THE EQUAL RESEARCH The Equal Research ,Plot no -26 pu-4,Vijay Nagar Indore near medanta hospital(M.P.) Email-Id : info@theequaleresearch.com KYC AND RISK-PROFILE FORM ***As per prescribed by SEBI circular No. . . . . . dated 22th Aug.2011*** (I)Note:- All Fields Marked with (*) are Mandatory. A. *IDENTITY DETAILS (All Fields Are Mandatory) Name of the Applicant: Father/ Spouse Name: Gender MaleFemale Marital status: SingleMarried Date of birth: Nationality: -Select Option-SELECTINDIANOTHERS Status RESIDENT INDIVIDUAL-NON RESIDENTFOREIGN NATIONALFPI CATEGORIES III PAN NO Unique Identity Number(UID)(Aadhaar): Specify the proof of Identity submitted: BANK ACCOUNT STATEMENT/PASSBOOKSSelectPassportPancardVoters Identity CardRation CardUnique Identification Number(uid)Registered Lease or Sale Agreement of ResidenceDriving LicenseID Card with address issued by Professional bodies such as ICAIID Card with address issued by Professional bodies such as ICWAL, ICSLBar Council etcto their MamberID Card with address issued by Scheduled Commercial BankID Card with address issued by Public financial Institution. NaiduID Card with address issued by Colleges affilliated to UniversitiesProof of address issued by ParliamentProof of address issued by Govt. or Statutory AuthorityID Card with address issued by Central/State GovtID Card with address issued by Statutory/Regulatory AuthoritiesProof of address issued by Gazetted OfficerProof of address issued by Notary publicProof of address issued by Elected representatives to the Legislative AssemblyProof of address issued by Bank Managers of Scheduled CommercialProof of address issued by Bank Managers of Scheduled Co-OperativeProof of address issued by Bank Managers of Multinational Foreign BankFlat Maintenance BillUtillity Bill Like Telephone Bill(land line)Electricity Bill or Gas BillBank Account Statement/PassbookSelf-declarartion by High court and Superme court Judges B. ADDRESS DETAILS (Address's is Mandatory) Address For Correspondence City/Town/Village Pincode State selectAndaman and Nicobar IslandsAndhra PradeshArunachal PradeshAssamBiharChandigarhChhattisgarhDadra and Nagar HaveliTelenganaTripuraUttar PradeshUttarakhandWest BengalMeghalayaMizoramNagalandOdishaPuducherryPunjabRajasthanSikkimTamil NaduDaman and DiuDelhiGoaGujaratHaryanaHimachal PradeshJammu and KashmirJharkhandKarnatakaKeralaLakshadweepMadhya PradeshMaharashtraManipur Countary: SELECTINDIANOTHERS Specify the proof of address submitted for correspondence address: selectPassportPancardVoters Identity CardRation CardRation CardUnique Identification Number(uid)Registered Lease or Sale Agreement of ResidenceDriving LicenseID Card with address issued by Professional bodies such as ICAIID Card with address issued by Professional bodies such as ICWAL, ICSLBar Council etcto their MamberID Card with address issued by Scheduled Commercial BankID Card with address issued by Public financial Institution. NaiduID Card with address issued by Colleges affilliated to UniversitiesProof of address issued by ParliamentProof of address issued by Govt. or Statutory AuthorityID Card with address issued by Central/State GovtID Card with address issued by Statutory/Regulatory AuthoritiesProof of address issued by Gazetted OfficerProof of address issued by Notary publicProof of address issued by Elected representatives to the Legislative AssemblyProof of address issued by Bank Managers of Scheduled CommercialProof of address issued by Bank Managers of Scheduled Co-OperativeProof of address issued by Bank Managers of Multinational Foreign BankFlat Maintenance BillUtillity Bill Like Telephone Bill(land line)Electricity Bill or Gas BillBank Account Statement/PassbookSelf-declarartion by High court and Superme court Judges C. CONTACT DETAILS Tel. (Residential) Mobile Email ID D. OTHER DETAILS 1. Gross Annual Income: Below 1 Lakh1-5 Lakh5-10 Lakh 10-25 LakhAbove 25 Lakh Details (Please Specify) 1. Net worth as on (Date) (Net worth should not be older then 1 year). 2. Occupation (Please tick any one and give brief details) (required) : Private SectorPublic SectorBusinessprofessional AgriculturistRetiredHousewifeStudent Others(Please Specify): Please Tick, If applicable : Politically Exposed Person (PEP)Related to a Politically Exposed Person (PEP) No Political Relation Any other Information : DECLARATION I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. Name of the Applicant: Signature of the Applicant Date: DISCLAIMER & TERMS 1. The Equal Research respects and values the right to privacy of each and every individual. By becoming clients you have a promise from our side that we shall remain loyal to all our clients and non clients whose information resides with us. This privacy policy of The Equal Research applies to the currents clients as well as former clients. 2. Your information, whether public or private, will NOT be sold , rented, exchanged, transferred or given to any company or individual for any reason without your consent. 3. Your information will be used SOLELY for providing the services to you for which you have subscribed to us and not for any other purposes. 4. Your information given to us represents your identity with us. If any changes are brought in any of the fields of which you have provided us the information, You shell bring it to our notice by either calling usor sending an email to us. 5. By filling out this form you are agreeing the comply with and be bound by the following terms and conditions of use along with the terms and conditions posted on the website www.theequalresearch.com, which together with our privacy policy govern The Equal Research relationship with you in relation to the website. 