FORM

X X   X X   Extracts   X X   X X

→ Full Text of the Document

X X   X X   Extracts   X X   X X

..... COMPLAINANT ……………… 2. FULL ADDRESS OF THE COMPLAINANT …………………… …………………… …………………… PIN CODE ………………….. PHONE NO. / FAX NO. …………………… 3. COMPLAINT AGAINST (NAME AND FULL ADDRESS OF THE LISTED COMPANY / INTERMEDIARIES ) …………………………. …………………………. PIN ……………&he .....

X X   X X   Extracts   X X   X X

→ Full Text of the Document

X X   X X   Extracts   X X   X X

..... een rejected ? YES/ NO (If yes, please enclose 'three copies' of the letter of rejection) (c) Whether the complainant has received any other final decision of the listed company /intermediary? YES/ NO (If yes, please enclose 'three copies' of the letter of the listed company/intermediary conveying its final decision) 8. NATURE OF RELIEF SOUGHT FROM THE OMBUDSMAN ……………………………………………………… ( Please enclose 'three copies' of documentary proof, if any, in support of your claim) 9. LIST OF DOCUMENTS ENCLOSED (Please enclose 'three copies' of all the documents) 10. DECLARATION 1. I/ We , the comp .....

X X   X X   Extracts   X X   X X

→ Full Text of the Document

X X   X X   Extracts   X X   X X

..... d Exchange Board of India/ Ombudsman is necessary and is required for redressal of any other complaint or our complaint. 2. I/We have carefully gone through the provisions of the Securities and Exchange Board of India (Ombudsman) Regulations, 2003. Yours faithfully (Signature) (Complainant ) NOMINATION / AUTHORISIATION - (If the complainant wants to nominate/authorise his representative, not being a legal practitioner, to appear and make submissions on his behalf before the Securities and Exchange Board of India/ Ombudsman or to the Office of the Securities and Exchange Board of India/ Ombudsman, the following declaration should also be submitted.) I/We the above named complainant/s hereby nominate Shri/Smt………&hel .....

X X   X X   Extracts   X X   X X

→ Full Text of the Document

X X   X X   Extracts   X X   X X