Applicant Name Father's/Spouse Name Email Id Phone Date of Birth Pan Card Aadhar Number Address City Name Pin Code Marital Status SINGLEMARRIED Nationality What is your age group?*Under 3536-4546-5556-65Above 65 Experience with Investments in past?* Very goodGoodModerateBadVery Bad Investment Goal ?*Capital AppreciationRegular IncomeCapital Appreciation and Regular Income What is Your Preferred Investment Type?* Short Term PositionalLong term PositionalIntraday What is Your Gross Annual Income?*< 2 lacs2-5 lacs5-10 lacs> 10 lacs Experience with Equity Investment?* Extensive experienceModerate experienceVery less experienceNo experience Experience with Commodity investments ?*Extensive experienceModerate experienceVery less experienceNo experience Experience with Forex investments?* Extensive experienceModerate experienceVery less experienceNo experience What is Your Occupation ?*Private SectorPublic SectorGovernment ServiceBusinessProfessionalAgriculturalistRetiredHousewifeStudentMarket Dealer/TraderOther Source of Income ?* SalaryCapital Gain IncomeHouse Rent IncomeOther IncomeBusiness & ProfessionRoyaltiesRentalsDividendOther, Specify What is your investment ?* < 2 lacs2-5 lacs5-10 lacs> 10 lacs Market Value of portfolio held?* < 2 lacs2-5 lacs5-10 lacs> 10 lacs When market is not performing well do you prefer to buy risky investments and sell less risky investments ?* Strongly PreferPreferIndifferentDo not preferStrongly do not prefer Experience in market products?* CommodityStockDerivatives StocksForexAll Size of your Emergency Fund?* Do not have< 1 Month Income1-3 Month Income3-6 Month Income> 6 Month Income What is your preference W.R.T securities with low risk, low return over high risk, high return?* Strongly PreferPreferIndifferentDo not preferStrongly do not prefer What is your Investment Experience?* < 2 Years2-5 Years>5 Years Risk Tolerance Ratio ?* HighMediumLow How familiar are you with your investment matters?* Not familiar at all With Investment and feel uncomfortable wrth ComplexitySomewhat familiar. I don't fully understand InvestmentsFairly Familiar. I understand the various factors which influence investment performanceVery Familiar. I Use Research to make investment decrsion. I understand va nous factors which Influence investment performance How would you describe your overall income status ?* About manage to make ends meet; no monthly savingsPF and other employment benefits are my only source of savingsPut aside at least 10% of my take - home salary every month in savingsHave more than 30% of my take - home salary every monthIncome from my wealth more than adequately provides for my cost of living What is your Marital Status?* SingleMarried Primary Source of Income ?* SalaryBusiness Secondary Source of Income?* Royalties/Rentals/DividendsOthers How to you long want to stay invested into Pointed investment?* less than a month1-6 months6-12 monthsbeyond 12 months How secure is your current and future income from sources?* Not SecureSomewhat SecureFairly SecureVery Secure Percentage of Monthly Income is allocated to pay off debt [all EMIs]?* Reckless ( I don't mind If I lose money )Willing to take evaluated risks (I can't tolerate a some loss)Low risk talking capability. (I'd have a hard time tolerating any losses)Extremely averse to risk. (I need to see at least some return) Assume that you have invested Rs 1,00,000 in a share that goes down by 10% the next day?* Book your loss and invest in fixed deposits or bonds.Hold on till the share comes back to your cost price and sell ItDo not bother because you had done enough research on the companyAverage your cost by investing another Rs 1,00,000 at a lower price How would you 'honestly' describe yourself as a risk -taker?* NoneBetween 0%-20%Between 20%-35%Between 35%-50%>50% Are you any of the following, or are directly or indirectly related to any of the following ?*Civil ServantPoliticianCurrent or Forrmer Head of StateBureaucrat (Tax Authorities. Foreign Services,IAS etc.Current or Former MP/MLA/MLCConnected to MediaConnected to any Company/Promoter/Group of Companies listed on any Stock Exchange UPLOAD PAN CARD FRONT UPLOAD PHOTO UPLOAD AADHAR FRONT UPLOAD AADHAR BACK UPLOAD SIGNATURE 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.