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. 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 / statutory authority from time to time. I
hereby authorize BSLAMC and/or SEBI Registered Entities to share the information
furnished in this form with all SEBI Registered KYC Registration Agencies / all
other Intermediaries registered with any of the Regulatory Authorities.