Gabriel India : Request For Registering Pan, KYC Details or Changes / Updation Thereof

Form ISR - 1

(see SEBI circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655 dated November 03, 2021 on Common and Simplified Norms for processing investor's service request by RTAs and norms for furnishing PAN, KYC details and Nomination)

REQUEST FOR REGISTERING PAN, KYC DETAILS OR CHANGES / UPDATION THEREOF

[For Securities (Shares / Debentures / Bonds, etc.) of listed companies held in physical form]

Date:___ /___ /______

1. I / We request you to Register / Change / Update the following (Tick  relevant box)

PAN
Bank details
Signature
Demat Account details

Postal Address

E-mail address

Mobile number

1. Security Details:

Name of the Issuer Company		Folio No.:
Name(s) of the Security	1.
holder(s)	as	per	the	2.
Certificate(s)				3.
Number & Face value of
securities
Distinctive		number	of	From	To
securities

1. I / We are submitting documents as per Table below (tick as relevant, refer to the instructions):

	Document /	Instruction / Remark
	Information /
	Details

1 PAN of (all) the (joint) holder(s)

PAN

Whether it is	PAN shall be valid only if it is linked to Aadhaar by March 31,
2021*
Valid (linked to
Aadhaar):	For Exemptions / Clarifications on PAN, please refer to Objection
	Yes
	Memo in page 4

	 No
2	Demat Account
	Number		Also provide Client Master List (CML) of your Demat Account,
			provided by the Depository Participant.
3	Proof	of	Provide any one of the documents, only if there is change in the
	Address of	the	address;
	first holder		∙ Client Master List (CML) of your Demat Account, provided by
			the Depository Participant
			∙ Valid	Passport /	Ration	Card /	Registered	Lease	or Sale
			Agreement of Residence / Driving License / Flat Maintenance
			bill.
			∙ Utility bills like Telephone Bill (only land line), Electricity bill or
			Gas bill - Not more than 3 months old.
			∙ Identity card / document with address, issued by any of the
			following: Central/State Government and its Departments,
			Statutory / Regulatory Authorities, Public Sector Undertakings,
			Scheduled Commercial Banks, Public Financial Institutions.
			∙ For FII / sub account, Power of Attorney given by FII / sub-
			account to the Custodians (which are duly notarized and / or
			apostilled or consularised) that gives the registered address
			should be taken.
			∙ The proof of address in the name of the spouse
4	Bank details		Provide the copy of the bank statement with details of bank name,
			branch, account number and IFS Code or copy of cheque leaf.
			Alternatively, Bank details available in the CML will be updated in
			the folio.
5	E-mail address	_________________________________
			Alternatively the e-mail address available in the CML will be
			updated in the folio
6	Mobile		____________________
			Alternatively the mobile number available in the CML will be
			updated in the folio
7	Specimen		∙ Provide banker's attestation of the signature of the holder(s)
	Signature		as	per	Form	ISR	-	2	in	SEBI	circular
			SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655	dated
			November 03, 2021) and

• Original cancelled cheque

8	Nomination** ∙ Providing	Nomination: Please submit the duly	filled up
	Nomination Form (SH-13)or'Declaration to Opt out of
	Nomination' as per Form ISR - 3, in SEBI circular
	SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655	dated
	November 03, 2021
	∙ Change in Existing Nomination: Please use Form SH-14 in SEBI
	circular	SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2021/655
	dated November 03, 2021
	∙ Cancellation of Existing Nomination: Please use Form SH-14
	andForm ISR - 3

• or any date as may be specified by the CBDT
• Nomination (Form SH-13or SH-14) / 'Declaration to Opt-Out of nomination' (Form ISR - 3), has to furnished by the holder(s) separately for each listed company.

Mode of submission of documents to the RTA

Please use any one of the following mode;

1. In Person Verification (IPV): by producing the originals to the authorized person of the RTA, who will retain copy(ies) of the document(s)
2. In hard copy: by furnishing self-attested photocopy(ies) of the relevant document, with date
3. Through e-mail address already registered with the RTA, with e-sign of scanned copies of documents
4. Service portal of the RTA with e-sign with scanned copies of documents, if the RTA is providing such facility

Note

• It is mandatory for holders of physical securities in listed company to furnish PAN, full KYC details (address proof, bank details, e-mail address, mobile number) and Nomination (for all the eligible folios).
• Upon receipt or up-dation of bank details, the RTA automatically, pay electronically, all the moneys of / payments to the holder that were previous unclaimed / unsuccessful.
• RTA shall update the folio with PAN, KYC details and Nominee, within seven working days of its receipt. However, cancellation of nomination, shall take effect from the date on which this intimation is received by the company / RTA.
• RTA shall not insist on Affidavits or Attestation / Notarization or indemnity for registering / up-dating / changing PAN, KYC details and Nomination.

Authorization: I / We authorise you (RTA) to update the above PAN and KYC details in my / our folio (s) _________, ________, in which I / We are the holder(s) (strike off what is not

applicable).

Declaration: All the above facts stated are true and correct.

	Holder 1	Holder 2	Holder 3
Signature			
Name			
Full postal address	

PIN	

(Page 4 is for information to investors; print out of the same is not needed.)

Objection Memo that can be raised by the RTA

(only if the relevant document / details is / are not available in the folio or if there is a

mismatch / discrepancy in the same or change thereof)

Note

RTAs shall raise all objections, if any / at all, in one instance only; the RTA shall not raise further objections on the same issue again and again, after the holder / claimant furnishes all the prescribed documents and details, unless there is any deficiency / discrepancy in the same.

No.		Item			Documents / Details to be provided to the RTA by the holder(s) /
						claimant(s)
1	PAN - Exceptions and	'Exemptions/clarifications to PAN', as provided in clause D to
	Clarification			'Instructions/Check List for Filing KYC Forms' in Annexure - 1 to SEBI
					circular No. MIRSD/SE/Cir-21/2011 dated October 05, 2011 on
					Uniform Know Your Client (KYC) Requirements for the Securities
					Market, shall also applicable for holder(s) / claimant(s) of securities
					held in physical mode.
2	Minor	mismatch	in	The RTA shall intimate the holder at the existing address, seeking
	Signature - minor		objection, if any, within 15 days
3	Major	mismatch	in	∙ Banker's attestation of the signature of the holder(s) as per Form
	Signature or its non-	∙	ISR - 2
	availability	with	the	Original cancelled cheque
	RTA
4	Mismatch in Name	Furnish any one of the following documents, explaining the difference
					in names;
					∙ Unique Identification Number (UID) (Aadhaar)
					∙	Valid Passport
					∙	Driving license
					∙ PAN card with photograph
					∙ Identity card / document with applicant's Photo, issued by any of
						the following: Central / State Government and its Departments,
						Statutory / Regulatory Authorities, Public Sector Undertakings,
						Scheduled Commercial Banks, Public Financial Institutions
					∙	Marriage certificate
					∙	Divorce decree
5	Present	address	of	RTA shall issue intimation to both the old and new addresses.
	the holder	is	not	If the letters sent to either the old and or new addresses is / are
	matching with	the	undelivered or if there is an objection in response to this letter, then
	address	available	in	provide any one of the following;
	the folio			∙ any one of the documents in row 3 in Table C, reflecting the old
						address or
					∙ Counterfoil of dividend warrant received from the company or
					∙ Bank statement showing the credit of previous dividend received
					The above procedure will be applicable for request for change in
					address of the holder also

(Page 4 is for information to investors; print out of the same is not required)