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Get Field Verification Form Axis Bank

Securities in PIS Account No. Name of the Co. Type of Investment (Shares /Convertible Debentures) IPO /Rights /Bonus /NONPIS/PIS Purchase* Acquisition Date Quantity Cost of acquisition including premium, if any paid Folio No. Repatriable Ref. No./RBI Approval to the Co. for issue of share/debenture benefit I request you to incorporate the shares to above mentioned PIS account held with you for RBI reporting in case of Secondary market transaction and update my portfolio.

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