FORMAT OF AFFIDAVIT/DECLARATION FOR CHANGE OF SIGNATURE

(Please type this Affidavit after carefully reading the notes mentioned below the format)

AFFIDAVIT I, __________ son/daughter/spouse of _____________ aged ___, residing at __________________, do hereby solemnly affirm and declare as under: 1. That I, Shri/Smt. (Name of the shareholder/s , am holding _____ e!uity shares in (the name of the company co"ered under #olio No. _______ and Share $ertificate No(s . ___________, bearing %istincti"e Nos. ________ to __________ of the face "alue of &s.__/' each. #olio No. $ertificate Nos. %istincti"e Nos. Shares co"ered in each certificate

The abo"ementioned shares ha"e been ac!uired by me out of my o(n in"estments/funds against (allotment in )ublic Issue/ &ight Issue/*onus issue or from the mar+et in the year____ . ,. I am residing at the abo"ementioned address and ha"e not changed my address in the past three years. -& I am residing at the abo"ementioned address for the past (period of time at the present address and before that I (as staying at (the earlier address for (period of time at the earlier address . .. That I ha"e changed my signature. -& That my signature has changed/altered by passing of time. Therefore I re!uest that the specimen signature registered in the records of the $ompany be cancelled and my present signature be ta+en on record against the same. /. I hereby affirm that the Transfer %eeds for sales of securities bearing my signature appended hereinbelo( can be ta+en as "alidly e0ecuted by me for all purposes, and intents of transferring the o(nership of securities held by me under the #olio No. ________. 1. -n registering the ne( signature in the records, I do hereby co"enant (ith the $ompany, its successors and assigns and agree and underta+e at all times sa"e, defend and to indemnify and +eep indemnified the $ompany, its successors and assigns its estate and effects, and its directors, manager, secretary and shareholders and their heirs, e0ecutors

and assigns from and against all actions, suits, proceedings, accounts, claims and demands (hatsoe"er for or on account of the said shares or di"idends or any part thereof or other(ise in connection (ith the same, and from and against all losses, costs, claims, actions, demands, ris+s, charges, e0penses, damages and losses arising in any manner ho(soe"er. I am e0ecuting this declaration to be submitted to the concerned authorities for the change of signature. I hereby state that (hate"er is stated herein abo"e are true to the best of my +no(ledge. Solemnly affirmed at ________ -n this ____ day of ______ ,22/ (Signature of the 3pplicant %eponent

Identified by me 3d"ocate

*efore 4e S.5.4./ -aths $ommissioner/Notary

N-T5S: 1. 3ffida"it should be on Non'6udicial stamp paper of &s.122/'. ,. )lease do not 6ust type this format as it is. .. 3ffida"it should be attested by Notary/S.5.4/ -aths $ommissioner