Page 283 - Tata_Chemicals_yearly-reports-2017-18

To,
TSR Darashaw Limited
Unit: Tata Chemicals Limited
6-10 Haji Moosa Patrawala Industrial Estate,
20 Dr. E. Moses Road, Mahalaxmi, Mumbai 400 011

Updation of Shareholder Information

I/We request you to record the following information against my/our Folio No.:
General Information:
Folio No.:

Name of the first named Shareholder:
PAN: *

CIN/Registration No.: *
(applicable to Corporate Shareholders)

Tel No. with STD Code:
Mobile No.:

Email Id:

*Self attested copy of the document(s) enclosed

Bank Details:
IFSC:
(11 digit)

MICR:
(9 digit)

Bank A/c Type:

Bank A/c No.: @
Name of the Bank:

Bank Branch Address:

@ A blank cancelled cheque is enclosed to enable verification of bank details

I/We hereby declare that the particulars given above are correct and complete. If the transaction is delayed because of incomplete or
incorrect information, I/we would not hold the Company/RTA responsible. I/We undertake to inform any subsequent changes in the above
particulars as and when the changes take place. I/We understand that the above details shall be maintained till I/we hold the securities under
the above mentioned Folio No./Beneficiary account.

Place: ____________________________

Date: ____________________________ Signature of Sole/First holder

Notice 281