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CLIENT COMPLAINT FORM

Section A: Complainant Details

1. Investor Name: __________________________________________________________________________

2. Folio / Client Code: _______________________________________________________________________

3. PAN Number: ___________________________________________________________________________

4. Email ID: ______________________________________________________________________________

5. Mobile Number: __________________________________________________________________________

6. Address: _______________________________________________________________________________

Section B: Complaint Details

1. Date of Occurrence: _______________________________________________________________________

2. Date of Complaint Submission: _______________________________________________________________

3. Nature of Complaint (Select one):

☑ Transaction delay / error

☑ Incorrect NAV / execution issue

☑ KYC / documentation issue

☑ Commission / disclosure issue

☑ Miscommunication / misleading information

☑ Others (please specify): __________________________________________________________________

1. Description of Complaint: __________________________________________________________________

_____________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

2. Documents Attached (if any) :

ü Transaction slip

ü Email copy

ü AMC letter

ü Screenshot

ü Others :

Declaration: I confirm that the above information is true and complete to the best of my knowledge.

Investor Signature: __________________________ Date: __________________________

Note: Please retain a copy of this form and acknowledgment for your records. Unresolved complaints after 21 days may be escalated to SEBI through the SCORES Portal. This complaint process complies with SEBI Master Circular (May 2023) & AMFI Code of Conduct (Clause 8).

Vardhaman Wealth And Lifestyle Private Limited

Location: Office No. 26, 6th floor Navjivan Commercial Premises, Dr D.B. Marg, Mumbai Central, Mumbai-400008.

Contact No.: 91 9969572995
Email: support@vardhamanwealth.com