Declaration by the registered owner of shares who does not hold the beneficial interest in such shares

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..... e company Registered office address: 1. Particulars of the Registered owner of shares: (i) Name : (ii) Father's / Mother's / Spouse' name: (iii) Occupation : (iv) Whether citizen of India Yes No (v) Nationality (vi) Date of Birth __________ (vii) Gender Male Female (viii) PAN No. (ix) Proof of Identity : • For Indian Nationals : (Any of the following) : * Income-tax permanent a .....

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..... of shares: 3. Declaration: In pursuance of sub-section (1) of section 89 of the Companies Act, 2013, I ………………hereby declare that the person (s) name below hold(s) the beneficial interest in the above mentioned shares registered in my name in the register of members of the company: Sl. No. Name of the beneficial owner(s) Address and Email id Date of b .....

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