6. By signing the form above, you agree to provide us your valid mobile number. Also by providing your mobile number, you provide us the consent to call you on the number provided by you and send SMS on your mobile number. You provide your consent for us to use your mobile numbers even if it is registered on the National 'DO Not Disturb' registry. 7. The Equal Research as a merchant shall be under no liability whatsoever in respect of any loss or damage arising directly or indirectly out of the decline of authorisation for any Transaction, on Account of the Cardholder having exceeded the preset limit mutually agreed by us with our acquiring bank from time to time. 8. The Equal Research is registered as a company incorporated in india with SEBI Registration Number as INA000004377. OFFICE USE ONLY 1.Self certified document received (Self-Attested) 2. Details match to KRA data basis Authorised Signatory Seal/Stamp of the intermediary & Signature (or The Equal Research head office) Date: INSTRUCTIONS 1. Fill out the form in its entirety and put signature on all the pages along with the supporting 2. Email the complete form along with the required documents to info@theequalresearch.com, Please note that your services can not be started before this form is received at The Equal Research as per SEBI regulations. RISK PROFILING AND RISK ASSESSMENT OF CLIENT (II)Note:- We do not Provide any low risk services. 1). Name of the Applicant: Investment Goal? [] Capital Preservation.Income.Income and Growth.Agressive Growth. Proposed Investment Amount. [] ›5 lacs.2-5 lacs.1-2 lacs.<1 lacs. Market Value of portfolio held? [] ›5 lacs.2-5 lacs.1-2 lacs.<1 lacs. How was your experience with investing in the market? [] Very positive and would like to keep on investing.I am new to the market and very cautious while investing.I have incurred losses in the past and invest very cautiously.Very bad. Risk Tolerance? [] Very Aggressive.Aggressive.High.Medium. What is your Age Group?[] Under 35.Under 45.46-60.60 Above. Your Total Score Above Mentioned Services fall into the risk category choosen by you. If you agree to the above then click Yes.If you do not agree please click NO. Yes.No If you disagree to the above risk assesment please select atleast two or more services mentioned below.(required) Stock Cash = Medium Stock Futures = Medium Nifty Futures = Medium Agri Pack = High Options - Call & Put =High Commodity Pack = High FOREX/Currency Pack = High Profit Call = High Premium Pack = High Super Premium Pack = High Risk involved with the above mentioned services will be the responsibilty of the applicant him self. (III)Note:- If you are willing to get telephonic support instead of SMS of our services then all the responsibility of loss or profit whether big or small, through holding or in intraday market, would only be yours and not of the company or any person associated with the company. If you agree to the above then click "YES".If you do not agree please click "NO". Yes.No Investment risk profile In setting up an investment portfolio suitable for you, your financial adviser will ask you a series of questions about your financial and lifestyle goals. Using this information, plus details of your current assets, liabilities and income, your adviser can determine what level of risk or exposure you are prepared to tolerate in relation to fluctuations in the marketplace - and the level that makes sense for your stage in life. From this, an appropriate mix of assets can be allocated to your investment portfolio. Your Total Score Your Investment Profile (17 Above)-Very Aggressive Investors As an very aggressive investor you are ready to take higher risk expecting greater returns. This is a result of your urge to get more income and capital growth. You are well place to recover from unforseen market downturns either because you have time on your side or access to to capital returns. (13-16)-Aggressive Investors As an aggressive investor you are ready to take higher risk expecting greater returns. This is a result of your urge to get more income and capital growth. You are well place to recover from unforseen market et downturns either because you have time on your side or access to to capital returns. (9-12)-High Growth Investors As a high growth investor your portfolio should have a bias towards capital growth and a little need of income. You are prepared to accept higher degree of volatility and risk. Your primary concern is to to accumulate assets over the medium to long term. (4-8) Moderate Investor As a moderate investor your investment portfolio is directly focused on capital growth as well as protecting the wealth already accumulated by you. Your portfolio should be yeilding capital for maintainingng assets. Calculated risk is accepted to yeild better returns. The questionnaire returns a score on the basis of which you fall in either of the category mentioned above. This assessment is made solely on the basis of your financial situation and the answers selected by you. As your advisor, I and you confirm that we have worked together to determine your risk profile and the investment options that are best suited for your investment style. Client Signature: Client Signature photo Date: Upload Photo
