Request Letter for Deletion of name

(Fill up this form & send original share certificate it may be noted that total holding under one folio will be considered for
deletion of name.)
TO
BEETAL FINANCIAL & COMPUTER SERVICES PVT LIMITED
BEETAL HOUSE, 99, MADANGIR
BEHIND LOCAL SHOPPING CENTRE
NEAR DADA HARSUKHDAS MANDIR, NEW DELHI-110062

Unit : Mayur Uniquoters Limited

Subject : DELETION OF NAME

Folio No. : - _____________________

Dear Sirs,

I/We the undersigned being the joint holder(s) with Mr./Mrs./Miss ________________________________
__________________________________________________( deceased) who expired on _____________
hereby request you to delete his/her name from Register of Members of the company in respect of _____________
Shares which are sent herewith for the purpose alongwith the Death Certificate. I/We give here under particulars
regarding surviving jointholders(s) as would be required by you for your record.

Details of the share certificates enclosed

S.No. Folio No. Distinctive Nos Share Certificate No of Shares
From To No.
1
2
3
4
5

Total No of certificates ________ No of Shares ______________

Name(s) of Survivors

1. ____________________________________________________________________

2. ____________________________________________________________________

3. ____________________________________________________________________
Father/Husband Name of the First Signatures of the Survived Shareholder(s)
Holder(survivor)
1.

Occupation of the First Holder 2.

3.

Date ______________ Place ______________

TO BE FILLED IN BY THE REGISTRAR

Inward No.
Transmission No.
New Folio No.
Date

Note : Please enclose all share certificates for the folios mentioned above. Also enclose copy of the death
certificate of the deceased duly attested.