Consent Form

 

Gyana Ranjan Rath (Investment & Port folio Mgmt P).
Po:- Birarama Chandra Pur (Part - 1)
Dist:- Puri - 752042
St :- Orissa (India)

Date:

Trading in the equity markets both in the cash & derivatives & Commodities format is a risky business. We may lose some or all of our capital. We understand that advisory services require proper money management and psychology. We are taking the services of Gyana Ranjan Rath (Investment & Portfolio Management Private ) as an educational mechanism. We shall solely be responsible for all trading and investment decisions taken by us.

Equ/Der/Comm:____________________________	Name:____________________________
Signature:_________________________________	Address:__________________________
	________________________________
	________________________________
Date of Birth:_____/____/________	Email ID:_________________________
Tel No (Home):_____________________________	Tel No (Mobile):___________________
Payment Mode:____________________________	Bank Name & Add:_____________________
Cheque/Demand Draft/Online Reference Number:________________________	Date:____/_____/_______

 

 

Please provide us two references who Trade / Invest in Stock Market

1. Name : _________________________________	2. Name : __________________________________
Contact Number : __________________________	Contact Number: ___________________________