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Share Application Forma in Word Format

This document is a share application form for a private placement of equity shares by DE's Technico Limited. It requests key information from applicants such as their name, address, phone number, email, PAN, and signature. Applicants must specify the number of shares they want to apply for and remit the corresponding payment amount. The form states that the application is irrevocable and binds the applicant by the scheme's provisions. It also collects details of the payment method, nominee information, and a tear-off portion for acknowledgment of receipt.

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karthikeyankarthikeyan868
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
1K views

Share Application Forma in Word Format

This document is a share application form for a private placement of equity shares by DE's Technico Limited. It requests key information from applicants such as their name, address, phone number, email, PAN, and signature. Applicants must specify the number of shares they want to apply for and remit the corresponding payment amount. The form states that the application is irrevocable and binds the applicant by the scheme's provisions. It also collects details of the payment method, nominee information, and a tear-off portion for acknowledgment of receipt.

Uploaded by

karthikeyankarthikeyan868
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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SHARE APPLICATION FORM

(Private & confidential, not for circulation)

DE’S TECHNICO LIMITED


“Martin Burn Business Park”, BP3,
Salt Lake, Sector - V, Unit: 804,
Kolkata – 700 091

Sir/Madam,

Sub: Application for private placement of equity shares of Rs.25/- each including premium of Rs.15/- each
Please refer to the offer document issued by you. Having read and understood the terms of offer and the instructions, apply for the allotment of
equity shares to me/us. The application is an irrevocable offer by me/us. The amount payable on application as shown below is remitted. On
allotment, please place my/our name(s) on the Register of shareholder(s). I/We bind myself/ourselves by the provisions as contained in the
scheme.
In Figures In words
Date:
No. of shares. FOR OFFICE USE ONLY
Date of receipt of application
Amount (Rs) Sl. No:

I am/we are applying as (Tick) whichever is applicable


Cheque/Demand Cheque/ Date Amount
Individual ( ) Society/ Trust ( )
Draft drawn on DD No
Mutual Fund ( ) Company ( )
Others ( )

APPLICANT’S NAME IN FULL (CAPITAL) Name of father/ husband Sex Age


Sole /First

Second

Third

Nominee’s Name for


sole/first applicant

Name (IN CAPITAL LETTERS): ……………………………………………………………………………………………..….


Address : ………………………………………………………………………………………………………………………..…
……………………………………………………………………………………………………………………………………..
Phone No: ………………………. Mobile No: …………………………… E-mail : ……………………………………………

Applicant PAN Sole/First applicant


SIGNATURES

Sole/ First Second applicant


SPECIMEN

Second Third applicant

Third Nominee

………………………………………………………….…………Tear Here…………………………………………..………………………….....

Receiver’s
NAME/S: ………………….…………………………………….……………..
Address for Correspondence: Stamp
CHEQUE/DEMAND DRAFT DRAWN
DE’S TECHNICO LIMITED
“Martin Burn Business Park”, BP3, ON ………………………………….…………………...……………………
Salt Lake, Sector - V, CHEQUE / DD NO: ……………………….. DT: ……….……………
Unit: 804, Kolkata – 700 091
AMOUNT RS. : ..…………………………………………………..….
Please draw the Cheque/DD in favour of : Received on
DE’S TECHNICO LIMITED
Note: Cheques and Drafts are subject to realization.

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