Nomination Form for Election to the Managing Committee of CSBF

(Last date of receipt - 13th September, 2022 upto 17:00 P.M.)

The Secretary & Treasurer

Company Secretaries Benevolent Fund (CSBF)
ICSI House, 22, Institutional Area,
Lodi Road, New Delhi - 110003

Dear Sir,

With reference to the Notice of the 46th Annual General Meeting of the Company Secretaries Benevolent Fund (CSBF),
scheduled to be held on Friday, 23rd September, 2022 in the Council Room, ICSI House, 22, Institutional Area, Lodi Road,
New Delhi regarding vacancies in the Managing Committee of CSBF, we, the undersigned, as life members of the CSBF,
do hereby nominate CS_____________________________________, ICSI Membership Number _________ and CSBF
Life Membership Number__________, as a candidate to stand in the election to the Managing Committee of CSBF in the
46th Annual General Meeting of CSBF. The consent of the nominee is also given below.

Proposer 1 Proposer 2

Name: Name:

ICSI membership Number: ICSI membership Number:

CSBF Life Membership Number: CSBF Life Membership Number:

Professional / Residential Address: Professional / Residential Address:

_________________________________________ _________________________________________
_________________________________________ _________________________________________

Email: Email:

Tel.: Tel.:

Mob. Mob.

Signature: Signature:

Date: Date:

Consent of Nominee

I hereby give my consent to stand as a candidate in the election to the Managing Committee of CSBF in the 46th Annual
General Meeting of CSBF scheduled to be held on Friday, 23rd September, 2022.

Name:

ICSI membership Number:

CSBF Life Membership Number:

Professional / Residential Address:

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Email:

Tel.: Mob.

Signature:

Date: