TSR DARASHAW PRIVATE LIMITED APPLICATION FORM FOR

TSR DARASHAW PRIVATE LIMITED
6-10 Haji Moosa Patrawala Industrial Estate, 20 Dr. E. Moses Road, Near Famous Studio, Mahalaxmi, Mumbai – 400 011
Tel 91 22 6656 8484 Fax 91 22 6656 8494 e-mail [email protected] website www.tsrdarashaw.com
Business hours Monday to Friday 10.00 a m to 3.30 p m
APPLICATION FORM FOR TRANSMISSION / NAME DELETION / TRANSPOSITION / AMALGAMATION
PLEASE FILL IN SEPARATE FORMS FOR EACH COMPANY SERIES AND EACH CATEGORY OF
SHARES / DEBENTURES / BONDS. KINDLY READ THE INSTRUCTIONS ON THE REVERSE.
PLEASE FILL THE FORM IN BLOCK LETTERS
A. TYPE OF REQUEST (Tick relevant box)
1. TRANSMISSION / NAME DELETION
:
2. TRANSPOSITION
3. AMALGAMATION
B. NAME OF THE COMPANY :
C. REGD. FOLIO NO. :
(The folio is mentioned on the front / reverse of the certificate)
D. NAME(S) OF THE HOLDER(S)
(As endorsed on the certificate[s]):
FULL NAME(S) OF HOLDER(S)
Sr. No.
1
2
3
4
E. PARTICULARS OF SHARE / DEBENTURE / BOND CERTIFICATE(S) (If space provided is insufficient then continue on reverse) :
CERTIFICATE NO.
F.
DISTINCTIVE NOS.
TOTAL NO. OF SHARES / DEBENTURES / BONDS
NO. OF SECURITIES
:
G. TO BE TRANSMITTED / TRANSPOSED IN FAVOUR OF (In case of Amalgamation, do not fill in this table) :
Sr. TITLE
No.
FULL NAME(S)
OCCUPATION
PAN
1
2
3
4
NOTE: Mandatory to attach Self attested copies of PAN cards of all holders / claimants under item G
H. FULL ADDRESS OF HOLDER UNDER ITEM G (1)
PINCODE
:
TEL:
EMAIL:
I. TICK THE TYPE OF DOCUMENTS SUBMITTED /
REGISTERED (Please see INSTRUCTION - C iv on reverse)
Sr. No.
TYPE OF DOCUMENT
TICK
J. DOCUMENT REGISTRATION DETAILS :
1.
REGISTRATION NO.
1
DEATH CERTIFICATE
2
SUCCESSION CERTIFICATE
2. REGISTRATION /
BOARD
APPROVAL DATE
3
PROBATE OF WILL
K. NEW REGD. FOLIO NO. :
4
LETTERS OF ADMINISTRATION
5
MARRIAGE CERTIFICATE
6
7
NOMINATION FORM
TWLR
8
ANY OTHER
L.
DELIVERY TYPE
(TICK RELEVANT BOX) :
COUNTER
POSTAL
M. SPECIMEN SIGNATURE(S) (To be attested by Bank Manager. Please see INSTRUCTION - A on reverse)
FOR OFFICE USE ONLY
1.
1.
Signature of Unit Staff ………………
2. Transfer No & Date of receipt…….
2.
3.
4.
INSTRUCTIONS
GENERAL
A. The specimen signature(s) of the holder(s) / claimant(s) under Item M is / are to be attested by Bank Manager under his full
name, designation with seal of the bank bearing its name and address. In case of attestation by multiple banks, separate
letters / sheets may be attached.
B. It is mandatory to submit self attested copies of PAN cards of all the holder(s) / claimant(s) under Item G.
(Copy of PAN card may be substituted with ID proof in case of residents of Sikkim after Furnishing address proof)
C. IN CASE OF TRANSMISSION/ NAME DELETION
i. In a Joint Account no names can be deleted apart from the name of the deceased nor can any fresh names be added.
ii. Request for transmission CANNOT be processed in case of securities standing in the single name of the deceased where
iii.
iv.
nomination is not registered, merely on the basis of Death Certificate. Attested copies of Legal documents viz.
Probate of W ill / Letters of Administration/Succession Certificate/ Administrator General’s Certificate are required to be
submitted.
For change from Minor to Major, attested copy of birth certificate/ school leaving certificate wherein name is the same
as that on the securities , is required to be submitted.
Copies of documents submitted should be attested by Bank Manager / Notary Public / 1st Class Magistrate / Gazetted
Officer. The attesting authorities should mention their name, full address, registration number and affix their seal,
Notarial/ Court fee stamps, as applicable .
D. IN CASE OF AMALGAMATION
i. Amalgamation of folios can be done only if, order of names are identical in all accounts.
ii. Only one form is required to be filled even if more than one folio is to be amalgamated.
iii. There is no need to fill up Item G.
iv. Mention the new Regd. Folio No. in Item K into which the securities are to be amalgamated.
PARTICULARS OF SHARE / DEBENTURE / BOND CERTIFICATE(S) CONTINUED FROM ITEM – E OVERLEAF.
SR. NO.
1
CERTIFICATE NO.
DISTINCTIVE NOS.
2
3
4
5
6
7
8
9
10
11
12
Securities to be forwarded to :
PINCODE
TEL:
EMAIL:
FOR OFFICE USE
SPACE FOR ANY SPECIAL REMARKS
NO. OF SECURITIES