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ADDRESS CHANGE FORM
To,                                                                                                                                                      Date:
INDIABULLS SECURITIES LIMITED
Account Opening Department – Address Change Team,
Indiabulls House, 448 – 451, Udyog Vihar,
Phase – V, Gurgaon – 122001,
Haryana
Dear Sir/Madam,
I/We would request you to change my/our Address & Contact Details in my/our Indiabulls Account given below:
Demat Account No. ____________________________                      Trading ID _________________________________
  Old Correspondence Address (Demat account)                                                  New Correspondence ( Foreign Address Applicable for NRI
  ___________________________________________                                                 Client Only)___________________________________________
  ___________________________________________                                                 ______________________________________________________
  Pin Code (Mandatory)_________________________                                               ______________________________________________________
                                                                                              ______________________________________________________
  Old Correspondence Address (Trading account)                                                Pin Code / Zip Code (Mandatory)___________________________
  ___________________________________________                                                 Mobile # (Mandatory)____________________________________
  ___________________________________________                                                 Landline 1 #________________, Landline 2 # ________________
  Pin Code (Mandatory)_________________________                                               (Country Code & Area Code for Foreign nos. & STD Code for Indian Contact nos. is mandatory)
                                                                                              E-mail ID (Mandatory) ___________________________________
                                                                                              New Permanent Address________________________________
  Old Permanent Address (Demat account)                                                       ______________________________________________________
  ___________________________________________                                                 ______________________________________________________
  ___________________________________________                                                 Pin Code / Zip Code (Mandatory)___________________________
  Pin Code (Mandatory)_________________________                                               Mobile # (Mandatory)____________________________________
                                                                                              Landline 1 #________________, Landline 2 # ________________
                                                                                              (Country Code & Area Code for Foreign nos. & STD Code for Indian Contact nos. is mandatory)
                                                                                              E-mail ID (Mandatory) ___________________________________
I/We request you that in future all my/our correspondence with Indiabulls Securities Limited should be sent at the above address till further notification from me/us. I/We also
undertake not to file any Suit, Claims, initiate Legal proceedings in any Arbitration Forum, Court of Law, Legal Forum, Tribunal or before any Regulatory Authorities against Indiabulls
Securities Limited or its Directors or its Employees in connection with non–receipt of Contract Notes and Statement of Accounts if the same is henceforth sent to the new address as
mentioned above. I/We further undertake that I/we shall indemnify and keep indemnified Indiabulls Securities Limited or its Directors or its Employees from and against any loss,
claims, liabilities, obligations, damages, deficiencies, actions, suits, proceedings or liability suffered or incurred or fastened due to any incorrect, wrong, false, misleading representations
provided/disclosed by me/us to Indiabulls Securities Limited.
I/We also authorize Indiabulls Securities Limited to debit my account in lieu of mailing charges for sending any documents at my foreign address (Applicable for NRI client only)
whenever required.

I/We am/are enclosing herewith copy of ID Proof(s) and ______________________________________________________________as proof of New
address.
Name(s)

