Request for linking Bank / Demat Accounts to ICICIdirect.

com Trading Account

Request for linking Bank / Demat Accounts to ICICIdirect.com Trading Account

existing
Request for: Bank Linking Demat Linking Both

For Resident Individual Account Holder

Please note:
1.

2. Please mention all three accounts viz., trading, bank and demat account number/s against delinking &
linking request for either of the accounts (bank /demat) in case you also want the linked Bank account to be
mapped to your linked demat account/s after linking as per above request, for receiving dividend / interest
on the securities in your demat account and for payment of bills related to demat account.
3.

4. I hereby authorize ICICI Securities Limited to collect Bank account Verification letter / Address verification
letter from ICICI Bank Limited for submissions at all investments made through ICICI Direct Account (i.e
Mutual Funds / FD's) etc.

    
Signature of 1st applicant Signature of 2nd holder Signature of 3rd holder Signature of Co-holder A Signature of Co-holder B

Page 1 of 6 Ver.5
This document is voluntary. Voluntary means that the document is not prescribed by Regulators, however the
same is required by ICICI Securities Limited for offering the 3 in 1 account i.e. seamless trading platform with
integrated bank account, demat account and broking account. If you do not wish to avail the services of ICICI Bank
Limited and ICICI Securities Limited, you need not execute such documents.

THIS POWER OF ATTORNEY is made at______________________________ this __________________ Day

of____________ 20__________by ________________ aged _____________________________________ residing at
______________________________________________________________________________________________________
IN FAVOUR OF
ICICI Securities Limited, a company incorporated under the Companies Act, 1956, and having its registered office
at ICICI Centre, H.T. Parekh Marg, Churchgate, Mumbai- 400020 and Corporate Office at Shree Sawan Knowledge
Park, Plot No. D-507, T.T.C Industrial Area, M.I.D.C, Turbhe, Navi Mumbai 400705, (hereinafter referred to as “ICICI
Securities”, which expression shall, unless repugnant to the meaning or context thereof be deemed to mean and
include the amalgamated/ demerged / transferee Company formed out of corporate restructuring, if any,
undertaken in compliance with Section 391-394 of Companies Act, 1956 and duly approved by the relevant High
Court
WHEREAS_(name of Joint Bank Account Holder 1) and (name of Joint Bank Account Holder 2) are Joint bank
account holders with ( name of First holder ) in the following Bank Account No(s) held with ICICI Bank
Limited __________________________ Branch of the ICICI Bank Limited (hereinafter referred to as “ICICI Bank”.)
WHEREAS_(name of Joint Demat Account Holder 1) and (name of Joint Demat Account Holder 2) are Joint Demat
account holders with ( name of First holder ) in the following Demat Account No(s) held with ICICI Bank
Limited in its capacity as Depository Participant (hereinafter referred to as “Depository Participant”) and wish to
participate in trading, Investment and other services and products offered by ICICI Securities Ltd.
For Resident Individual Account Holder

WHEREAS as a consideration for providing various facilities and services and to facilitate proper execution of all
transactions, including but not limited to, transactions for purchase, sale, investment in shares & securities, scrips,
stocks, bonds, debentures, mutual fund units, units of any collective investment scheme or any other security or
financial instrument, derivatives, including but not limited to, Equity Derivatives, Currency Derivatives, Interest
Rates Derivatives, forwards, futures, swaps and options, purchase, sale, investment, subscription of Public
Provident Fund, National Savings Schemes, New Pension System / Scheme and other savings schemes of
Government of India or other undertakings, transactions for payment to allowable billing companies, Fixed
Deposits, Life Insurance, General Insurance or order for purchase or sale of or application for any offer or public
issue of shares, and to sell securities in my behalf in any buy back or open offers made by the issuers or acquirers of
such securities or to refer my name as per my instructions for availing of credit facilities from banks and finance
companies or for making investments (hereinafter referred to as “Purpose” ) and to give effect to all the terms
contained in account opening form, I am desirous of appointing ICICI Securities as my attorney and confer upon it
the powers hereinafter stated.

