BOB ESPS 2019 APPLICATION FORM

Application/Reference No: 1078145

An offer of upto 15,00,000,000 (Fifteen Crores) fresh equity shares of face value of Rs. 2/- (Rupee Two
Only) each of Bank to eligible employees of bank under Bank of Baroda Employee Share Purchase
Scheme 2019 (BOB ESPS 2019) at offer price of Rs. 75.47/- per equity share.
(Please refer Circular No. BCC:BR:111/456 dated 18-09-2019 for BOB ESPS 2019 scheme and other detail guidelines)
Issue Opens on : September, 19 , 2019
Issue Closes on : October, 05 , 2019

Employee Details:

Employee Code: 96036

Full Name: K DIVYASUBHA

Designation: CLERK.CL PAN: AYXPD2712K

Present Place of Posting: NAGARCOIL,PARVATHIPURAM

HO/CO: CHENNAI,ZO CHENNAI

ZO/RO: MADURAI,RO MADURAI

Corporate Email: DIVYASUBHA.K@bankofbaroda.com

Personal Details:

Contact Number(As per HRMS): 9698883213

Alternate Contact No. (Mobile No):

Personal Email:

18/11,narayana veethi,kottar,,kanyakumari,,TN,629002
Complete Address:

Depository Details:

Depository (CDSL/NSDL) : NSDL Depository Name : Bank of baroda

DP ID: IN300870 Client ID: 10531008

Note:
• Employees are advised to provide valid and active DEMAT account in his/her individual name or Joint
DEMAT account where the first name must be of the applicant employee.
• First 8 digits/alphabet of your DEMAT Account no. are DP ID and next 8 digits are Client ID.

Investment Details:

No. of Shares Eligible: 1000

No. of equity shares applied : 100

Offer Price per equity Share(in Rs): 75.47

Total Share Application Price (in Rs): 7547

Bank Account Details:

Savings Bank Account No.: 33090100001528

Note: Employees are advised to provide salary saving account details here. In case, the salary is credited in OD
account, then the operative saving bank account in the first name of applicant employee should be given. In case of
employee posted in overseas, the detail of NRO account should be mention here.

Terms and Conditions:

I , K DIVYASUBHA ,hereby confirm that I have read, understood and agreed
to the terms & conditions of circular BCC:BR:111/456 dated 18-09-2019 and BOB ESPS 2019 scheme. I
also understand the risk involved in investing in the BOB ESPS 2019.
I hereby certify that I am an eligible employee of the bank under BOB ESPS 2019, and consequently
eligible to participate in the offer being made under BOB ESPS 2019. I hereby certify that I have read and
understood the Bank's Code of Fair Disclosure and Conduct(formerly known as Code of Conduct for
Prohibition of Insider Trading)understood the provisions contained therein. I hereby certify that the
information provided by me in the application form is true and correct in all respects.
I hereby authorize Bank of Baroda to mark lien/debit my A/C No. 33090100001528 with an amount
of Rs. 7547 towards my Share Application Money for 100 no. Of shares
applied by me under BOB ESPS 2019.

Date:

Place:
Applicant Signature

VERIFICATION

Date:

Place:
Branch /Office Head Signature