Closure Form 19315j

CLOSURE FORM Indiabulls Ventures Limited Formerly Indiabulls Securities Limited Corporate Identity Number (CIN): L74999DL1995PLC069631 Opening Department, Indiabulls House, 448 – 451, Udyog Vihar Phase – V, Gurgaon – 122016, Haryana.

Date: _ _ / _ _ / _ _ _ _

I/We hereby request you to process my/our request for following with you. Trading ID

Demat No. Close Both Trading & Demat no. mentioned above

Action to be taken

Close Demat no. mentioned above Suspend Trading a/c mentioned above with effect from ___________(DD/MM/YY)*

Reason(s) for Temporarily Suspending/Closing of the

Incase of closure -Balance remaining in the to be (If any) Incase of closure - Balances to be transferred to my/our following with

Partly rematerialized and partly transferred. Transferred to another (Number given below). Rematerialized. # Not applicable. DP Name: DP ID Client ID

Instructions: 1. 2. 3. 4. 5. 6.

Please clear all outstanding dues before submitting this form. All unused DIS (if any) needs to be submitted while closing your Demat with Indiabulls. Relevant portions to be filled in. Please mention N.A. for whatever is inapplicable and strike-off wherever unfilled. To be submitted in duplicate. Your balance amount (if any) would be transferred to the linked bank or the cheque for the same shall be sent at your ed address. 7. In case of transfer of Lock-in / Inactive ISIN, we require additional “copy of Client Master Report of the target beneficiary Id duly attested by the target DP with Original stamp” for each ISIN i.e. if BO has two Lock-in / Inactive ISIN, he has to provide two “Client Master Report of the target beneficiary Id duly attested by the target DP”. All Lock-in / Inactive ISIN are transferred to target beneficiary ID by/through concern registrar. 8. The Lock-in ISIN can also be rematerialized. 9. Incase the is in the name of a corporate body, please submit Board of Resolution duly signed by the Authorized Signatory along with Company Stamp. 10. Incase of transfer cum closure, we require the "Target DP crystal client master with original stamp" for transferring of shares. 11. In case of transfer cum closure, for t s the sequence of name should be the same in the target DP as well 12. Submit a duly-filled Delivery Instruction Slip [DIS] (off market instruction slip) if the balances are to be transferred to another . This requirement is not applicable in the case of “SHIFTING OF /Transfer cum closure request. # Submit a duly-filled RRF if the balances are to be rematerialized. * a) If you want to deactivate/reactivate your Demat as well, then please submit a duly filled & signed Freeze/Unfreeze request form. b) If you want to close your Margin Demat as well, then please submit a duly filled & signed MTF Cancellation Form. c) Please note that trading shall be reactivated only on the submission of duly filled & signed Reactivation Form.

I/We hereby declare that all transactions executed in the mentioned are true and authentic in all aspects. Name(s) Signature(s)

First/Sole Holder

Second Holder

Note: All Demat holder(s) need to sign.

Third Holder

All the documents must be self attested in original. Form should be filled in CAPITAL letters only ============================================================================== FOR OFFICE USE ONLY Closure ID _______________________________________, S.No._________________________________________ Checked By

Captured By

Verified By

Dues Checked By

Stocks Checked By

Holdings Checked By

Please note that you can call us on our helpline no 0124-4572444 or mail us at [email protected] on the 5th working day from the submission of the documents (i.e. if you have submitted the documents on Monday then call us on Friday after 2:30 p.m.) to check the status. Version 1.10