Registration Form

Registration Form

Please fill in the form below.
Registration No
(For Office Use Only)
Full Name*

PrefixFirst NameMiddle NameLast Name
No.*
No.*
Place of Birth*
Enter Birth Place
Date of Birth*

MonthDayYear
Father's Name*

PrefixFirst NameMiddle NameLast Name
Mother's Name*

PrefixFirst NameMiddle NameLast Name
Spouse Name

PrefixFirst NameMiddle NameLast Name
Marital Status*
Citizen*

IndianOther
Gender*
Occupation Type*

Private SectorPublic SectorSelf EmployedRetiredHousewifeStudentBusinessGov SectorOther
Gross Annual Income*

Below 1 Lac1-5 Lac5-10 Lac10-25 Lac>25-1 Cr>1 Cr
Permanent Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Is Permanent Address same as Communication Address?

YesNo
Communication Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mobile No.*
Enter Mobile No.
WhatsApp No.
Enter Mobile No.
Phone Number

Area CodePhone Number
E-mail*
Nominee Name 1*

PrefixFirst NameMiddle NameLast Name
Relation*
Relation With Investor
Date of Birth*

MonthDayYear
Nominee Name 2

PrefixFirst NameMiddle NameLast Name
Relation
Relation With Investor
Date of Birth

MonthDayYear
Nominee Name 3

PrefixFirst NameMiddle NameLast Name
Relation
Relation With Investor
Date of Birth

MonthDayYear
Upload File in JPG or PDF format.
Statement*

Browse Files

Cancelof
Remarks (if Any)
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.

I hereby declare that I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute of legislation or any notifications/directions issued by any governmental or statutory authority from time to time.
Date

DayMonthYear
Place
Place
Note:
- Copy of Cheque/ Bank statement (1 Month) is required to verify bank account for Pay in or Pay out purpose.
- Following Services will be given: (based on Discussion Held).
  - Portfolio Building
  - Mutual Fund Advice / Application
  - Investment Solutions
  - Wealth Creation.
- Registration (One time) charge will be applicable (As Discussed). You can send it via paytm (9426325120) or transfer in bank account as mentioend in E-mail.
- We will facilitate and provide advice and guidance only. All investments are subject to market risks.
- For more details visit http://infyture.wordpress.com
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