Emp No : 553287

Request No : 1376301

Branch : TCS - Hyderabad

Location : Coromandel House

FORM OF APPOINTMENT OF BENEFICIARY (NOMINATION)

Name of Employee Sex Permanent Address

: Peteti, Mr. Siva Sankar : Male

Father's\Husband's Name Marital Status : SINGLE

: Mr. RAGHURAM PETETI Date of Birth : 22 Aug 1990

: Siva Sankar Peteti, S/O RaghuRam,D.No: 2-138, Kallaplem Village Kalidindi Mandal

To The Trustees Tata Consultancy Services Employees Gratuity Fund Air India Bldg., 11th Floor, Nariman Point, Mumbai 400021.
Dear Sir,

I Peteti, Mr. Siva Sankar a Member of the TATA CONSULTANCY SERVICES Employees Gratuity Fund hereby agree to abide by the Rules of the said Fund and do also hereby appoint in terms Rule of the Beneficiary / Beneficiaries / Nominee/s mentioned hereunder to receive the benefits, payable under the Fund, in the event of my death before the amount become payable has not been paid. I hereby direct that the benefits under the Fund, payable in respect of me, shall be paid to the said Beneficiary/Beneficiaries/ Nominee/s in proportion indicated against their respective names as given below. Name and address of nominee or nominees Nominees relationship with employee Father Date of Birth Name and address of the Guardian Relationship of the Guardian with minor nominee Not Applicable Share of moneys payable

MR. PETETI RAGHURAM S/O P.NAGESWARA RAO D.NO: 2-138, KALLAPALEM VILLAGE, KALIDINDI MANDAL KAIKALUR KRISHNA DISTRICT ANDHRA PRADESH 521344 MS. PETETI VANI W/O P.RAGHURAM D.NO: 2138, KALLAPALEM VILLAGE, KALIDINDI MANDAL KAIKALUR KRISHNA DISTRICT ANDHRA PRADESH 521344

01/01/1966

Not Applicable

50

Mother

01/01/1971

Not Applicable

Not Applicable

50

1 Certified that I have no family and should I acquire a family hereafter, the above nomination should be deemed as cancelled.
2. Certified that my father/mother/sister(s) /minor brother(s) is/are dependant upon me. Signed on 02nd Jan 2012 at ___________________

Signature of the Member I. (1) Signature

(2) Name (3) Address : : : II. (1) Signature (2) Name (3) Address : : :

Certified that the above appointment of Beneficiary/Nominee has been signed by Peteti, Mr. Siva Sankar before me after he/she has read the entries, the entries have been read to him/her by me and that the said appointment of Beneficiary/Nominee is recorded under the Fund on 02nd Jan 2012

____________________
Signature of Trustee/s Date : 02nd Jan 2012 FOR SELF AND CO-TRUSTEES OF TATA CONSULTANCY SERVICES EMPLOYEES GRATUITY FUND