Nomination Form

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..... ke nomination and do hereby nominate the following persons in whom shall vest, all the rights in respect of such securities in the event of my/our death. (1) PARTICULARS OF THE SECURITIES (in respect of which nomination is being made) Nature of securities Folio No No. of securities Certificate No .....

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..... ity holder:(i) Relationship with the minor nominee Name: Address: Name of the Security Holder(s) Signature Witness with name and address ] ********* Notes 1. Substituted vide Notification [F. No. 1/4/2013-CL-V(Pt I)] dated 18-03-2015 - Forms Tax Man .....

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