GODREJ INDUSTRIES LIMITED
LETTER OF UNDERTAKING
(TO BE SUBMITTED SEPARATELY FOR EACH DIVIDEND PERIOD IN CASE THE DIVIDENT WARRANT AMOUNT EXCEEDS RS.1000 /-)
RE : LOSS OF DIVIDEND WARRANT
I/We ________________________________________________________________________ residing at
__________________________________________________________________________ hereby request
GODREJ INDUSTRIES LIMITED
to issue to me a duplicate Dividend Warrant for Rs.
_________________ in lieu of the original Dividend warrant for Rs. _____________ bearing no.
________________ Dated ________________ issued to me/us being lost or destroyed and in consideration
of the Company so doing, I/We hereby for myself/ourselves my/our heirs, executors and administrators
agree to indemnify the Company against all claims, damages, costs and expenses which may be made
against or suffered or incurred by the Company by reasons or in consequence of the issue of such duplicate
Dividend Warrant or otherwise howsoever in relation thereto.
I/We further agree and undertake if the said original Dividend Warrant shall hereafter be found forthwith to
deliver the same or cause the same to be delivered to the Company without costs.
Dated this _____________________ day of _____________________.
Signature of the Witness
Signature of the 1st Shareholder
Name & Address of the Witness
Signature of the 2nd Shareholder
Signature of the 3rd Shareholder
I/We, the below named Guarantor concur in the above request and guarantee the performance by the said
_________________________________ of the undertaking therein mentioned.
Dated this _______________________ day of
________________________.
Name & Address of the Guarantor
____________________________________
___________________________________
FOLIO NO : ________________________
______________________________________
Signature of the Guarantor
PERIOD : _____________________________