Form No. SH-14
Cancellation or Variation of Nomination

[Pursuant to sub-section (3) of section 72 of the Companies Act, 2013 and rule 19(9) of the Companies (Share Capital and Debentures) Rules 2014]


Name of the Company :
I/We hereby cancel the nomination(s) made by me/us in favor of name and address of the nominee) in respect of the below mentioned securities.
or
I/We hereby nominate the following person in place of as nominee in respect of the below mentioned securities in whom shall vest all rights in respect of such securities in the event of my/our death.
(1) PARTICULARS OF THE SECURITIES (in respect of which nomination is being cancelled / varied )

Nature of Securities Folio No. No. of Securities Certificate No. Distinctive No. From Action
 
(1) PARTICULARS OF THE (2) (a) PARTICULARS OF THE NEW NOMINEE:
i. Name
ii. Date of Birth
iii. Father’s/ Mother’s/ Spouse’s name
iv. Nationality
v. Address-1
Address-2
Address-3
City
PIN Code
vi. eMail Address
vii. Relationship with the Security holder

(b) IN CASE NEW NOMINEE IS A MINOR--

i. Date of Birth
ii. Date of Attaining majority
iii. Name of guardian
iv. Address of guardian
Address-2
Address-3
City
PIN Code
Signature

Name of the Security

Holder (s)
1
2
3
Witness with name and address
 

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