DEMATERIALISATION REQUEST FORM (CDSL)

1 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 HolderThird HolderParticipant Authorisation (From DP to RTA)We have received the above mentioned securities bearing ISIN for DEMATERIALISATION .

2 The application form is verified with the Certificates / Documents surrendered for DEMATERIALISATION and we certify that the application form is in accordance with the details mentioned in the enclosed certificates / documents. It is also certified that the Holder(s) of securities have a beneficiary account with us in the name (s) and order of name(s).Signature verifiedName & Signature of Authorised DP Official Acknowledgement (DP TO BO)Application No. CDSLWe hereby acknowledge the receipt of the following securities for DEMATERIALISATION subject to verification :Account No. Sole / First Holder NameName of the CompanyType of the Security Equity Debentures Bonds Units Other Specify)ISINNo. of SecuritiesNo. of CertificatesINBranch Stamp & SignatureBranch Name:Branch Code:Zerodha Broking Ltd.#153/154 4th Cross Dollars Colony, Opp.

3 Clarence Public School, Nagar 4th Phase, Bangalore - 560078 Help Desk: 080 47181888 Email : Broking Ltd.#153/154, 4th Cross, Dollars Colony, Opp. Clarence Public School, Nagar 4th Phase, Bangalore - 560078DP ID No. : DP ID No. : DP SEBI Reg. No: IN-DP-431-2019DP SEBI Reg. No: IN-DP-431-2019 Dematirialization REQUEST form has to be filled in triplicateOne copy for Beneficial Owner | One copy for DP | One copy for Issuer/RTAD ocuments Required: Physical Share Certificate and Self-attested ID proof