Date:

To,
The Registrar
[City and PIN code]

Subject: Consent for appointment as director on the Board of XYZ Company Private Limited

I hereby give my consent to act as director of XYZ Company Private Limited, pursuant to
sub-section (5) of section 152 of the Companies Act 2013 and certify that I am not
disqualified to become a director under the Companies Act, 2013.
Please find attached my consent in Form as required by the Companies Act, 2013 read with
Companies (Appointment and Qualification of Director) Rules, 2014.
Please acknowledge this letter and provide me with companies.

Sincerely,
Director Signature
[Name]