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DEMATERIALISATION REQUEST FORM (CDSL)

DEMATERIALISATION REQUEST form (CDSL)I/We REQUEST you to dematerialise the enclosed certificates registered in my/our name into my / our demat of Securities Free Securities Locked-in-SecuritiesName of the CompanyISINType of Security Equity Debentures Bonds Units Other (Specify)Please fill all the details in Block Letters in English (FILL UP ISIN WISE. SEPARATE DRF FOR FREE SECURITIES AND LOCKED-IN SECURITIES) Account No. DateDRN (to be filled by DP)Application Slip/Ref. No. /DRF D M M YYYYF olio of Certificates (In words)Face Value of Securities to be Dematerialised(In Figures)(In words)(If the space above is found to be insufficient, an annexure containing the certificate details duly signed in the same format may be attached.)In case of Locked-in Securities fill up a separate DRF for Locked - in Securities having different release ReasonLock-in Release DateThe Original Certificates / documents are hereby surrendered by me / us for DEMATERIALISATION and the same are free from any lien or charge or encumbrance and represent the bona fide securities of the Issuer Company to the best of my / our knowledge and with DPSignature with RTA/ / Sole HolderSecond Hol

DEMATERIALISATION REQUEST FORM (CDSL) I/We request you to dematerialise the enclosed certificates registered in my/our name into my / our demat account. Details of Securities Free Securities Locked-in-Securities Name of the Company ISIN Type of Security Equity Debentures Bonds Units Other (Specify) Please fill all the details in Block Letters ...

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