(see circular No. SEBI/HO/MIRSD/MIRSD_RTAMB/P/CIR/2022/8 dated January 25, 2022 on Issuance of
Securities in dematerialized form in case of Investor Service Requests)
Request for issue of Duplicate Certificate and other Service Requests
(for Securities ‐ Shares / Debentures / Bonds, etc., held in physical form)
Date:___ /___ /______
Mandatory Documents / details required for processing all service request:
I / We are submitting the following documents / details and undertake to request the Depository Participant to dematerialize my / our securities within 120 days from the date of issuance of Letter of Confirmation, received from the RTA/Issuer Company (tick as relevant, refer to the instructions):
∙ Demat Account No. (If available):
Provide Client Master List (CML) of your Demat Account from the Depository Participant*
Provide the following details, if they are not already available with the RTA (see SEBI circular dated November 03, 2021in this regard)
PAN
Specimen Signature
Nomination / Declaration to Opt‐out
(Your address, e‐mail address, mobile number and bank details shall be updated in your folio from the information available in your CML). You can authorize the RTA to update the above details for all your folios. In this regard, please refer to and use Form ISR‐1in SEBI circular dated November 03, 2021.
I / We request you for the following (tick relevant box)
Issue of Duplicate certificate
Claim from Unclaimed Suspense
Account
Replacement / Renewal / Exchange of
Endorsement
securities certificate
Sub‐division / Splitting of securities Consolidation of Folios certificate
Consolidation of Securities certificate
Transmission
Transposition (Mention the new order of holders here)
C. I / We are enclosing certificate(s) as detailed below**: Name of the Issuer Company
Folio Number
Name(s)
of
the
security
1.
holder(s)
as
per
the
2.
certificate(s)
3.
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Certificate numbers Distinctive numbers Number & Face value of securities
** Wherever applicable / whichever details are available
Document / details required for specific service request:
I. Duplicate securities certificate
Claim from Unclaimed Suspense Account
Securities claimed
(in numbers)
(in words)
Replacement / Renewal / Exchange of securities certificate
(that is defaced, mutilated, torn, decrepit, worn out or where the page on the
IV.
reverse is fully utilized)
Endorsement
V.
Sub‐division / Splitting of securities certificate
VI.
Consolidation of securities certificate/Folios
VII.
Transmission
VIII.
Transposition
Provide / attach original securities certificate(s) for request for item numbers III to VIII above.
Declaration: All the above facts stated are true and correct to best of my / our knowledge and belief.
Security Holder 1 / Claimant
Security Holder 2
Security Holder 3
Signature
Name
Full
address
PIN
After processing the service request, the RTA shall issue a 'Letter of Confirmation' to the securities holder/claimant, which is valid only for 120 days. Using this 'Letter of Confirmation', the securities holder/claimant shall request the DP to dematerialize the securities, failing which the securities shall be credited to the Suspense Escrow Demat Account of the Company.
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India Glycols Ltd. published this content on 28 January 2022 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 28 January 2022 04:05:08 UTC.
India Glycols Limited is an India-based company, which is engaged in manufacturing green technology-based bulk, specialty and performance chemicals and natural gums, spirits, industrial gases, sugar and nutraceuticals. The Company's segments include Bio-based Specialities and Performance Chemicals, Potable Spirits, and Ennature Biopharma. The Bio-based Specialities and Performance Chemicals segment comprises glycols, specialty chemicals, natural gum and other related goods. The Potable Spirits segment is engaged in the manufacturing and sale of ethyl alcohol (potable). The Ennature Biopharma segment is engaged in the manufacturing and sale of nutraceutical products. It has a product range that covers a variety of specialties and herbal products, such as nutraceuticals, phytochemicals, biopolymers, mainly Polygalactomannans, industrial gases and liquor. It serves various industries, such as automotive, detergents, healthcare and food processing, mining, and oil and gas, among others.