TMI BlogForm for Informant’s Reward Claim to be submitted to the Board within the time specified in the intimation of prima facie eligibility to receive an Informant Reward.X X X X Extracts X X X X X X X X Extracts X X X X ..... to be submitted to the Board within the time specified in the intimation of prima facie eligibility to receive an Informant Reward. All fields are mandatory I . PERSONAL INFORMATION A. Informant: Last name:--------------------- First Name:------------------------ Title:----------------- ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Provide any material information that may be relevant in light of the criteria for determining the amount of Reward or denial thereof. Include any supporting documents if necessary. IV DECLARATION BY INFORMANT I/we hereby declare that,- I/we have read and understood the Securities and Exchange Board of India (Prohibition of Insider Tra ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... d I/we shall not challenge it in any litigation, appeal, adjudication, etc. In the event of my/our death before the reward is paid to me/us, it may be paid to . (Details of nominee) I/we declare that the information contained herein is true, correct and complete to the best of my/our knowledge and belief and not obtained from the categories of persons indicated in sub-regulation (2 ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Place: V CERTIFICATE BY LEGAL REPRESENTATIVE (where applicable) I hereby certify as follows,- (a) I have reviewed the completed and signed claim form for completeness and accuracy and the information contained therein is true, correct and complete to the best of my knowledge; and (b) The declarant is the person who signed the original Vol ..... X X X X Extracts X X X X X X X X Extracts X X X X
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