BASIC INFORMATION FORM

All the shareholders holding equity Shares in physical form are requested to
update the following details and submit it to M/s. Datamatics Business Solutions
Ltd. Plot No. B-5, Part B Cross Lane, MIDC Andheri (East), Mumbai-400093,
Ph-022 66712151/ 2156

Information Furnished for the use of RTA

Name of the Company /

Unit
Name

Address

Folio No.

DPID/CLIENT ID

Income tax PAN

Mobile No.

e-mail id

Aadhar No.

Bank’s Name

Branch

Account Number

IFS Code

MICR Code

Note: Self attested photocopy of PAN, Aadhar Card and Cheque leaf (of presently
active a/c) should be attached.

Place:

Date:

Signature