Transcription of E-DIVIDEND MANDATE/REPLACEMENT FORM - …
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E-DIVIDEND MANDATE/REPLACEMENT FORM - …
Please take this as authority to credit my/our under-mentioned account with any dividend payment(s)/lost/misplaced/stale/unclaime d dividend warrants due on my/our shareholding in the aforementioned company(ies) the particulars of which are stated below from the date hereof:(Other Names)(Surname)Shareholder's Name:*Shareholder's Account No. (if Known):Address:*Mobile Number:*e-mail Address:*Branch:*Account Type:*Fax Number:Bank Name:*Bank Account No:*Age of account*:Bank Stamp & Authorized Signatory(ies)Shareholder(s) Signature & dateNote:The provision of information on your Bank Name, Bank Account No., E-mail address and Mobile number are very important to enable us process your request.
Please take this as authority to credit my/our under-mentioned account with any dividend payment(s)/lost/misplaced/stale/unclaimed dividend warrants due on
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