Securities Transfer Form

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..... ecified below subject to the conditions on which the said securities are now held by the Transferor(s) and the Transferee(s) do hereby agree to accept and hold the said securities subject to the conditions aforesaid. CIN: Name of the company (in full): Name of the Stock Exchange where the company is listed, if any: DESCRIPTION OF SECURITIES: Kind/Class of securiti .....

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..... Corresponding Certificate Nos. Transferor s Particulars- Registered Folio Number: Name(s) in full Signat .....

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..... 2. 3. Folio No. of Transferee Specimen Signature of Transferee .......................... .....

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..... . Entered in the Register of Transfer on vide Transfer No .. Approval Date .. Power of attorney/Probate/Death Certificate/Letter of Administration Registered on .at No .. On the reverse page of the certificate Name of the Transferor Name of the Transferee No. of shares Date of Transfer . .....

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