    
Signature of 1st applicant Signature of 2nd holder Signature of 3rd holder Signature of Co-holder A Signature of Co-holder B

Page 2 of 6
 WHEREAS the “Joint Bank Account Holder(s)” hold jointly with the “First Holder”, Bank A ccount(s) with
ICICI Bank Limited (herein after referred to as “ICICI Bank”), the details whereof are specified in the
Application Form and /or have applied to ICICI Bank for opening of a joint Bank Account through the
Application Form (“Bank Account(s)”).

WHEREAS the “Joint Demat Account Co-Holder(s)” hold jointly with “First Holder”, Demat Account(s) with
ICICI Bank Limited (herein after referred to as “Demat Account(s)”) in its capacity as the Depository
Participant (hereinafter referred to as “Depository Participant“), the details whereof are specified in the
Application Form and/or have applied to ICICI Bank for opening of Demat Account(s) through the
Application Form.

Whereas First Holder wishes to participate on his/her own as also on behalf of the “Joint Bank Account
Holders” and “Joint Demat Co-Holders” in the secondary market trading facility under the Reserve Bank of
India's Portfolio Investment Scheme (PINS) and I/We are desirous that the First Holder so participate in the
aforementioned scheme for this purpose and also sell securities, enter into client agreements and to avail
of various services offered by ICICI Securities Limited, ICICI Bank & ICICI Bank Depository Participant.
(Applicable for NRI's only).

THEREFORE, THIS POWER OF ATTORNEY WITNESSETH that I/we hereby nominate, appoint and
constitute ICICI Securities as my/our true and lawful attorney to do, execute and perform or cause to be
done, executed and performed, the following acts, deeds and things or any of them for and on my/our
behalf namely:

1. To operate the above mentioned Demat Account(s) with ICICI Bank Limited, sign and execute
necessary documents, forms, agreements, undertakings, confirmations, declarations etc. and
accept terms & conditions, on my/our behalf for the purpose of operating the said demat account(s).

2. To operate, block and/or debit the above named Bank Account as per my/our instructions to ICICI
Securities furnished in any manner acceptable to ICICI Securities and to operate, debit, pledge,
transfer or mark lien on securities in the Demat Account(s), as the case may be, to meet all my/our
obligation in terms of the client agreement for transaction done on the National Stock Exchange of
India Limited (NSE) & Bombay Stock Exchange Limited (BSE), or any other recognized Stock
Exchange by transferring my/our on my/our funds to account(s) 000405069726, 000405069729,
000405069731, 000405005406, 000405005970, 000405008178, 000405070670 or any other bank
account and securities to pool/ beneficiary account no IN300183 13632245, IN302902 44963232,
IN300183 13632254, IN302902 44963249, IN302902 44963257, IN302902 46841937 or any other
pool/ beneficiary account of ICICI Securities Limited on my/our instructions and to give other
instructions relating to the Bank Account(s) and the Demat Account(s), for any matter concerning
the above mentioned Purpose, and also to meet obligation in terms of client agreement entered into
me/us, including charges for account opening and availing of various services and facilities from
ICICI Securities.

3. To credit/debit the Bank Account and the Demat Account(s) with monies/ securities due to me/us.

4. To credit/debit the Bank Account and Demat Account(s) with monies/ securities received from/
delivered by ICICI Securities erroneously on my/our behalf.

5. To send, in addition to any other document required to be disseminated by ICICI Securities as

specified by SEBI or any other regulator from time to time, consolidation summary of my/our scrip-
wise buy and sell positions taken with average rates to me/us by way of SMS/email on a daily basis.

