Name of Investor* @error('name_of_investor') {{ $message }} @enderror

Email Address* @error('email') {{ $message }} @enderror

Mobile Number* @error('mobile_no') {{ $message }} @enderror

Date of Birth* @error('dob') {{ $message }} @enderror

City* @error('city') {{ $message }} @enderror

State/UnionTerritory ( Please put in country also if outside India)* @error('state') {{ $message }} @enderror

Pincode* @error('pin_code') {{ $message }} @enderror

GST No. @error('gst_no') {{ $message }} @enderror

Please provide your PAN NO* @error('pan_no') {{ $message }} @enderror

Full Street Address @error('street_address') {{ $message }} @enderror

Residential Status* @error('residential_status') {{ $message }} @enderror

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Age*

< 30 years 30 - 60 years > 60 years

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Select all the investments you currently hold

Stocks Mutual Funds Bank FD Other

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What percentage of your income goes in repayment of existing liabilities like bank loans etc. ?*

>50% 20% - 50% <20%

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Select your source of Income

Employment Business Investment Pension Real Estate Other

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What is your comfortable holding investments period?*

< 12 Months 12 - 36 Months Over 36 Months

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What is your annual income? *

< 10 lacs 10-50 lacs 50 lacs- 1 Cr Above 1 Cr

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Percentage of your liquid net worth you would like to invest? *

< 25% 25%- 50% > 50%

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What is your investment objective? *

Protect invested capital with very low chance of a loss (investment horizon - < 2 years)
Seek balance between invested capital growth and protection (investment horizon - < 2-5 years)
Seek long term wealth creation with chances of higher short term loss (investment horizon - > 5 years)

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Pick a possible outcome along with potential capital drawdown of your investment - Average Return *

Avg Return - 7% Best Return - 12 % Worst Return - (-5%)
Avg Return - 10% Best Return - 18 % Worst Return - (-12%)
Avg Return - 12% Best Return - 22 % Worst Return - (-19%)

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What best describe your Risk Attitude? *

SECURE : I seek complete safety of my capital with no returns
MODERATE : I seek a balance of regular income and capital appreciation over medium term
AGGRESIVE : I am comfortable with volatility and seek aggressive returns over a long term

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What best describe your Knowledge & Experience? *

LIMITED : I have limited understanding & experience of financial investments
MODERATE : I am comfortable with financial products 4 have fair understanding & experience in investments
EXTENSIVE : I have extensive knowledge & experience of financial products

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Do you confirm that your legal residential status allows you to take this advisory and invest in the Indian stock markets?

Yes No

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Have you suitably assessed by your own research the ability and the knowledge of the advisor Mr Arvind Kothari to provide you with the required services?*

Yes No

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Do you understand the Risk & Reward associated with Niveshaay investment Strategy?

Yes No

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