ANMI Indemnity Insurance Registration Form for FY- 2024
Name of Authorized officer
*
Email
*
Entity Name (in full)
*
Company / Trade Name
*
Mobile No.
*
-
Area Code
Phone Number
Designation
*
PAN No.
*
GST No.
*
Region
*
Please Select
Select Region
ANMI National Secretariat
Eastern India Regional Council
Western India Regional Council
Northern India Regional Council
Southern India Regional Council APT
Southern India Regional Council TKK
Registered Office Address
Address
*
Address Line 1
Address Line 2
City
State
Pin Code
Back
Next
Communication address for correspondance /ANMI Journal
Same as the Registered Office Address
Yes
No
Address
Address Line 1
Address Line 2
City
State
Pin Code
ANMI Complementary INSURANCE COVER Rs. 5 lac
*
Please Select
Yes
No
Select ANMI Indemnity Insurance Cover Rs. 5 Lac
Existing Policy No.
Insurance Data
With Error and Omission or without Error and Omission
*
Please Select
With Error and Omission
Without Error and Omission
Insured Name
*
Company/trade Name
*
Same GSTN as above
Yes
No
GST No
Total Number of Segments - e.g. Equity , derivatives , currency,etc.
*
SEBI REGISTRATION NO.NSE
*
SEBI REGISTRATION NO.BSE
SEBI REGISTRATION NO.MCX
SEBI REGISTRATION NO.MSEI
SEBI REGISTRATION NO.NCDEX
Date of Submission
*
-
Day
-
Month
Year
Total no.of securities Exchanges
NSE
BSE
MSEI
Total no.of Commodities Exchanges
MCX
NCDEX
ANMI Complementary INSURANCE COVER Rs. 10 lac
*
Please Select
Yes
No
Select ANMI Indemnity Insurance Cover Rs. 5 Lac
Existing Policy No.
Insurance Data
Insured Name
*
With Error and Omission or without Error and Omis
*
Please Select
With Error and Omission
Without Error and Omission
Company/trade Name
*
Same GSTN as above
Yes
No
GST No
Total Number of Segments - e.g. Equity , derivatives , currency,etc.
*
SEBI REGISTRATION NO.NSE
*
SEBI REGISTRATION NO.BSE
SEBI REGISTRATION NO.MCX
SEBI REGISTRATION NO.MSEI
SEBI REGISTRATION NO.NCDEX
Date of Submission
*
-
Day
-
Month
Year
Total no.of securities Exchanges
NSE
BSE
MSEI
Total no.of Commodities Exchanges
MCX
NCDEX
Submit
Should be Empty: