Annexure 10.
                           Registered Office: 807, New Delhi House, Barakhamba Road, Connaught Place, New Delhi, 110 011
Correspondence Office: RKSV Securities India Private Limited, Salasar Business Park, Off 150 Feet Flyover Road, Bhayander West, Thane, Maharashtra 401101
        Telephone: +91-22-6130-9999 | Fax: +91-22-6710-7492 | Email: vidya.jadhav@rksv.net / harishchandra.sawant@rksv.net, www.upstox.com
                                                            ACCOUNT CLOSURE REQUEST FORM
    Application No.                                                     Date (dd/mm/yyyy)
    Closure Initiated by              BO               DP           CDSL
  To be filled by the BO (in case of BO - initiated closure). Please fill all the details in Block Letters in English.
  Dear Sir / Madam,
  I / We the Sole Holder / Joint Holders / Guardian (in case of Minor) / Clearing Member request you to close my / our account
  with you from the date of this application. The details of my/our account are given below:
  Account Holder’s details
    DP ID       1       2        0         8       1         8      0        0     Client ID
    Name of First / Sole Holder
    Name of Second Holder
    Name of Third Holder
    Address for Correspondence
    City                                                    State                                                  Pin Code
  Details of remaining security balances in the account (if any)
    Reasons for Closing the Account
    Balance remaining in the account (if any) to be :
           Partly rematerialised and partly transferred                                       Rematerialised
           Transferred to another account (Number given below)                                Not Applicable
    DP ID                                                                          Client ID
    Balance present in account for (To be filled by DP, if applicable)
           Ear - marked                                                                       Pledged
           Pending for Dematerialisation                                                      Frozen
           Pending for Rematerialisation                                                      Lock - In
    DECLARATION: In case of Account Closure due to SHIFTING OF ACCOUNT:
    I/We declare and confirm that all the transactions in my/our demat account are true/ authentic.
                                         First / Sole Holder                             Second Holder                                 Third Holder
    Name
    Signature*
  *If DP or CDSL initiates account closure, Signature(s) of account holder(s) not required.
                                                                                                                     Powered by RKSV Securities India Private Limited
                                                                                                                                       SEBI REG NO.IN-DP-118-2015
                                                                           (Please Tear Here)
                                                                    Acknowledgement Receipt
  Application No.:                                                                                          Date:
  We hereby acknowledge the receipt of the your instruction for Closing the following Account subject to verification:
    DP ID       1       2        0         8       1         8      0        0     Client ID
    Name of First / Sole Holder
    Name of Second Holder
    Name of Third Holder
    Reason for Closure
  Instructions to Account Holder(s):
  - Submit a duly-filled RRF if the balances are to be rematerialised.
  - Submit a duly-filled Delivery Instruction Slip [DIS] (off market instruction slip) if the balances are to be
  transferred to another Account. This requirement is not applicable in the case of “SHIFTING OF ACCOUNT”.                 For RKSV Securities India Private Limited