Name (*)

Father Name (*)

Email Address (*)

Phone Number (*)

Pan Number (*)

UID/Aadhar Number (*)

DOB (*)

Mail id (*)

Address (*)

On the basis of below mentioned evaluation: Mr./Ms (*)

(Name of Client)considered as (*)

Client in (*)

Risk based classification of the services
Product term/Risk classification (*)
Stock Cash/MediumBase Metal/HighMCX /HighNifty/Bank Nifty / HighStock Future Premium / HighNcdex Premium / HighInventory Calls / HighHNI /HighCircuit Plan (Stock Cash)/MediumStock Option Platinum / Highstock Future/HighPreciousMetal / HighNCDEX / HighNifty Option / HighStock Option Premium / HighEnergy Premium / HighStock Future BTST /STBT / HighNifty Star / HighStock Cash Platinum / MediumStar India Pariwar Premium / HighOption Call-Put/HighEnergy / HighForex / HighStock Cash Premium / MediumBullion Premium / HighStar India Pariwar / HighStock Cash BTST / MediumPlatinum Tips (Combo Pack) / HighStock Future Platinum / High
The above classification of products is done based on following Segment: segment/Risk (*)
Cash/MediumF&O/HighCommodity/Highforex/High
Risk Assessment Form
Would you invest where a small return is earned associated with small risk instead of a high return associated with high risk?/Direct questions to ascertain risk appetite
strongly prefer /0prefer/10indifferent /20do not prefer /30do not prefer /30
When market is not performing well would you like to invest in more risky investment instead of less risky investment to earn high return?/Direct questions to ascertain risk appetite
strongly prefer /0prefer/10indifferent /20do not prefer /30do not prefer /30
High risk is associated with high return, medium risk is associated with medium returns and low risk is associated with low returns? What risk you can bear (not prefer)?/ Direct questions to ascertain risk appetite
strongly prefer /0prefer/10indifferent /20do not prefer /30do not prefer /30
What is the duration of investment you are looking forward to keep invested?
short term positional(from 1 month to 6 months)/10long term positional(more than 1 year)/0intraday/20

In which of the following market segments have you traded previously?/ For selection of product
commoditystockderivatives stocksforexAll

In which of the following market segments have you traded previously?/ For selection of product
extensive experiencemoderate experiencevery less experienceno experience

What is your experience with commodity investments?/For selection of product
extensive experiencemoderate experiencevery less experienceno experience

What is your experience with forex investments?/For selection of product
extensive experiencemoderate experiencevery less experienceno experience

What is your age group?/Weight allotted
under 35/40under 45/3046-55/2055-60/1060+/0

Investment goal
capital appreciation /0regular income /40capital appreciation and regular income/20

Proposed investment amount

Gross annual income detail

Sources of income

Market value of portfolio held

Investment experience

How many dependents do you financially support?

What is the size of your emergency fund ?
do not have /0less 1 month income/01-3 months income/103-6 months income/206 months income/30

What is your experience with investments in past ?
Very good/40good/30moderate/20bad/20

What percentage of monthly income is allocated to pay off debt (all EMIs)?
none /40between 0%-20% /30between 20%-35%/20between 35%50% /10between 35%50% /1050%/0

Occupation

Are you any of the following, or are directly or indirectly related to and of the following
civil servantpoliticiancurrent or former head of statebureaucrat (tax authorities, foreign services, IAS etc)connected to mediaconnected to any company/promoter group/group of companies listed on any stock exchangenone

DISCLAIMER

The information received by subscriber is for their personal use. Investing involves a great deal of risk, including the loss of all or a portion of your investment, as well as emotional distress. Nothing contained herein should be construed as a warranty and guarantee of investment results. All risks, losses and costs associated with investing, including total loss of principal, are your responsibility. It is possible that Investment Models, Inc, (hereinafter referred as Equity Express)., may have a position in stocks or funds discussed within this site or in correspondence sent to clients. All information provided or contained in this Web site is the property of Equity Express (an Investment Advisor)., and should not be reproduced, copied, redistributed, transferred, or sold without the prior written consent of Equity Express(an Investment Advisor). All rights reserved.

DECLARATION:

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.

Date (*)