Documents required for Deletion of name
1.
2.
Original Share/Debenture Certificates
Death Certificate duly Attested
3. Request letter from Joint Holder
IMPORTANT : Please Submit separate forms for SHARES and each series of DEBENTURES along with
relative certificates(s) to:
KARVY COMPUTERSHARE PVT LIMITED
(Registrar & transfer Agent for Company Name.)
Registered office : Plot No.17 to 24 ,Vittal Rao Nagar , Madhapur ,Hyderabad – 500 081
To,
Company Name.
Date ______________
Dear Sirs,
RE : DELETION OF NAME
I/We the undersigned being the joint holder(s) with Mr./Mrs./Miss ________________________________
______________________________________________________________________________________
_______________________________________________________(deceased) who expired on ________
hereby request you to delete his/her name from Register of Members/Debentures holders of the company in
respect of _____________ Shares/Debentures which are sent herewith for the purpose along with the Death
Certificate. I/We give here under particulars regarding surviving joint holders(s) as would be required by
you for your record.
NAME(S) OF SURVIVOR
1.
2.
3
Address of the 1 st holder
Occupation of
1st holder
Your’s faithfully
1.
Father’s/Husband’s
Name of 1st holder
2.
3.
.
Total
Certificates
Total Shares/
Debentures
PIN
Current Folio No. of Shares
Debentures
Distinctive number
From
Certificate No.
New Folio
Document Registration
Specimen Signature(s) :
No.__________ Date _______________
1.__________________________________
Transfer No.______________________
2.__________________________________
Date ____________________________
3.__________________________________
Please Submit separate forms for SHARES and each series of DEBENTURES along with relative
certificates(s).