Client Information Sheet (Loan Request for Loan against Securities) (Please fill in Capital letters – Fields marked with are Compulsory Fields) KFSL Relationship Manager Details: RM Name: Branch Mobile: Email ID: Client Personal Details: Name First Name Middle Name Surname Father’s Name First Name Middle Name Surname Spouse’s Name First Name Middle Name Surname PAN Date of Birth/ Incorporation Voter ID Passport Telephone Mobile DD / MM / YYYY Gender M/F Email ID: Current Address: State/UT Pincode Email ID Name of the Company/Firm: Office Address: State/UT Pincode Contact Person Name: Mobile Email ID: Client Financial Details: Networth: as on date:_____________ nd Annual Income: ______________ (Last Year) _____________(2 Last Year) Portfolio Value as on date:_____________ List of 5 major scrips in Portfolio (Please also attached list of Scrips with Value) Scrip Name Qty Rate Total of 5 scrip values Average Daily Trading Value (In case of LAPS Clients) (Rs) Scrip Holding Value Existing Association with KSBL: KSBL Branch Name: Sourcing (Tick one) Client Trading Code: Broking/Distribution/Wealth/Fortune No. of Years of Association Lead Sourced by (Name of Employee) Employee Code Dealer Mail Id Contact No Loan Proposal: Loan Amount Required Product LAPS / LAS Purpose: Tenure: ________ Months Margin (Specific Requirement %) Funding Against Specific Scrip Interest (Specific Requirement %) Scrip Name Value (Rs) Specific Requirement if any: Remarks of RM: Trading History: Conduct of applicant in trading as well as overall trading history: Regular intraday trader – working more on rumors + quality of scrips usually dealt in approved or unapproved, Regular trader but holds particular scrips for short duration (may or may not follow some pattern) – frequent churning of portfolio quality of scrips usually dealt in approved or unapproved. Regular trader but holding stock over longer periods – signifying solid investment intentions + quality of scrips usually dealt in approved or unapproved. Infrequent trader – hold stock for longer periods – in anticipation of long term capital gains + quality of scrips usually dealt in approved or unapproved. Documents Require along with CIS – (For LAS/PF Facility ): 1) Latest Financial, ITR , Annual returns for last 2 Years 2) Latest Bank Statement of Account from Principal Banker for Last 3 Months 3) Latest CA Certify Net worth Certificate Declaration from the Client: I certify that KFSL may by itself or through authorised persons, lawyers, agencies, bureau etc verify any/all information given, check credit references, employment details and obtain credit reports to determine my credit worthiness in connection with this Loan request or in case KFSL requires to conduct additional/further checks in order to assess my eligibility for further loans in the future. I hereby agree and give my consent to the company to disclose and furnish all/any information and/or data relating to any credit facility availed of/or to be availed by me to the affiliates of the Company, Credit Bureau, Credit Rating agencies, Banks, Financial Institutions, Non Banking Financial Institutions, Data Bank or any governmental or regulatory authorities/ bodies/departments for the purpose of complying with legal and/or regulatory requirements. Date: Place: Signature of Client Signature of Relationship Manager Karvy Financial Services Ltd Corporate Office: Office No.762, Building No.7, 6th Floor, Solitaire Park,Andheri (E),Mumbai - 400093. Phone: +91-22-67875300, Email:[email protected]
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