Application Form - Edelweiss - Personalized Managed Accounts

ACCOUNT OPENING FORMACCOUNT OPENING FORM - EDELWEISS PERSONALIZED MANAGED ACCOUNTS - NON-INDIVIDUALPlease fill this Form in English & in BLOCK LETTERS.STATUS (Please tick which ever is applicable)o Public Company o Private Company o Partnership Firmo Trust/ NGOs o FII o Societyo Others (please specify)_______________________________o FIo HUFA. IDENTITY DETAILSName of the Applicant (as per PAN Card)Date of Incorporation D D M M Y Y Y Y Date of Commencement of Business D D M M Y Y Y YRegistration No. with ROC / ROFPlace of RegistrationPANSEBI/RBI/Any Govt. Authority Registration No. (if applicable)Specify Proof of Identity SubmittedB. ADDRESS DETAILSCorrespondence AddressStateCountryName of the contact personTel. No.Mobile No.Email IDSpecify Proof of Correspondence AddressRegistered Address (If different from Correspondence Address)FaxCityDesignationPINStateCountryTel. No.Specify proof of Registered AddressAddress for Communication (Default is Correspondence Address)C. OTHER DETAILSFaxo Registered AddressCityPINo Correspondence AddressFINANCIAL DETAILS (Please tick 3)Gross Annual Income Range (`) o < 25 LACS o 25-50 LACS o 50 LACS - 1 CRORE o 1-5 CRORE o > 5 CRORENet worth (as on date________)_____________________________________________(Net worth should not be older than one year)*Nature of BusinessEdelweiss Personalized Managed Accounts is a division of Edelweiss Asset Management Limited rendering Portfolio Management Services. 3