TRANSMISSION FORM
To,
The Director,
Reliance Industries Limited, Maker Chamber No IV,
3rd floor, Nariman Point, Mumbai 400021
Date ______________
Dear Sirs,
Re.: TRANSMISSION OF SHARES /DEBENTURES
I/We undersigned signed the Executive(s) of the will Administrator(s) of the Estate/Successor(s) to the
Estate/Legal heir of Mr./Mrs./Miss _________________________________________(deceased) of which
Probate/letters of Administration /Succession Certificates was duly granted to me/us on the __________
day of ____________hereby request you to register me/us as Member(s)/Debentures holder(s) of the
company in respect of ______________ Shares/Debentures in your Company, now standing in the name
of the said deceased in the Register of Members/Debenture holders of your Company.
I/We, hereby agree and bind myself/ourselves to hold the said shares/debenture subject to the
provisions of the Memorandum & Articles of Association of your Company.
I/We given hereunder such other particulars/information as would be required by you for your records.
FULL NAME
Occupation
Father’s Husband’s
Name
1.
2.
3.
4.
Your’s faithfully
ADDRESS OF THE 1ST HOLDER
1.
2.
3.
4.
S-F
No. of Shares/
Debentures
Distinctive Number
From
Certificate No.
To
B-F
Document Registration
No._______ Date ____________
Specimen Signature (s):
1. __________________________
Internal
Transfer No. ________________
2. __________________________
Date ______________________
3. __________________________