Folio
No. : _________________
|
No.of Shares: _________________
|
(To be filled in by individual(s)
applying singly or jointly)
I/We
................................... and
......................................and........................................
the holders of Equity
Shares bearing distinctive No(s). ...................….......to. ........................…….of HB
Portfolio Ltd. wish to make a nomination and do here by nominate the following
person in whom all rights of transfer and /or amount payable in respect of
Shares shall vest in the event of my or our death.
Name, Address and Signature of Nominee
Name |
: |
........................................................................................................………………… |
Address |
: |
........................................................................................................………………… |
Signature |
: |
........................................................................................................………………… |
Date of Birth* |
: |
........................................................................................................………………… |
(*To be furnished in the case the
nominee is a minor) ** The Nominee is a
minor whose guardian is |
||
Name |
: |
........................................................................................................………………… |
Address |
: |
........................................................................................................………………… |
Signature |
: |
........................................................................................................………………… |
**To be deleted if not applicable |
1. |
Signature |
: |
........................................................................................................………………… |
|
Name |
: |
........................................................................................................………………… |
|
Address |
: |
........................................................................................................………………… |
|
Date |
: |
........................................................................................................………………… |
2. |
Signature |
: |
........................................................................................................………………… |
|
Name |
: |
........................................................................................................………………… |
|
Address |
: |
........................................................................................................………………… |
|
Date |
: |
........................................................................................................………………… |
3. |
Signature |
: |
........................................................................................................………………… |
|
Name |
: |
........................................................................................................………………… |
|
Address |
: |
........................................................................................................………………… |
|
Date |
: |
........................................................................................................………………… |
Name, Address and Signatures of two Witnesses
|
||
|
Name and Address |
Signature with date |
1. |
|
|
2. |
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Instructions:
|
|
1. |
The
Nomination can be made by individuals only holding Shares on their own behalf
singly or jointly. Non-individuals including society, trust, body corporate,
partnership firm, Karta of Hindu Undivided Family, power of attorney holder
cannot nominate. If the Shares are held jointly, all joint holders are
required to sign the nomination form. Space is provided as a specimen, if
there are more joint holders more sheets can be added for signatures of
holders of Shares and witnesses. |
2. |
A
minor can be nominated by a holder of Shares and in that event the name,
address and signature of the guardian shall be given by the holder. |
3. |
The
nominee shall not be a trust, society, body corporate, partnership
firm, Karta of Hindu Undivided Family or a power of attorney holder. A
non-resident Indian can be a nominee on repatriable
basis. |
4. |
Nomination
stand rescinded upon transfer of Shares. |
5. |
Transfer
of Shares in favour of a nominee shall be a valid
discharge by the Company against the legal heir. |
6. |
Nomination form, duly completed,
should be sent to the Company Registar & Share
Transfer Agent RCMC SHARE REGISTRY PVT. LTD., B-106, Sector-2, Noida-201301. |
Nomination
Registration Number |
Date of
Registration |
Checked by (Name
and Signature) |