ZUARI INVESTMENTS LIMITED
[Regd. Office:Jaikisan Bhawan, Zuarinagar, Goa-403 726. (India)]
Corporate Office :F-Block, IInd Floor, International Trade Tower,
Nehru Place, New Delhi-110 019
Tel. : 26413319/76/78 Fax : 26413391

DP ID: IN301055

Cliend ID________________

Details of Securities:

 Free Secirities

 Locked-in Securities

Folio

Certificate Nos.

Distinctive Nos.

Quantity

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To

From

To

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total No. of Certificate : ______________________

Signature of the Client ___________________ __________________ _________________