    
Signature of 1st applicant Signature of 2nd holder Signature of 3rd holder Signature of Co-holder A Signature of Co-holder B

Page 3 of 6
 6. To debit/credit my/our Bank Account(s) towards monies/fees/charges etc. payable to ICICI
Securities, ICICI Bank and/or Depository Participant or to a third party service provider or to any of
the affiliates/subsidiaries of ICICI Bank by virtue of I/we using/ subscribing to any of the
facilities/services provided either by ICICI Securities, ICICI Bank, Depository Participant or through a
third party service provider or by any of the affiliates / subsidiaries of ICICI Bank.

7. To make applications for such credit facilities on a referral basis/investment/financial products

including but not limited to, insurance policies, mutual funds etc. as may be instructed to be applied
for me/us in terms of the Client Agreement and to do all things necessary for and incidental to
availing investment/ financial products by me/us including but not limited to pledging of scrips,
stocks, securities, bonds, debentures, mutual fund units, units of any collective investment scheme
or any other security or financial instrument on behalf of me/us through ICICI Securities or any third
party.

8. To authorize the Bank / Depository participant to provide and ICICI Securities to receive my/our bank
/ demat transaction statement, either in a physical copy format or a format which can be uploaded in
system from time to time.

9. To have the first and paramount lien on the Bank Account and the Demat Account or any other bank
account(s) and demat Account(s) as may be instructed by me/us and to exercise such lien in the
event of any loss suffered/costs incurred on account of any transaction done / executed by ICICI
Securities and/or ICICI Bank on ICICI Securities Ltd. instructions or on my/our behalf

10. To do all such acts, deeds and things as may be necessary for or incidental to provision of services
and facilities to me/us, including giving intimations, confirmation, undertaking etc. on my/our
behalf.

11. To retain all originals of documents executed by me/us.

12. AND GENERALLY to do or cause to be done every other act, deeds, matter or thing as ICICI
Securities may deem necessary or expedient for the purpose of or in relation to these presents.

I/We hereby declare that all and every receipts made, executed or done for the aforesaid purposes by virtue
of these presents shall be as good, valid and effectual to all intents and purposes whatsoever as if the same
had been made, executed or done by me/us in my/our own name(s).

I/We hereby ratify and confirm and agree to ratify and confirm all that ICICI Securities or any of their
respective Officer shall do or cause to be done in or concerning the premises by virtue of these presents.

I/We hereby agree and confirm that this Power of Attorney shall be canceled or revoked by furnishing a
written intimation of the cancellation/revocation request to ICICI Securities, which request shall bear an
acknowledgment of receipt by ICICI Securities. I/We further agree and confirm that the Power of Attorney
will be revoked / canceled immediately upon fulfillment of my/our obligation pertaining to unsettled
transaction and outstanding dues payable to ICICI Securities/ ICICI Bank/ and/or Depository Participant or to
a third party service provider or to any of their affiliates/subsidiaries as per the terms and conditions of the
service/products availed by me/us.

IN WITNESS WHEREOF I/We have hereunto set and subscribed our respective hands
at_______________________________ on this _______________________________day of 20_______.

    
Signature of 1st applicant Signature of 2nd holder Signature of 3rd holder Signature of Co-holder A Signature of Co-holder B

Page 4 of 6
GENERAL INFORMATION FOR APPLICANT

6. In case both Bank and Demat Account numbers are filled then new bank account would be mapped to
the demat account. In case only demat account is mentioned then the bank details already registered in
demat account would not be changed.

Checklist for linking Bank and / or Demat Account with Trading Account

Match ID/ User ID :

Requestor
Centre HUB RPC

Customer has mentioned the date on the day the POA is signed

d
1

dw

dw

Page 5 of 6
 Centre HUB RPC

(ie.
paid

Customer has m
ed
mentioned

mentioned
the which is to be linked
2) New bank account number which is to be linked is to be
mentioned in the grid.

mentioned the for the

, be
mentioned

mentioned
mentioned
required on POA as per bank/ Demat records.

and

and

s are

EMP ID: ___________________

EMP ID: ___________________

EMP ID: ___________________

Page 6 of 6