SPECIMEN SIGNATURE FORM Share Holder Name Specimen

SPECIMEN SIGNATURE FORM
Company Name
Registered Folio
Number of Shares
Certificate Numbers
Share Holder Name
Specimen Signature
First / Sole Holder
Second Joint Holder
Third Joint Holder
Address of the Share Holder (This should match with the address in our records)
VERIFICATION OF SIGNATURES (BY BANK MANAGER OR ABOVE ONLY)
Bank Account Number #
Type of Account #
Account Opening Date #
Last Transaction Date #
Full Name of Branch Manager #
Employee Identification Number of Branch Manager #
Full Name and Postal Address of Bank #
Contact Number of Bank Manager #
Signature of Branch Manager with Seal #
DOCUMENTS TO BE SUBMITTED ALONG WITH THIS FORM
A copy of any one document from Category A & B attested by the Banker who has attested this form.
Category A #: Passport or Driving License or PAN Card
Category B #: Ration Card or Election Card or Telephone (Land Line) Bill or Electricity Bill
1. Mere sending of this form should NOT be construed as our confirmation that the earlier signature(s) recorded
with us, if any, will be replaced with the fresh ones being submitted herewith. This will be done only after proper
verification and our finding the same to be in order.
2. Signature(s) should be verified only by your banker and the verification must be complete in all respects. Forms
which are not verified properly as per instruction will be rejected.
3.
#
Informations / Documents are mandatory