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    Form A Affidavit For Issuance of Duplicate Securities

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    kilewr reora
    This document is an affidavit for the issuance of duplicate securities. It states that the original security certificates have been misplaced and despite a diligent search they have not been found. It also states that the securities have not been sold, pledged, or deposited. The affidavit promises that if the original certificates are found, they will be surrendered rather than dealt with in any way. It was signed in the presence of a public notary.

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    Form A Affidavit For Issuance of Duplicate Securities

    Uploaded by

    kilewr reora
    6 views3 pages
    This document is an affidavit for the issuance of duplicate securities. It states that the original security certificates have been misplaced and despite a diligent search they have not been found. It also states that the securities have not been sold, pledged, or deposited. The affidavit promises that if the original certificates are found, they will be surrendered rather than dealt with in any way. It was signed in the presence of a public notary.

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    Form_A_Affidavit_for_issuance_of_duplicate_securities

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    This document is an affidavit for the issuance of duplicate securities. It states that the original security certificates have been misplaced and despite a diligent search they have not been found. It also states that the securities have not been sold, pledged, or deposited. The affidavit promises that if the original certificates are found, they will be surrendered rather than dealt with in any way. It was signed in the presence of a public notary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views3 pages

    Form A Affidavit For Issuance of Duplicate Securities

    Uploaded by

    kilewr reora
    This document is an affidavit for the issuance of duplicate securities. It states that the original security certificates have been misplaced and despite a diligent search they have not been found. It also states that the securities have not been sold, pledged, or deposited. The affidavit promises that if the original certificates are found, they will be surrendered rather than dealt with in any way. It was signed in the presence of a public notary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    FORM –A

    AFFIDAVIT

    [For issuance of duplicate securities]

    Note: This affidavit is to be executed in the presence of a Public Notary

    [To be submitted in non-judicial stamp paper of appropriate value]

    I/We,_______________________________________________________
    Son / daughter/spouse of ____________________________________________________ residing at
    __________________________________________________________________________________________
    __________________________________________________________________________, having Permanent
    Account No (s) ______________________________do hereby solemnly affirm and state on oath as follows.

    1. That I/We, _________________________________________ (“all the shareholders ”) hold the following


    (number of) securities under Folio no. _____ in (name of the company) in my/ our name as single
    holder / joint holder:

    Company Folio No. No. of Security Distinctive Nos.


    Name securities held Certificate
    No.

    From To

    1)

    2)

    3)

    2. I/We_____________________________________________________________________ further swear /


    solemnly declare that I/ we am/are applying for issue of duplicate certificate(s) to me/us on the ground that
    the original security(ies) certificate(s) has/have been misplaced / not found by me/us, despite a diligent
    search made by me/us in this behalf.

    3. I/We_______________________________________________________________________ further swear


    /solemnly declare that the said securities are not sold or pledged or deposited by way of security to any
    person/company.

    4. I/We_______________________________________________________________________________here
    by further swear / solemnly declare that if, after the duplicate share certificate(s) is / are issued to us as
    aforesaid, the original security(ies) certificate(s) is / are at any time subsequently, found, recovered or traced
    by us or by anyone on our behalf, then, we unconditionally undertake not to deal with the said original share
    certificate(s) in any manner whatsoever (whether by physical transfer or dematerialization or as security or
    pledge) and further unconditionally undertake to promptly surrender the original share certificate(s) to the
    RTA / Company, for cancellation.
    5. I/We _________________________________________________________am/are making the above
    solemn declaration on oath with full knowledge of the fact that in the event the original security (ies)
    certificate(s) issued is /are found, recovered and traced by me/us and instead of surrendering the same is /
    are dealt with by me/us as aforesaid, the Company will be at liberty to adopt civil and / or criminal
    proceedings against me/us for my/our failure to promptly surrender the original security (ies) certificate(s),
    for cancellation and for breach of my/our solemn declaration and undertaking not to deal with the original
    security (ies) certificate(s) in any manner whatsoever as aforesaid at my/our entire risk as to cost and
    consequences.

    Signature of all deponents : X________________


    ________________
    ________________
    VERIFICATION

    We hereby solemnly affirm and state that what is stated herein above is true to our knowledge and
    nothing has been concealed therein and that we are competent to contract and entitled to rights and
    benefits of the above mentioned securities.

    Deponent(s) (1) ____________(2) __________________(3) ____________________

    Solemnly affirmed at ______________________

    Signature of the Deponent(s): X____________________________

    _______________________________________________________________________________

    Signed before me

    Place: __________________________

    Date : ___________________________

    X --------------------------------------------------

    Signature of Notary with Official Seal of Notary & Regn.No.

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