Signature(s)
                                 First/Sole Holder                                         Second Holder                                              Third Holder
                                                                  Note: All Demat account holder(s) need to sign.
NOTE:
          Please note that in order to change your Demat & Trading Account Address, you are required to provide your ID Proof(s) copy AND Proof of New Address.
          All proof must be duly self attested (all the holders in case of joint DP account).
          Hand written documents /Any Overwriting & Correction on the documents should be attested by issuing authority with original stamp & signature e.g. Hand written bank
          passbook should be attested by bank official, Overwriting & Correction on Driving license should be attested by RTO official etc.
          Please submit separate proof in case the correspondence and Permanent Addresses are different.
          Please mention N.A for whatever is inapplicable and strike-off wherever unfilled & submit the form in duplicate.
          FOR NSDL ACCOUNT- Last DP Transaction Statement is required for Demat Address change.
List of valid Identity Proof:
(1) PAN card with photograph, (2) Passport, (3) Voter ID card, (4) Driving License, (5) Identity Card/Document with applicant’s photo, issued by: (a) Central/State Government and its
Departments,(b) Statutory/Regulatory Authorities,(c) Public Sector Undertakings,(d) Scheduled Commercial Banks,(e) Public Financial Institutions,(f) Colleges affiliated to Universities (this can be
treated as valid only till the time the applicant is a student),(g) Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to their Members.
List of valid Address Proof (Applicable for both Indian & foreign Address):
(1) Ration Card, (2) Passport, (3) Voter ID card, (4) Driving License, (5) Bank Passbook/Bank Statement: (a) Bank Statement (with bank logo)/Bank Passbook (printed) – should clearly display
account number, name & address of the client (not more than three months old). Bank Statement needs to be accompanied with a copy of bank cheque. (b) Bank Statement (without bank logo)/Bank
Passbook (handwritten) – should clearly display account number, name & address of the client and it should be attested in original by the bank official with name, designation and signature of the
attesting officer (not more than three months old). Bank Statement needs to be accompanied with a copy of original cancelled bank cheque; (6) Electricity Bill/Telephone Bill – Landline (not more
than two months old), (7) Lease and License Agreement/Agreement for sale/Rent Agreement (8) Self – declaration by High Court & Supreme Court judges, giving the new address in respect of their
own accounts (valid only for Demat). (9) Identity Card/Document with applicant’s address, issued by: (a) Central/State Government and its Departments, (b) Statutory/Regulatory Authorities, (c)
Public Sector Undertakings, (d) Scheduled Commercial Banks, (e) Public Financial Institutions, (f) Colleges affiliated to Universities (this can be treated as valid only till the time the applicant is a
student), (g) Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to their Members.
The following additional documents can be submitted as valid proof of Foreign Address in addition to the above mentioned proofs: (1) PIO card, (2) Resident Permit (Govt. issued I-card)
List of Documents sent at Demat Account Address:
(1) Client Master, (2) Bill for Demat Account, (3) Transaction Statement, (4) Holding Statement, (5) Delivery Instruction Slip (DIS), (6) Pledge Books, (7) Physical Share Certificates.
List of Documents sent at Trading Account Address:
(1) Welcome Letter, (2) Password, (3) Contract Notes along with STT Annexure, (4) Statement of Account and Ledgers.
Note: For the list of valid proofs of non-individual account kindly refer to the checklist updated on our website. NRI Checklist - http://nri.indiabulls.com/document_required.html
Demat Checklist - http://www.indiabulls.com/securities/services/indiabulls-depository-services.htm#; Trading Checklist – http://www.indiabulls.com/securities/services/indaibulls-signature-
account.htm#.
Please note that you can call us on our helpline no 0124-4572444 or mail us at helpdesk@indiabulls.com on the 5th working day from the submission of the documents (i.e. if you have submitted the
documents on Monday either in the branch or directly to the H.O. then call us on Friday after 2:30 p.m.) to check the status.

