FORM 117

INSTRUMENT OF TRANSFER OF SHARES / DEBENTURES

Certificate No. :

Transfer No. :

Allotment No. :

Register Folio No. :

Name of the Company :

I/We ______________________________________________ of __________________________________
___________________________________________________________________ in consideration of the
sum of Tk. ___________ paid to me/us by ___________________________________________________
of _____________________________________________________________________________________
(hereinafter called the said Transferee) do hereby transfer to the said Transferee _________
Shares / Debentures of Tk. __________ each, Tk. __________ paid up numbered from
________________

to

________________

inclusive

in

the

undertaking

called

________________________________________
______________________________________________ LIMITED to hold upto the said Transferee,
his/her executors, administrators and assigns, subject to the several conditions on which I held the
same at the time of the execution hereof and I/we the said Transferee, do hereby agree to take the
said shares subject to the conditions aforesaid. I/We further hereby declare that I/we am/are legally
entitled to execute this instrument/document. In witness whereof I/we have subscribed our hands
this ____________ day of ___________________ ___________.
WITNESSES :
Signed by the Transferor in the presence of :
Signature

: ___________________________

Name

: ___________________________

Occupation

: ___________________________

Address:

: ___________________________

SIGNATURE OF TRANSFEROR

Signed by the Transferee in the presence of :

Signature

: ___________________________

Name

: ___________________________

Occupation

: ___________________________

Address:

: ___________________________

SIGNATURE OF TRANSFEREE

Approved vide resolution of the Board of directors in the meeting held on _________________

Chairman / Managing Director / Director