Verification of applicant for application for DIN

Form DIR-4

Verification of applicant for application for DIN

(To be in the form of Affidavit)

[Pursuant to section 153 and rule 9(3)(a)(iv) of Companies (Appointment and

Qualification of Directors) Rules, 2014]

I, ……………….., Son*/ Daughter* of ……….., born on ………….., resident of

………………………………….. hereby confirm and verify that the particulars given

in the Form DIR-3 are true and also are in agreement with the documents

being attached to the Form DIR-3.

I hereby confirm and declare that

1.   The photograph and documents being attached to the Form DIR-3belong to me. I further confirm that all required documents have been dulycertified by the respective government authority and are being attached tothe Form DIR-3, and

2.   I am not restrained, disqualified, removed of, for being appointed asdirector of a company under the provisions of the Companies Act, 2013including sections 164 and 169, and

3.   I have not been declared as proclaimed offender by any EconomicOffence Court or Judicial Magistrate Court or High Court or any other Court,and

4.   I have not been already allotted a Director Identification Number(DIN) under section 154 of the Companies Act, 2013, and

5.   I shall be liable under section 448 of the Act and under the relevantprovisions of the Indian Penal Code, 1860 and any other law as applicable, ifany statement in this application is found to be false or any material fact isfound to have been omitted.

Signature:

(Name)