Application – Duplicate Share Certificate
Application to the company requesting a duplicate share certificate.
What this format contains
Date: [DATE]
To, The Board of Directors,
[Company Name],29-33, [ADDRESS], [PLACE] – [PIN]
SUBJECT: APPLICATION FOR ISSUE OF DUPLICATE SHARE CERTIFICATE(S)
Dear Sir,
I [SHAREHOLDER NAME], residing at [ADDRESS] – [PIN], the registered holder of equity shares of [COMPANY NAME] having CIN: [CIN] & having ISIN: ____________ under Folio No. [●], comprising [QUANTITY] fully paid-up equity shares of face value [AMOUNT] each, represented by share certificate(s) bearing Certificate No(s). ____________ and Distinctive No(s) from [FIGURE] to [QUANTITY].
The aforesaid original share certificate(s) has/have been lost and are not traceable despite of diligent search. The shares are not pledged, hypothecated or otherwise encumbered, and no transfer has been executed by me.
I hereby request issuance of duplicate share certificate(s) in lieu of the lost certificate(s). I undertake to surrender the original certificate(s) to the Company if found hereafter.
Enclosed please find the following documents for your consideration:
Affidavit of loss of Shares;
Indemnity bond in favour of Company;
FIR/e-FIR/Police Complaint No. [FIR/COMPLAINT NO.] dated [DATE] (copy)
Self-attested KYC (PAN and Address proof)
Thanking You,
______________________ [SHAREHOLDER NAME] PAN: [PAN]
Shareholder