ISSUANCE OF NEW DIS BOOKLET

Name :

Address :

Date: : _______________ 20
To,
SBICAP Securities Ltd.
12th Floor, "A & B " Wing, Marathon Futurex,
N. M. Joshi Marg, Lower Parel (E), Mumbai- 400013.
Tel.: 022 - 43487240 / 41

Ref. : Issuance of New DIS booklet, DP Account No.

Dear Sir/Madam,

I /We have a above mentioned Demat account with your Branch.

I/We declare that I/We have misplaced / lost the earlier Delivery Instruction Slip (DIS) booklet and hence I/
We request you to Issue a fresh DIS booklet.

In case the original DIS booklet comes into my/our possession, I/We undertake not to present it for
execution and to return it to you immediately. I/We also keep you indemnified against all losses, claims,
damages, demands and charges etc., if any, arising out of misuse of the lost DIS and as a consequence
of your acting on the basis of my/our above declaration and issuing a duplicate of the DIS under reference,
at my request.

I/We request you to do the needful.

Yours faithfully,

(Name & Sign of Sole/1st Holder) (Name & Sign of 2nd Holder) (Name & Sign of 3rd Holder)

Date :

Place :

D:\Murali\DP Letters - SSL.p65