address with Pincode)
Contact Person Name of Sub Broker/AP/ Branch
Telephone No. with STD Code
Email ID
Mode Of Connectivity
CTCL Terminal / New/Existing/Deactivation
Segment / MCX
NCDEX
Branch Code/Commission Code

I/We hereby agree and bind myself/ourselves to be responsible for all acts, quotations made and transactions done, trades made, or effected by Mr. / Ms. ______as our Approved User on the Trading System on the Commodity Market of Commodity Exchange. I confirm that I am aware for CTCL User charges are debited to My/Our Commission Account in Advance on Monthly basis.

I/We shall ensure that he/she will not execute any order on his/her own account or on account of anyone without such order having my/our prior approval in writing.

In case of Mr. /Ms. ______ceasing to be associated with us as ______, we shall

communicate to you and seek the disablement of the User Id so allotted against this application.

I / We certify that we have not applied for any other User Id in the name of Mr. / Ms. ______on the same segment for which this ID’s now being applied for.

The User Id so allotted would be utilized by Mr. / Ms. ______only to access the Odin/ Dion trading system.

Signature of the Approved User

Signature (with Stamp if applicable) of the AP/Sub Broker/Branch

Date:Location: FOR OFFICE USE ONLY

Terminal ID
12/13 Digit id / MCX
NCDEX
Date of Activation / Modification /Deactivation
IP Address (for IT Purpose)

Note: Please attached the certified copy of PAN/Certificate of the Approved User