                                                                                                                                                                                          Version 1.3

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Address change form

  • 1. ADDRESS CHANGE FORM To, Date: INDIABULLS SECURITIES LIMITED Account Opening Department – Address Change Team, Indiabulls House, 448 – 451, Udyog Vihar, Phase – V, Gurgaon – 122001, Haryana Dear Sir/Madam, I/We would request you to change my/our Address & Contact Details in my/our Indiabulls Account given below: Demat Account No. ____________________________ Trading ID _________________________________ Old Correspondence Address (Demat account) New Correspondence ( Foreign Address Applicable for NRI ___________________________________________ Client Only)___________________________________________ ___________________________________________ ______________________________________________________ Pin Code (Mandatory)_________________________ ______________________________________________________ ______________________________________________________ Old Correspondence Address (Trading account) Pin Code / Zip Code (Mandatory)___________________________ ___________________________________________ Mobile # (Mandatory)____________________________________ ___________________________________________ Landline 1 #________________, Landline 2 # ________________ Pin Code (Mandatory)_________________________ (Country Code & Area Code for Foreign nos. & STD Code for Indian Contact nos. is mandatory) E-mail ID (Mandatory) ___________________________________ New Permanent Address________________________________ Old Permanent Address (Demat account) ______________________________________________________ ___________________________________________ ______________________________________________________ ___________________________________________ Pin Code / Zip Code (Mandatory)___________________________ Pin Code (Mandatory)_________________________ Mobile # (Mandatory)____________________________________ Landline 1 #________________, Landline 2 # ________________ (Country Code & Area Code for Foreign nos. & STD Code for Indian Contact nos. is mandatory) E-mail ID (Mandatory) ___________________________________ I/We request you that in future all my/our correspondence with Indiabulls Securities Limited should be sent at the above address till further notification from me/us. I/We also undertake not to file any Suit, Claims, initiate Legal proceedings in any Arbitration Forum, Court of Law, Legal Forum, Tribunal or before any Regulatory Authorities against Indiabulls Securities Limited or its Directors or its Employees in connection with non–receipt of Contract Notes and Statement of Accounts if the same is henceforth sent to the new address as mentioned above. I/We further undertake that I/we shall indemnify and keep indemnified Indiabulls Securities Limited or its Directors or its Employees from and against any loss, claims, liabilities, obligations, damages, deficiencies, actions, suits, proceedings or liability suffered or incurred or fastened due to any incorrect, wrong, false, misleading representations provided/disclosed by me/us to Indiabulls Securities Limited. I/We also authorize Indiabulls Securities Limited to debit my account in lieu of mailing charges for sending any documents at my foreign address (Applicable for NRI client only) whenever required. I/We am/are enclosing herewith copy of ID Proof(s) and ______________________________________________________________as proof of New address. Name(s) Signature(s) First/Sole Holder Second Holder Third Holder Note: All Demat account holder(s) need to sign. NOTE: Please note that in order to change your Demat & Trading Account Address, you are required to provide your ID Proof(s) copy AND Proof of New Address. All proof must be duly self attested (all the holders in case of joint DP account). Hand written documents /Any Overwriting & Correction on the documents should be attested by issuing authority with original stamp & signature e.g. Hand written bank passbook should be attested by bank official, Overwriting & Correction on Driving license should be attested by RTO official etc. Please submit separate proof in case the correspondence and Permanent Addresses are different. Please mention N.A for whatever is inapplicable and strike-off wherever unfilled & submit the form in duplicate. FOR NSDL ACCOUNT- Last DP Transaction Statement is required for Demat Address change. List of valid Identity Proof: (1) PAN card with photograph, (2) Passport, (3) Voter ID card, (4) Driving License, (5) Identity Card/Document with applicant’s photo, issued by: (a) Central/State Government and its Departments,(b) Statutory/Regulatory Authorities,(c) Public Sector Undertakings,(d) Scheduled Commercial Banks,(e) Public Financial Institutions,(f) Colleges affiliated to Universities (this can be treated as valid only till the time the applicant is a student),(g) Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to their Members. List of valid Address Proof (Applicable for both Indian & foreign Address): (1) Ration Card, (2) Passport, (3) Voter ID card, (4) Driving License, (5) Bank Passbook/Bank Statement: (a) Bank Statement (with bank logo)/Bank Passbook (printed) – should clearly display account number, name & address of the client (not more than three months old). Bank Statement needs to be accompanied with a copy of bank cheque. (b) Bank Statement (without bank logo)/Bank Passbook (handwritten) – should clearly display account number, name & address of the client and it should be attested in original by the bank official with name, designation and signature of the attesting officer (not more than three months old). Bank Statement needs to be accompanied with a copy of original cancelled bank cheque; (6) Electricity Bill/Telephone Bill – Landline (not more than two months old), (7) Lease and License Agreement/Agreement for sale/Rent Agreement (8) Self – declaration by High Court & Supreme Court judges, giving the new address in respect of their own accounts (valid only for Demat). (9) Identity Card/Document with applicant’s address, issued by: (a) Central/State Government and its Departments, (b) Statutory/Regulatory Authorities, (c) Public Sector Undertakings, (d) Scheduled Commercial Banks, (e) Public Financial Institutions, (f) Colleges affiliated to Universities (this can be treated as valid only till the time the applicant is a student), (g) Professional Bodies such as ICAI, ICWAI, ICSI, Bar Council etc., to their Members. The following additional documents can be submitted as valid proof of Foreign Address in addition to the above mentioned proofs: (1) PIO card, (2) Resident Permit (Govt. issued I-card) List of Documents sent at Demat Account Address: (1) Client Master, (2) Bill for Demat Account, (3) Transaction Statement, (4) Holding Statement, (5) Delivery Instruction Slip (DIS), (6) Pledge Books, (7) Physical Share Certificates. List of Documents sent at Trading Account Address: (1) Welcome Letter, (2) Password, (3) Contract Notes along with STT Annexure, (4) Statement of Account and Ledgers. Note: For the list of valid proofs of non-individual account kindly refer to the checklist updated on our website. NRI Checklist - http://nri.indiabulls.com/document_required.html Demat Checklist - http://www.indiabulls.com/securities/services/indiabulls-depository-services.htm#; Trading Checklist – http://www.indiabulls.com/securities/services/indaibulls-signature- account.htm#. Please note that you can call us on our helpline no 0124-4572444 or mail us at helpdesk@indiabulls.com on the 5th working day from the submission of the documents (i.e. if you have submitted the documents on Monday either in the branch or directly to the H.O. then call us on Friday after 2:30 p.m.) to check the status. Version 1.3