ANNEXURE A

AUTHORITY LETTER CUM DISCHARGE RECEIPT

I, _KAILASH CHANDRA SHARMA, a member of UltraTech Employees’

Superannuation Scheme hereby request the Trustees of __HOLTECH _ to transfer
in accordance with Rule 3.C(ii) of the said Scheme the value of the benefits secured
under the Assurance/ Annuities by the contributions paid by _HOLTECH on my
behalf upto the date of my leaving the said _HOLTECH on__ DATE: UltraTech
Employees’ Superannuation Scheme , to the Trustee of UltraTech Employees’
Superannuation Scheme , of which I have become a member having joined their
service.

In consideration whereof, I hereby agree and declare that this authority and the
transfer made in pursuance of such authority shall constitute a complete and
sufficient discharge in full satisfaction of all my claims and rights secured by the
contributions amounting to Rs.___________ paid by the Trustees to Life Insurance
Corporation of India under Master Policy No. GSCA/________

Dated _17_08_2010_

Signature in full
on Revenue Stamp of Rs 1/-
(signature of member)
Witness
Signature :

Designation :
Name in full :
Address :