SHAREHOLDING PATTERN (FOR CORPORATE)

(ON COMPANY’S LETTER HEAD)

SHAREHOLDING PATTERN of (Name of Member) as on

Paid up capital : Rs.

Face value of each equity share (or any other instrument) : Rs.

Sr. no. Name # Number of Amt paid-up %age of total

shares held (Rs.)
1
2
3
4
5
6
7
8
9
10
Others @
TOTAL 100%

NOTES :

In case any share holder(S) individual / non individual having more than 10% stake. Please arrange KYC documents for the same.

1. 2.

SIGNATURE(s) SIGNATURE(s)
DESIGNATED DIRECTORS DESIGNATED DIRECTORS
DATE: WITH THEIR NAMES WITH THEIR NAMES

PLACE: Rubber Stamp Rubber Stamp

AUDITOR’S CERTIFICATE

This is to certify that the Shareholding in as given above, based on my/ our scrutiny of the books of accounts, records and
documents is true and correct to the best of my/our knowledge and as per information provided to my/our satisfaction.

Place: ……………………………………………………………….

Date: For (Name of Accounting Firm)

Name of Partner

Chartered Accountant

Membership Number

Rubber Stamp

OR

Company Secretary:

Membership Number:

Rubber Stamp:

Date & Place: