Securities and Exchange Board of India - Investor Complaint Format

1. Investor Name*
Address of the Investor*
2. Email Address*
3. Name of the Intermediary*
Address of the Intermediary*
4.SEBI Registration Number of the Intermediary
5. SEBI Acknowledgement Reference No. (in case of reminder)
6. Complaint Details Market Intermediary Related, against:
	Broker Merchant Banker Banker to an Issue Depository Participant Sub Brokers Registrar and Share Transfer Agent Underwriter Securities Lending Intermediaries Debenture Trustee Credit Rating Agencies
Please state your Complaint in brief:
* Indicates Mandatory Field