Naasa Securities

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Personal Information (For Demat Creation)

First Name *

Middle Name

Last Name *

Mobile No. *

Alternative Contact No. *

Email *

Date of Birth (in B.S.) *

Date of Birth (in A.D.) *

Gender *

Male

Female

Others

Nationality *

Citizenship No. *

Citizenship Issued From *

Citizenship Issued Date (in B.S.) *

Citizenship Issued Date (in A.D.) *

Passport No.

Passport Issued From

Passport Issued Date

Passport Expiry Date

PAN No.

Family Information

Grand Father's Name *

Father's Name *

Mother's Name *

Marital Status

Married

Single

Is this a Minor Account?

Yes

No

Do you want to keep nominee?

Yes

No